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Sample records for abdominal withdrawal reflex

  1. Postnatal development of the nociceptive withdrawal reflexes in the rat: a behavioural and electromyographic study.

    PubMed Central

    Holmberg, H; Schouenborg, J

    1996-01-01

    1. The postnatal development of nociceptive withdrawal reflexes was studied. In awake intact rats, forelimb, hindlimb and tail reflexes were recorded on videotape. In decerebrate spinal rats, electromyography (EMG) was used to record nociceptive withdrawal reflexes in musculi extensor digitorum longus (EDL), peronei, gastrocnemius-soleus (G-S) and biceps posterior-semitendinosus (BP-ST). Thermal (short-lasting CO2 laser pulses) and mechanical stimulation were used. 2. In adults, nociceptive withdrawal reflexes were typically well directed and reflex pathways to single hindlimb muscles had functionally adapted receptive fields. By contrast, at postnatal day (P) 1-7, the nociceptive withdrawal reflexes were often inappropriate, sometimes producing movements towards the stimulation, and EMG recordings revealed unadapted variable receptive fields. With increasing age, the nociceptive withdrawal reflexes progressively became well directed, thus producing localized withdrawal. Both withdrawal movements and spatial organization of the receptive fields were adult-like at P20-25. 3. Up to P25, reflex thresholds were more or less constant in both intact awake rats and spinal decerebrate rats, except in G-S in which no nociceptive withdrawal reflexes were evoked from P20 on. After P25, mechanical, but not thermal, thresholds increased dramatically. 4. EMG recordings revealed that during the first three postnatal weeks, the latency of the CO2 laser-evoked nociceptive withdrawal reflexes decreased significantly in peronei and BP-ST, but not in EDL, and thereafter increased significantly in peronei, BP-ST and EDL. The magnitude of the nociceptive withdrawal reflexes in these muscles increased markedly between P7 and P20 and showed little change thereafter. 5. Possible mechanisms underlying the postnatal tuning of the nociceptive withdrawal reflexes are discussed. PMID:8735709

  2. Development of a data acquisition and analysis system for nociceptive withdrawal reflex and reflex receptive fields in humans.

    PubMed

    Biurrun Manresa, Jose A; Hansen, John; Andersen, Ole K

    2010-01-01

    A system for data acquisition and analysis of nociceptive withdrawal reflex (NWR) and reflex receptive field (RRF) is introduced. The system is constituted by hardware and software components. The hardware consists of devices commonly used for electrical stimulation and electromyographic and kinematic data recording. The software comprises two different programs: Wirex, a stand-alone program developed in LabView for data acquisition, and Reflex Lab, a Matlab-based toolbox for data analysis. These programs were developed to maximize the potential of the hardware, turning it into a complete stimulation system capable of automatic quantification of NWR and RRF. In this article, a brief review of NWR and RRF analysis is presented, the system features are described in detail and its present and future applications are discussed. PMID:21096727

  3. The relationship between nociceptive brain activity, spinal reflex withdrawal and behaviour in newborn infants

    PubMed Central

    Hartley, Caroline; Goksan, Sezgi; Poorun, Ravi; Brotherhood, Kelly; Mellado, Gabriela Schmidt; Moultrie, Fiona; Rogers, Richard; Adams, Eleri; Slater, Rebeccah

    2015-01-01

    Measuring infant pain is complicated by their inability to describe the experience. While nociceptive brain activity, reflex withdrawal and facial grimacing have been characterised, the relationship between these activity patterns has not been examined. As cortical and spinally mediated activity is developmentally regulated, it cannot be assumed that they are predictive of one another in the immature nervous system. Here, using a new experimental paradigm, we characterise the nociceptive-specific brain activity, spinal reflex withdrawal and behavioural activity following graded intensity noxious stimulation and clinical heel lancing in 30 term infants. We show that nociceptive-specific brain activity and nociceptive reflex withdrawal are graded with stimulus intensity (p < 0.001), significantly correlated (r = 0.53, p = 0.001) and elicited at an intensity that does not evoke changes in clinical pain scores (p = 0.55). The strong correlation between reflex withdrawal and nociceptive brain activity suggests that movement of the limb away from a noxious stimulus is a sensitive indication of nociceptive brain activity in term infants. This could underpin the development of new clinical pain assessment measures. PMID:26228435

  4. The relationship between nociceptive brain activity, spinal reflex withdrawal and behaviour in newborn infants.

    PubMed

    Hartley, Caroline; Goksan, Sezgi; Poorun, Ravi; Brotherhood, Kelly; Mellado, Gabriela Schmidt; Moultrie, Fiona; Rogers, Richard; Adams, Eleri; Slater, Rebeccah

    2015-01-01

    Measuring infant pain is complicated by their inability to describe the experience. While nociceptive brain activity, reflex withdrawal and facial grimacing have been characterised, the relationship between these activity patterns has not been examined. As cortical and spinally mediated activity is developmentally regulated, it cannot be assumed that they are predictive of one another in the immature nervous system. Here, using a new experimental paradigm, we characterise the nociceptive-specific brain activity, spinal reflex withdrawal and behavioural activity following graded intensity noxious stimulation and clinical heel lancing in 30 term infants. We show that nociceptive-specific brain activity and nociceptive reflex withdrawal are graded with stimulus intensity (p < 0.001), significantly correlated (r = 0.53, p = 0.001) and elicited at an intensity that does not evoke changes in clinical pain scores (p = 0.55). The strong correlation between reflex withdrawal and nociceptive brain activity suggests that movement of the limb away from a noxious stimulus is a sensitive indication of nociceptive brain activity in term infants. This could underpin the development of new clinical pain assessment measures. PMID:26228435

  5. The nociceptive withdrawal reflex does not adapt to joint position change and short-term motor practice

    PubMed Central

    Riley, Zachary A

    2013-01-01

    The nociceptive withdrawal reflex is a protective mechanism to mediate interactions within a potentially dangerous environment. The reflex is formed by action-based sensory encoding during the early post-natal developmental period, and it is unknown if the protective motor function of the nociceptive withdrawal reflex in the human upper-limb is adaptable based on the configuration of the arm or if it can be modified by short-term practice of a similar or opposing motor action. In the present study, nociceptive withdrawal reflexes were evoked by a brief train of electrical stimuli applied to digit II, 1) in five different static arm positions and, 2) before and after motor practice that was opposite (EXT) or similar (FLEX) to the stereotyped withdrawal response, in 10 individuals. Withdrawal responses were quantified by the electromyography (EMG) reflex response in several upper limb muscles, and by the forces and moments recorded at the wrist. EMG onset latencies and response amplitudes were not significantly different across the arm positions or between the EXT and FLEX practice conditions, and the general direction of the withdrawal response was similar across arm positions. In addition, the force vectors were not different after practice in either the practice condition or between EXT and FLEX conditions. We conclude the withdrawal response is insensitive to changes in elbow or shoulder joint angles as well as remaining resistant to short-term adaptations from the practice of motor actions, resulting in a generalized limb withdrawal in each case. It is further hypothesized that the multisensory feedback is weighted differently in each arm position, but integrated to achieve a similar withdrawal response to safeguard against erroneous motor responses that could cause further harm. The results remain consistent with the concept that nociceptive withdrawal reflexes are shaped through long-term and not short-term action based sensory encoding. PMID:24555075

  6. Reexamination of the gill withdrawal reflex of Aplysia californica Cooper (Gastropoda; Opisthobranchia).

    PubMed

    Leonard, J L; Edstrom, J; Lukowiak, K

    1989-06-01

    The gill withdrawal reflex (GWR), an important model system for neural mechanisms of learning, varies in form and amplitude within as well as between preparations and is therefore a heterogeneous collection of action patterns, not a reflex. At least 4 action patterns occur in response to mechanical stimulation of the siphon. It is often impossible to categorize a particular movement unambiguously. All may occur spontaneously. Gill movements may be described as combinations of 10 actions; 4 involving vein movements are described here. All actions and action patterns can occur in preparations lacking the central nervous system. Some vein movements may generate considerable force without markedly altering gill area. It is suggested that this explains why some early studies failed to identify the important role of the peripheral nervous system in the GWR. Studies based on the assumption that the GWR involves a single type of movement controlled by cells of the parietovisceral ganglion require reevaluation. PMID:2544202

  7. Reflex control of rat tail sympathetic nerve activity by abdominal temperature

    PubMed Central

    Shafton, Anthony D; Kitchener, Peter; McKinley, Michael J; McAllen, Robin M

    2014-01-01

    The thermoregulatory reflex effects of warming and cooling in the abdomen were investigated in 4 urethane-anesthetized Sprague-Dawley rats. Animals were shaved and surrounded by a water-perfused silastic jacket. Skin temperature under the jacket was recorded by thermocouples at 3 sites and brain temperature was monitored by a thermocouple inserted lateral to the hypothalamus. A heat exchanger made from an array of silicon tubes in parallel loops was placed through a ventral incision into the abdomen; it rested against the intestinal serosa and the temperature of this interface was monitored by a thermocouple. Few- or multi-unit postganglionic activity was recorded from sympathetic nerves supplying tail vessels (tail SNA). Intra-abdominal temperature was briefly lowered or raised between 35–41 °C by perfusing the heat exchanger with cold or warm water. Warming the abdomen inhibited tail SNA while cooling it excited tail SNA in all 4 animals. We also confirmed that cooling the trunk skin activated tail SNA. Multivariate analysis of tail SNA with respect to abdominal, brain and trunk skin temperatures revealed that all had highly significant independent inhibitory actions on tail SNA, but in these experiments abdominal temperature had the weakest and brain temperature the strongest effect. We conclude that abdominal temperature has a significant thermoregulatory action in the rat, but its influence on cutaneous vasomotor control appears to be weaker than that of skin or brain temperatures.

  8. Alfaxalone Anaesthesia Facilitates Electrophysiological Recordings of Nociceptive Withdrawal Reflexes in Dogs (Canis familiaris).

    PubMed

    Hunt, James; Murrell, Jo; Knazovicky, David; Harris, John; Kelly, Sara; Knowles, Toby G; Lascelles, B Duncan X

    2016-01-01

    Naturally occurring canine osteoarthritis represents a welfare issue for affected dogs (Canis familiaris), but is also considered very similar to human osteoarthritis and has therefore been proposed as a model of disease in humans. Central sensitisation is recognized in human osteoarthritis sufferers but identification in dogs is challenging. Electromyographic measurement of responses to nociceptive stimulation represents a potential means of investigating alterations in central nociceptive processing, and has been evaluated in conscious experimental dogs, but is likely to be aversive. Development of a suitable anaesthetic protocol in experimental dogs, which facilitated electrophysiological nociceptive withdrawal reflex assessment, may increase the acceptability of using the technique in owned dogs with naturally occurring osteoarthritis. Seven purpose bred male hound dogs underwent electromyographic recording sessions in each of three states: acepromazine sedation, alfaxalone sedation, and alfaxalone anaesthesia. Electromyographic responses to escalating mechanical and electrical, and repeated electrical, stimuli were recorded. Subsequently the integral of both early and late rectified responses was calculated. Natural logarithms of the integral values were analysed within and between the three states using multi level modeling. Alfaxalone increased nociceptive thresholds and decreased the magnitude of recorded responses, but characteristics of increasing responses with increasing stimulus magnitude were preserved. Behavioural signs of anxiety were noted in two out of seven dogs during recordings in the acepromazine sedated state. There were few significant differences in response magnitude or nociceptive threshold between the two alfaxalone states. Following acepromazine premedication, induction of anaesthesia with 1-2 mg kg-1 alfaxalone, followed by a continuous rate infusion in the range 0.075-0.1 mg kg-1 min-1 produced suitable conditions to enable assessment

  9. Alfaxalone Anaesthesia Facilitates Electrophysiological Recordings of Nociceptive Withdrawal Reflexes in Dogs (Canis familiaris)

    PubMed Central

    Hunt, James; Murrell, Jo; Knazovicky, David; Harris, John; Kelly, Sara; Knowles, Toby G.; Lascelles, B. Duncan X.

    2016-01-01

    Naturally occurring canine osteoarthritis represents a welfare issue for affected dogs (Canis familiaris), but is also considered very similar to human osteoarthritis and has therefore been proposed as a model of disease in humans. Central sensitisation is recognized in human osteoarthritis sufferers but identification in dogs is challenging. Electromyographic measurement of responses to nociceptive stimulation represents a potential means of investigating alterations in central nociceptive processing, and has been evaluated in conscious experimental dogs, but is likely to be aversive. Development of a suitable anaesthetic protocol in experimental dogs, which facilitated electrophysiological nociceptive withdrawal reflex assessment, may increase the acceptability of using the technique in owned dogs with naturally occurring osteoarthritis. Seven purpose bred male hound dogs underwent electromyographic recording sessions in each of three states: acepromazine sedation, alfaxalone sedation, and alfaxalone anaesthesia. Electromyographic responses to escalating mechanical and electrical, and repeated electrical, stimuli were recorded. Subsequently the integral of both early and late rectified responses was calculated. Natural logarithms of the integral values were analysed within and between the three states using multi level modeling. Alfaxalone increased nociceptive thresholds and decreased the magnitude of recorded responses, but characteristics of increasing responses with increasing stimulus magnitude were preserved. Behavioural signs of anxiety were noted in two out of seven dogs during recordings in the acepromazine sedated state. There were few significant differences in response magnitude or nociceptive threshold between the two alfaxalone states. Following acepromazine premedication, induction of anaesthesia with 1–2 mg kg-1 alfaxalone, followed by a continuous rate infusion in the range 0.075–0.1 mg kg-1 min-1 produced suitable conditions to enable

  10. Signaled avoidance in the eye withdrawal reflex of the green crab

    PubMed Central

    Abramson, Charles I.; Armstrong, Philip M.; Feinman, Robin A.; Feinman, Richard D.

    1988-01-01

    Learning in a signaled avoidance procedure was studied in the eye withdrawal reflex of the green crab, Carcinus maenas. A puff of air to the eye, which causes eye retraction, was used as the unconditioned stimulus (US). A mild vibration on the carapace, which has no effect on untrained animals, was used as a warning (conditioned) stimulus (CS). Eye withdrawal during the CS led to the omission of the otherwise scheduled US. Acquisition was rapid, reaching about 75% avoidance after 30 trials. Extinction occurred slowly over the course of 40 CS-only trials. Yoked controls did not perform as well. The behavior of experimental animals in the avoidance procedure was found to be essentially identical to the performance of animals subjected to a classical conditioning paradigm in which CS responses had no effect on US presentation. Additional groups of animals were subjected to experiments in which (a) avoidance conditioning (60 trials) was followed by classical conditioning (40 trials) or (b) classical conditioning was followed by avoidance. The behavior of these groups was, again, essentially identical. The results suggest that there may be an underlying Pavlovian mechanism for the learned response, although the contribution of an operant process is not excluded. The results expand the range of invertebrate animals in which fundamental conditioning phenomena can be demonstrated, and may provide a neuronal model for learning in a signaled avoidance procedure. PMID:16812569

  11. The Tail-Elicited Tail Withdrawal Reflex of "Aplysia" Is Mediated Centrally at Tail Sensory-Motor Synapses and Exhibits Sensitization across Multiple Temporal Domains

    ERIC Educational Resources Information Center

    Philips, Gary T.; Sherff, Carolyn M.; Menges, Steven A.; Carew, Thomas J.

    2011-01-01

    The defensive withdrawal reflexes of "Aplysia californica" have provided powerful behavioral systems for studying the cellular and molecular basis of memory formation. Among these reflexes the (T-TWR) has been especially useful. In vitro studies examining the monosynaptic circuit for the T-TWR, the tail sensory-motor (SN-MN) synapses, have…

  12. Methods to evaluate functional nerve recovery in adult rats: walking track analysis, video analysis and the withdrawal reflex.

    PubMed

    Dijkstra, J R; Meek, M F; Robinson, P H; Gramsbergen, A

    2000-03-15

    The aim of this study was to compare different methods for the evaluation of functional nerve recovery. Three groups of adult male Wistar rats were studied. In group A, a 12-mm gap between nerve ends was bridged by an autologous nerve graft; in rats of group B we performed a crush lesion of the sciatic nerve and group C consisted of non-operated control rats. The withdrawal reflex, elicited by an electric stimulus, was used to evaluate the recovery of sensory nerve function. To investigate motor nerve recovery we analyzed the walking pattern. Three different methods were used to obtain data for footprint analysis: photographic paper with thickened film developer on the paws, normal white paper with finger paint, and video recordings. The footprints were used to calculate the sciatic function index (SFI). From the video recordings, we also analyzed stepcycles. The withdrawal reflex is a convenient and reproducible test for the evaluation of global sensory nerve recovery. Recording walking movements on video and the analysis of footplacing is a perfect although time-consuming method for the evaluation of functional aspects of motor nerve recovery. PMID:10720672

  13. Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: 2. Biomechanical characteristics.

    PubMed

    Kutz, D F; Kaulich, Th; Föhre, W; Gerwig, M; Timmann, D; Kolb, F P

    2014-03-01

    This study addresses cerebellar involvement in classically conditioned nociceptive lower limb withdrawal reflexes in standing humans. A preceding study compared electromyographic activities in leg muscles of eight patients with cerebellar disease (CBL) and eight age-matched controls (CTRL). The present study extends and completes that investigation by recording biomechanical signals from a strain-gauge-equipped platform during paired auditory conditioning stimuli (CS) and unconditioned stimuli (US) trials and during US-alone trials. The withdrawal reflex performance-lifting the stimulated limb (decreasing the vertical force from that leg, i.e. 'unloading') and transferring body weight to the supporting limb (increasing the vertical force from that leg, i.e. 'loading')-was quantified by the corresponding forces exerted onto the platform. The force changes were not simultaneous but occurred as a sequence of multiple force peaks at different times depending on the specific limb task (loading or unloading). Motor learning, expressed by the occurrence of conditioned responses (CR), is characterized by this sequence beginning already within the CSUS window. Loading and unloading were delayed and prolonged in CBL, resulting in incomplete rebalancing during the analysis period. Trajectory loops of the center of vertical pressure-derived from vertical forces-were also incomplete in CBL within the recording period. However, exposing CBL to a CS resulted in motor improvement reflected by shortening the time of rebalancing and by optimizing the trajectory loop. In summary, associative responses in CBL are not absent although they are less frequent and of smaller amplitude than in CTRL. PMID:24445111

  14. Differences in unconditioned and conditioned responses of the human withdrawal reflex during stance: muscle responses and biomechanical data.

    PubMed

    Kaulich, Thomas; Föhre, Wolfram; Kutz, Dieter Friedhelm; Gerwig, Markus; Timmann, Dagmar; Kolb, Florian Peter

    2010-04-22

    The aim of this study was to characterize differences between unconditioned and classically conditioned lower limb withdrawal reflexes in young subjects during standing. Electromyographic activity in the main muscle groups and biomechanical signals from a strain-gauge-equipped platform on which subjects stood were recorded from 17 healthy subjects during unconditioned stimulus (US)-alone trials and during auditory conditioning stimuli (CS) and US trials. In US-alone trials the leg muscle activation sequence was characteristic: ipsilateral, distal muscles were activated prior to proximal muscles; contralaterally the sequence was reversed. In CSUS trials latencies were shorter. Subjects unloaded the stimulated leg and shifted body weight to the supporting leg. In US-alone and in CSUS trials leg forces on each side were inversely related and asymmetric, due to preparation for unloading, whilst conditioned responses (CR), representing the unloading preparation, were symmetric. The trajectory of the center of vertical pressure during US-alone trials moved initially forward (a preparatory balance reaction) and to the stimulation side, followed by a large lateral shift to the side of the supporting limb. During CSUS trials the forwards shift was absent but the CR (early lateral shift) represented a preponed preparatory unloading. Electrophysiological and biomechanical responses of the classically conditioned lower limb withdrawal reflex in standing subjects changed significantly in CSUS trials compared to US-alone trials with higher sensitivity in the biomechanics. These findings will serve as a basis for a subsequent study on a group of patients with cerebellar diseases in whom the success of establishing procedural processes is known to be impaired. PMID:20188078

  15. Comparison of the classically conditioned withdrawal reflex in cerebellar patients and healthy control subjects during stance: I. electrophysiological characteristics.

    PubMed

    Timmann, D; Kaulich, T; Föhre, W; Kutz, D F; Gerwig, M; Kolb, F P

    2013-02-01

    The aim of this study was to demonstrate the involvement of the human cerebellum in the classically conditioned lower limb withdrawal reflex in standing subjects. Electromyographic activity was recorded from the main muscle groups of both legs of eight patients with cerebellar disease (CBL) and eight control subjects (CTRL). The unconditioned stimulus (US) consisted of electrical stimulation of the tibial nerve at the medial malleolus. The conditioning stimulus (CS) was an auditory signal given via headphones. Experiments started with 70 paired conditioning stimulus-unconditioned stimulus(CSUS) trials followed by 50 US-alone trials. The general reaction consisted of lifting and flexing the stimulated (stepping) leg with accompanying activation of the contralateral (supporting) leg. In CTRL, the ipsilateral (side of stimulation) flexor and contralateral extensor muscles were activated characteristically. In CBL, the magnitudes of ipsilateral flexor and contralateral extensor muscle activation were reduced comparably. In CTRL, the conditioning process increased the incidence of conditioned responses (CR), following a typical learning curve, while CBL showed a clearly lower CR incidence with a marginal increase, albeit, at a shorter latency. Conditioning processes also modified temporal parameters by shortening unconditioned response (UR) onset latencies and UR times to peak and, more importantly in CBL, also the sequence of activation of muscles, which became similar to that of CTRL. The expression of this reflex in standing subjects showed characteristic differences in the groups tested with the underlying associative processes not being restricted exclusively to the CR but also modifying parameters of the innate UR. PMID:22836373

  16. Habituation in the Tail Withdrawal Reflex Circuit is Impaired During Aging in Aplysia californica.

    PubMed

    Kempsell, Andrew T; Fieber, Lynne A

    2016-01-01

    The relevance of putative contributors to age-related memory loss are poorly understood. The tail withdrawal circuit of the sea hare, a straightforward neural model, was used to investigate the aging characteristics of rudimentary learning. The simplicity of this neuronal circuit permits attribution of declines in the function of specific neurons to aging declines. Memory was impaired in advanced age animals compared to their performance at the peak of sexual maturity, with habituation training failing to attenuate the tail withdrawal response or to reduce tail motoneuron excitability, as occurred in peak maturity siblings. Baseline motoneuron excitability of aged animals was significantly lower, perhaps contributing to a smaller scope for attenuation. Conduction velocity in afferent fibers to tail sensory neurons (SN) decreased during aging. The findings suggest that age-related changes in tail sensory and motor neurons result in deterioration of a simple form of learning in Aplysia. PMID:26903863

  17. Habituation in the Tail Withdrawal Reflex Circuit is Impaired During Aging in Aplysia californica

    PubMed Central

    Kempsell, Andrew T.; Fieber, Lynne A.

    2016-01-01

    The relevance of putative contributors to age-related memory loss are poorly understood. The tail withdrawal circuit of the sea hare, a straightforward neural model, was used to investigate the aging characteristics of rudimentary learning. The simplicity of this neuronal circuit permits attribution of declines in the function of specific neurons to aging declines. Memory was impaired in advanced age animals compared to their performance at the peak of sexual maturity, with habituation training failing to attenuate the tail withdrawal response or to reduce tail motoneuron excitability, as occurred in peak maturity siblings. Baseline motoneuron excitability of aged animals was significantly lower, perhaps contributing to a smaller scope for attenuation. Conduction velocity in afferent fibers to tail sensory neurons (SN) decreased during aging. The findings suggest that age-related changes in tail sensory and motor neurons result in deterioration of a simple form of learning in Aplysia. PMID:26903863

  18. Involvement of spinal α2 -adrenoceptors in prolonged modulation of hind limb withdrawal reflexes following acute noxious stimulation in the anaesthetized rabbit.

    PubMed

    Harris, John

    2016-03-01

    The role of spinal α2 -adrenoceptors in mediating long-lasting modulation of hind limb withdrawal reflexes following acute noxious chemical stimulation of distant heterotopic and local homotopic locations has been investigated in pentobarbitone-anaesthetized rabbits. Reflexes evoked in the ankle extensor muscle medial gastrocnemius (MG) by electrical stimulation of the ipsilateral heel, and reflexes elicited in the ankle flexor tibialis anterior and the knee flexor semitendinosus by stimulation at the base of the ipsilateral toes, could be inhibited for over 1 h after mustard oil (20%) was applied to either the snout or into the contralateral MG. The heel-MG response was also inhibited after applying mustard oil across the plantar metatarsophalangeal joints of the ipsilateral foot, whereas this homotopic stimulus facilitated both flexor responses. Mustard oil also caused a significant pressor effect when applied to any of the three test sites. The selective α2 -adrenoceptor antagonist, RX 821002 (100-300 μg, intrathecally), had no effect on reflexes per se, but did cause a decrease in mean arterial blood pressure. In the presence of the α2 -blocker, inhibitory and facilitatory effects of mustard oil on reflexes were completely abolished. These data imply that long-lasting inhibition of spinal reflexes following acute noxious stimulation of distant locations involves activation of supraspinal noradrenergic pathways, the effects of which are dependent on an intact α2 -adrenoceptor system at the spinal level. These pathways and receptors also appear to be involved in facilitation (sensitization) as well as inhibition of reflexes following a noxious stimulus applied to the same limb. PMID:26804327

  19. Spinal 5-HT-receptors and tonic modulation of transmission through a withdrawal reflex pathway in the decerebrated rabbit.

    PubMed Central

    Clarke, R. W.; Harris, J.; Houghton, A. K.

    1996-01-01

    1. In decerebrated, non-spinalized rabbits, intrathecal administration of either of the selective 5-HT1A-receptor antagonists (S)WAY-100135 or WAY-100635 resulted in dose-dependent enhancement of the reflex responses of gastrocnemius motoneurones evoked by electrical stimulation of all myelinated afferents of the sural nerve. The approximate ED50 for WAY-100635 was 0.9 nmol and that for (S)WAY-100135 13 nmol. Intrathecal doses of the antagonists which caused maximal facilitation of reflexes in non-spinalized rabbits had no effect in spinalized preparations. 2. In non-spinalized animals, intravenous administration of (S)WAY-100135 was significantly less effective in enhancing reflexes than when it was given by the intrathecal route. 3. When given intrathecally, the selective 5-HT 2A/2C-receptor antagonist, ICI 170,809, produced a bellshaped dose-effect curve, augmenting reflexes at low doses (< or = 44 nmol), but reducing them at higher doses (982 nmol). Idazoxan, the selective alpha 2-adrenoceptor antagonist, was less effective in enhancing reflex responses when given intrathecally after ICI 170,809 compared to when it was given alone. Intravenous ICI 170,809 resulted only in enhancement of reflexes and the facilitatory effects of subsequent intrathecal administration of idazoxan were not compromised. 4. The selective 5-HT3-receptor blocker ondansetron faciliated gastrocnemius medialis reflex responses in a dose-related manner when given by either intrathecal or intravenous routes. This drug was slightly more potent when given i.v. and it did not alter the efficacy of subsequent intrathecal administration of idazoxan. 5. None of the antagonists had any consistent effects on arterial blood pressure or heart rate. 6. These data are consistent with the idea that, in the decrebrated rabbit, 5-HT released from descending axons has multiple roles in controlling transmission through the sural-gastrocnemius medialis reflex pathway. Thus, it appears 5-HT tonically inhibits

  20. Infant reflexes

    MedlinePlus

    ... neck reflex; Galant reflex; Truncal incurvation; Rooting reflex; Parachute reflex; Grasp reflex ... was stroked and begin to make sucking motions. PARACHUTE REFLEX This reflex occurs in slightly older infants ...

  1. Responses of motor units during the hind limb flexion withdrawal reflex evoked by noxious skin heating: phasic and prolonged suppression by midbrain stimulation and comparison with simultaneously recorded dorsal horn units.

    PubMed

    Carstens, E; Campell, I G

    1992-02-01

    In rats anesthetized with sodium pentobarbital, we quantitatively analyzed descending modulation from the midbrain of a nociceptive flexion withdrawal reflex and responses of associated spinal neurons. We monitored the isometric force of hind limb withdrawal elicited by noxious heat stimuli (42-54 degrees C, 10 sec) on the hind paw. In one series of experiments, single-fiber EMG electrodes recorded responses of single muscle fibers (i.e., motor units) in biceps femoris during the hind limb withdrawal, without and during electrical stimulation in the midbrain periaqueductal gray (PAG) or lateral midbrain reticular formation (LRF). In a second series, responses of single lumbar dorsal horn neurons were also recorded simultaneously. Withdrawal force and associated motor unit responses were suppressed for prolonged periods (4 to greater than 60 min) following the initial episode of PAG or LRF stimulation in 40% of the rats, while they were suppressed phasically (i.e., only during brain stimulation) in the remainder. Motor unit responses increased in a graded fashion with increasing skin stimulus temperature from threshold (45 degrees C) to 54 degrees C. During PAG stimulation, the slope of the rate coding function was reduced with no change in threshold temperature. During LRF stimulation the rate coding function was shifted toward higher temperatures with increased threshold (47 degrees C). In 14 experiments 43 paired recordings were made from a dorsal horn and a motor unit during hind limb withdrawals. Mean latency to onset and peak of the heat-evoked response was shorter for dorsal horn compared to motor units. In 6/14 rats withdrawal force and motor unit responses were significantly suppressed for more than 8 min following mechanical placement of the stimulating electrodes and/or the initial episode of midbrain stimulation, while the simultaneously recorded dorsal horn unit responses remained constant. Following supplemental administration of pentobarbital (10

  2. Infant reflexes

    MedlinePlus

    ... or her hips toward the touch in a dancing movement. Grasp reflex . This reflex occurs if you ... reflex occurs in slightly older infants when the child is held upright and the baby’s body is ...

  3. Human flexor reflexes

    PubMed Central

    Shahani, Bhagwan T.; Young, Robert R.

    1971-01-01

    One type of flexor reflex, that recorded from the tibialis anterior muscle in response to electrical stimulation of the sole of the foot, was studied in normal subjects and patients with several neurological disorders. Normally this reflex consists of two components, the second of which is related to the actual withdrawal. The first component, normally of lower threshold, is difficult to evoke in patients with chronic spinal cord or discrete cerebral lesions, whereas it has an unusually low threshold and is very clearly seen in those with Parkinson's disease. In patients with spinal cord disease, the exaggerated flexor reflexes are seen at long latencies after relatively small stimuli. During the early phase of recovery from spinal transection, both components may be seen and are, therefore, spinal in origin. Studies of patients with the sensory neuropathy of Friedreich's ataxia suggest that the afferent fibres responsible for these flexor reflexes are the small myelinated fibres. Recovery curves demonstrate very long-lasting changes in flexor reflex excitability in normal subjects and patients with `spasticity' from spinal lesions. This differs in patients with `spasticity' from lesions rostral to the brain-stem. Examples in man of such physiological phenomena as reciprocal inhibition, local sign, habituation, temporal and spatial summation are discussed. Images PMID:5122389

  4. Moro reflex

    MedlinePlus

    ... area into the arm may be present (these nerves are called brachial plexus). A Moro reflex in an older infant, child, or adult is ... be done to examine the child's muscles and nerves. Diagnostic ... absent reflex, may include: Shoulder x-ray Tests for disorders ...

  5. Cocaine withdrawal

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000947.htm Cocaine withdrawal To use the sharing features on this page, please enable JavaScript. Cocaine withdrawal occurs when someone who has used a ...

  6. Reflexives in Mohawk.

    ERIC Educational Resources Information Center

    Bonvillain, Nancy

    1994-01-01

    This paper presents an analysis of the meanings and uses of two reflexive morphemes in the Mohawk language. Reflexive "atat" is shown to have both reflexive and reciprocal meanings. It is also realized in kinship terms and in the transitive pronominal prefix "yutat." Semi-reflexive "at" has some reflexive functions, and can mark middle voice and…

  7. Abdominal Adhesions

    MedlinePlus

    ... Abdominal Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91– ... are abdominal adhesions and intestinal obstructions ... generally do not require treatment. Surgery is the only way to treat abdominal ...

  8. Alcohol withdrawal.

    PubMed

    Manasco, Anton; Chang, Shannon; Larriviere, Joseph; Hamm, L Lee; Glass, Marcia

    2012-11-01

    Alcohol withdrawal is a common clinical condition that has a variety of complications and morbidities. The manifestations can range from mild agitation to withdrawal seizures and delirium tremens. The treatments for alcohol withdrawal include benzodiazepines, anticonvulsants, beta-blockers and antihypertensives. Although benzodiazepines are presently a first-line therapy, there is controversy regarding the efficacies of these medications compared with others. Treatment protocols often involve one of two contrasting approaches: symptom-triggered versus fixed-schedule dosing of benzodiazepines. We describe these protocols in our review and examine the data supporting symptom-triggered dosing as the preferred method for most patients in withdrawal.The Clinical Institute Withdrawal Assessment for Alcohol scoring system for alcohol withdrawal streamlines care, optimizes patient management, and is the best scale available for withdrawal assessment. Quality improvement implications for inpatient management of alcohol withdrawal include increasing training for signs of withdrawal and symptom recognition, adding new hospital protocols to employee curricula, and ensuring manageable patient-to-physician and patient-to-nurse ratios. PMID:23128805

  9. Satb2 Stations Neurons along Reflex Arcs.

    PubMed

    Hantman, Adam W; Kaltschmidt, Julia A

    2016-08-17

    The nociceptive flexor withdrawal reflex has an august place in the history of neuroscience. In this issue of Neuron, Hilde et al. (2016) advance our understanding of this reflex by characterizing the molecular identity and circuit connectivity of component interneurons. They assess how a DNA-binding factor Satb2 controls cell position, molecular identity, pre-and postsynaptic targeting, and function of a population of inhibitory sensory relay interneurons that serve to integrate both proprioceptive and nociceptive afferent information. PMID:27537478

  10. Reflexives in Japanese

    ERIC Educational Resources Information Center

    Kishida, Maki

    2011-01-01

    The purpose of this dissertation is to reconsider reflexives in Japanese through the following three steps: (a) separation of genuine reflexive elements from elements that are confounded as reflexives, (b) classification of reflexive anaphors into subtypes based on their semantic difference, and (c) classification of predicates that occur with…

  11. Reflexives in Veracruz Huastec.

    ERIC Educational Resources Information Center

    Constable, Peter G.

    A study examines various Huastec clause types that are reflexive in some sense, including ordinary reflexives, which involve co-reference. Two mutually exclusive morphosyntactic devices are used in Huastec: reflexive pronouns and verbal morphology. In this way, Huastec is like various European languages. Clauses involving reflexive pronouns and…

  12. Abdominal mass

    MedlinePlus

    Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  13. Abdominal mass

    MedlinePlus

    ... Several conditions can cause an abdominal mass: Abdominal aortic aneurysm can cause a pulsating mass around the navel. ... This could be a sign of a ruptured aortic aneurysm, which is an emergency condition. Contact your health ...

  14. Alcohol withdrawal

    MedlinePlus

    ... Seeing or feeling things that aren't there (hallucinations) Seizures Severe confusion ... alcohol withdrawal. You will be watched closely for hallucinations and other signs of delirium tremens. Treatment may ...

  15. Cocaine withdrawal

    MedlinePlus

    Cocaine withdrawal occurs when someone who has used a lot of cocaine cuts down or quits taking the drug. Symptoms ... even if the user is not completely off cocaine and still has some of the drug in ...

  16. Abdominal bloating: pathophysiology and treatment.

    PubMed

    Seo, A Young; Kim, Nayoung; Oh, Dong Hyun

    2013-10-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  17. Nicotine Withdrawal

    PubMed Central

    McLaughlin, Ian; Dani, John A.; De Biasi, Mariella

    2015-01-01

    An aversive abstinence syndrome manifests 4–24 h following cessation of chronic use of nicotine-containing products. Symptoms peak on approximately the 3rd day and taper off over the course of the following 3–4 weeks. While the severity of withdrawal symptoms is largely determined by how nicotine is consumed, certain short nucleotide polymorphisms (SNPs) have been shown to predispose individuals to consume larger amounts of nicotine more frequently—as well as to more severe symptoms of withdrawal when trying to quit. Additionally, rodent behavioral models and transgenic mouse models have revealed that specific nicotinic acetylcholine receptor (nAChR) subunits, cellular components, and neuronal circuits are critical to the expression of withdrawal symptoms. Consequently, by continuing to map neuronal circuits and nAChR subpopulations that underlie the nicotine withdrawal syndrome—and by continuing to enumerate genes that predispose carriers to nicotine addiction and exacerbated withdrawal symptoms—it will be possible to pursue personalized therapeutics that more effectively treat nicotine addiction. PMID:25638335

  18. Embodied Self-Reflexivity

    ERIC Educational Resources Information Center

    Pagis, Michal

    2009-01-01

    Drawing on G. H. Mead and Merleau-Ponty, this paper aims to extend our understanding of self-reflexivity beyond the notion of a discursive, abstract, and symbolic process. It offers a framework for embodied self-reflexivity, which anchors the self in the reflexive capacity of bodily sensations. The data consist of two years of ethnographic…

  19. Abdominal sounds

    MedlinePlus

    ... during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation. Increased ( hyperactive ) bowel sounds ...

  20. Abdominal MRI

    MedlinePlus

    ... provider if you have: Artificial heart valves Brain aneurysm clips Heart defibrillator or pacemaker Inner ear (cochlear) ... which the test may be performed: Abdominal aortic aneurysm Atheroembolic renal disease Carcinoma of the renal pelvis ...

  1. Abdominal pain

    MedlinePlus

    ... threatening conditions, such as colon cancer or early appendicitis , may only cause mild pain or no pain. ... Food poisoning Stomach flu Other possible causes include: Appendicitis Abdominal aortic aneurysm (bulging and weakening of the ...

  2. Abdominal Pain

    MedlinePlus

    ... can help the overall situation for the child. Teaching kids self-hypnosis [8] or guided imagery [8a] ... related topics? Functional Abdominal Pain (English, French or Spanish)—from The North American Society for Pediatric Gastroenterology, ...

  3. Crossed linguo-buccal reflex in post-stroke patients.

    PubMed

    Nagumo, K; Hirayama, K; Nakajima, Y; Takahashi, M

    2000-12-15

    A pathological crossed orofacial reflex, called crossed linguo-buccal reflex in the present study, was observed in approximately 1/3 of post-stroke patients with central facial palsy. Stroking with pressure two or three times with a split wooden tongue-blade to the tongue or palate contralateral to the central facial palsy elicited a reflex movement consisting of retraction of the angle of mouth and medio-posterior withdrawal of the buccal mucosa on the paretic side. Seventy-seven patients with central hemifacial palsy caused by a unilateral cerebral lesion were examined clinically, electromyographically and by computed tomography (CT) and magnetic resonance imaging (MRI). In addition, three men with bilateral cerebral lesions and bilateral crossed linguo-buccal reflexes were electromyographically examined. Twenty-two patients with unilateral cerebral lesions had this reflex. It was found that this reflex was most frequently observed in patients with a capsulo-caudate lesion involving the head of the caudate nucleus, the anterior limb and genu of the internal capsule. The electromyogram of the reflex showed increased activity in the orbicularis oris, depressor anguli oris, risorius, zygomaticus major and buccinator muscles on the paretic side with a long latency (254-856 ms), and a prolonged after-discharge after the stimulation. Reciprocal inhibition was observed in patients with bilateral positive reflexes. These findings suggest that liberation of the polysynaptic brainstem reflex in the medulla oblongata and pons from the indirect corticobulbar inhibition may underlie the occurrence of the crossed linguo-buccal reflex in post-stroke patients. PMID:11102639

  4. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy. PMID:27363829

  5. What is a reflex?

    PubMed Central

    Truog, Robert D.

    2015-01-01

    Uncertainty in diagnosing disorders of consciousness, and specifically in determining whether consciousness has been lost or retained, poses challenging scientific and ethical questions. Recent neuroimaging-based tests for consciousness have cast doubt on the reliability of behavioral criteria in assessing states of consciousness and generate new questions about the assumptions used in formulating coherent diagnostic criteria. The reflex, a foundational diagnostic tool, offers unique insight into these disorders; behaviors produced by unconscious patients are thought to be purely reflexive, whereas those produced by conscious patients can be volitional. Further investigation, however, reveals that reflexes cannot be reliably distinguished from conscious behaviors on the basis of any generalizable empirical characteristics. Ambiguity between reflexive and conscious behaviors undermines the capacity of the reflex to distinguish between disorders of consciousness and has implications for how these disorders should be conceptualized in future diagnostic criteria. PMID:26085602

  6. Opiate and opioid withdrawal

    MedlinePlus

    ... opiate withdrawal; Oxycontin - opiate withdrawal; Hydrocodone - opiate withdrawal; Detox - opiates; Detoxification - opiates ... facilities set up to help people with detoxification (detox). In a regular hospital, if symptoms are severe. ...

  7. Opiate and opioid withdrawal

    MedlinePlus

    ... Oxycontin - opiate withdrawal; Hydrocodone - opiate withdrawal; Detox - opiates; Detoxification - opiates ... Using facilities set up to help people with detoxification (detox). In a regular hospital, if symptoms are ...

  8. Abdominal thrusts

    MedlinePlus

    ... call 911 . If the person loses consciousness, start CPR . If you are not comfortable performing abdominal thrusts, ... American Red Cross. First Aid/CPR/AED Participant's Manual. 2nd ... Red Cross; 2014. Berg RA, Hemphill R, Abella BS, et al. Part 5: ...

  9. Abdominal Adhesions

    MedlinePlus

    ... Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91–111. Seek Help for ... and how to participate, visit the NIH Clinical Research Trials and You website ... Foundation for Functional Gastrointestinal Disorders 700 West Virginia ...

  10. On Reflexive Data Models

    SciTech Connect

    Petrov, S.

    2000-08-20

    An information system is reflexive if it stores a description of its current structure in the body of stored information and is acting on the base of this information. A data model is reflexive, if its language is meta-closed and can be used to build such a system. The need for reflexive data models in new areas of information technology applications is argued. An attempt to express basic notions related to information systems is made in the case when the system supports and uses meta-closed representation of the data.

  11. Abdominal Aortic Aneurysms: Treatments

    MedlinePlus

    ... information Membership Directory (SIR login) Interventional Radiology Abdominal Aortic Aneurysms Interventional Radiologists Treat Abdominal Aneurysms Nonsurgically Interventional radiologists ...

  12. [The endonasopalpebral reflex].

    PubMed

    Vinnitskiĭ, A R; Vinnitskaia, N V

    1989-06-01

    The authors describe the endonasopalpebral reflex which is evoked from the nasal mucosa. Reduction of this reflex may be used as a fine index of involvement of the trigeminus in patients with acoustic neuromas. This makes it possible to differentiate this tumour at early stages of its development from neuritis of the acoustic nerve. This is of great importance for this pathological situation. PMID:2781776

  13. Reflex operculoinsular seizures.

    PubMed

    Xiao, Handsun; Tran, Thi Phuoc Yen; Pétrin, Myriam; Boucher, Olivier; Mohamed, Ismail; Bouthillier, Alain; Nguyen, Dang Khoa

    2016-03-01

    Activation of specific cortical territories by certain stimuli is known to trigger focal seizures. We report three cases of well documented operculo-insular reflex seizures, triggered by somatosensory stimuli in two and loud noises in the third. Limited operculoinsular resection resulted in an excellent outcome for all. We discuss these observations in regard to the literature on reflex epilepsy and known functions of the insula. [Published with video sequences online]. PMID:26892245

  14. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  15. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  16. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  17. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  18. 29 CFR 4219.11 - Withdrawal liability upon mass withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Withdrawal liability upon mass withdrawal. 4219.11 Section... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.11 Withdrawal liability upon mass withdrawal. (a) Initial withdrawal liability. The plan sponsor of a multiemployer plan that experiences a...

  19. Corneomandibular reflex: Anatomical basis

    PubMed Central

    Pistacchi, Michele; Gioulis, Manuela; Mazzon, Davide; Marsala, Sandro Zambito

    2015-01-01

    Corneomandibular reflex is a pathological phenomenon evident in cases of severe brainstem damage. It is considered to be a pathological exteroceptive reflex, associated with precentro bulbar tract lesions. The sign is useful in distinguishing central neurological injuries to metabolic disorders in acutely comatose patients, localizing lesions to the upper brainstem area, determining the depth of coma and its evolution, providing evidence of uncal or transtentorial herniation in acute cerebral hemisphere lesions, and it is a marker of supraspinal level impairment in amyotrophic lateral sclerosis and multiple sclerosis. This sign was evident in a patient with severe brain damage. We discuss the literature findings and its relevance in prognosis establishment. PMID:26752910

  20. Experimenting With Baroreceptor Reflexes

    NASA Technical Reports Server (NTRS)

    Eckberg, Dwain L.; Goble, Ross L.

    1988-01-01

    Carotid arteries stimulated by pressure or suction on neck. Baro-Cuff is silicone-rubber chamber that fits on front of subject's neck. Electronic system, stepping motor, bellows, and umbilical tube furnish controlled pressure to chamber. Pressure sensor provides feedback to microprocessor in electronic system. Developed to study blood-pressure-reflex responses of astronauts in outer space. Useful for terrestrial studies of patients with congestive heart failure, chronic diabetes mellitus, and other conditions in which blood-pressure-reflex controls behave abnormally.

  1. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Resources Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis ... aortic aneurysm treated? What is an abdominal aortic aneurysm? The aorta, the largest artery in the body, ...

  2. Abdominal CT scan

    MedlinePlus

    ... results may also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal ... Livingstone; 2014:chap 4. Read More Abdominal aortic aneurysm Abdominal aortic aneurysm repair - open Abscess Acute cholecystitis ...

  3. Reflexivity in Pigeons

    ERIC Educational Resources Information Center

    Sweeney, Mary M.; Urcuioli, Peter J.

    2010-01-01

    A recent theory of pigeons' equivalence-class formation (Urcuioli, 2008) predicts that reflexivity, an untrained ability to match a stimulus to itself, should be observed after training on two "mirror-image" symbolic successive matching tasks plus identity successive matching using some of the symbolic matching stimuli. One group of pigeons was…

  4. Heart rate variability during abdominal surgical manipulation under general and epidural anesthesia.

    PubMed

    Hirata, Naoyuki; Miyashita, Ryo; Maruyama, Daisuke; Kawaguchi, Ryoichi; Shimizu, Hitoshi; Yamakage, Michiaki

    2012-12-01

    Anesthesiologists occasionally encounter bradycardia during abdominal surgery and recognize the phenomenon as a vagal reflex. The presence of bradycardia implies efferent vagal dominance in the autonomic nervous system during this vagal reflex. In this study, we investigated the effect of abdominal surgical manipulation on autonomic nervous activity, using heart rate variability analysis. Abdominal surgical manipulation decreased the heart rate and enhanced not only the high-frequency power (0.15-0.4 Hz) but also the low-frequency power (0.04-0.15 Hz) calculated from the power spectral density of heart rate variability. Our results suggest that both vagal tone and sympathetic tone could be activated during the vagal reflex caused by abdominal surgical manipulation. PMID:22718015

  5. Mentalis muscle related reflexes.

    PubMed

    Gündüz, Ayşegül; Uyanık, Özlem; Ertürk, Özdem; Sohtaoğlu, Melis; Kızıltan, Meral Erdemir

    2016-05-01

    The mentalis muscle (MM) arises from the incisive fossa of the mandible, raises and protrudes the lower lip. Here, we aim to characterize responses obtained from MM by supraorbital and median electrical as well as auditory stimuli in a group of 16 healthy volunteers who did not have clinical palmomental reflex. Reflex activities were recorded from the MM and orbicularis oculi (O.oc) after supraorbital and median electrical as well as auditory stimuli. Response rates over MM were consistent after each stimulus, however, mean latencies of MM response were longer than O.oc responses by all stimulation modalities. Shapes and amplitudes of responses from O.oc and MM were similar. Based on our findings, we may say that MM motoneurons have connections with trigeminal, vestibulocochlear and lemniscal pathways similar to other facial muscles and electrophysiological recording of MM responses after electrical and auditory stimulation is possible in healthy subjects. PMID:26721248

  6. Corporeal reflexivity and autism.

    PubMed

    Ochs, Elinor

    2015-06-01

    Ethnographic video recordings of high functioning children with autism or Aspergers Syndrome in everyday social encounters evidence their first person perspectives. High quality visual and audio data allow detailed analysis of children's bodies and talk as loci of reflexivity. Corporeal reflexivity involves displays of awareness of one's body as an experiencing subject and a physical object accessible to the gaze of others. Gaze, demeanor, actions, and sotto voce commentaries on unfolding situations indicate a range of moment-by-moment reflexive responses to social situations. Autism is associated with neurologically based motor problems (e.g. delayed action-goal coordination, clumsiness) and highly repetitive movements to self-soothe. These behaviors can provoke derision among classmates at school. Focusing on a 9-year-old girl's encounters with peers on the playground, this study documents precisely how autistic children can become enmeshed as unwitting objects of stigma and how they reflect upon their social rejection as it transpires. Children with autism spectrum disorders in laboratory settings manifest diminished understandings of social emotions such as embarrassment, as part of a more general impairment in social perspective-taking. Video ethnography, however, takes us further, into discovering autistic children's subjective sense of vulnerability to the gaze of classmates. PMID:25939529

  7. Primary sensory neurones and naloxone-precipitated morphine withdrawal.

    PubMed Central

    Donnerer, J.

    1989-01-01

    1. The C-fibre-evoked depressor reflex following i.a. injection of capsaicin and the wiping movements following chemical irritation of the cornea by capsaicin were both found to be augmented in the naloxone-precipitated morphine withdrawal phase. 2. The in vitro capsaicin-evoked release of substance P from central terminals of C-fibre afferents in the spinal cord was decreased in morphine-treated rats. Following naloxone, the release in the morphine-treated group was as large as in the control group. 3. The C-fibre mediated plasma extravasation in the rat paw after naloxone was found to be the same in morphine-treated and control rats. 4. It is concluded that C-fibre-evoked reflex reactions are augmented during morphine withdrawal, but that the mechanisms responsible are either located postsynaptically to the primary sensory neurone or further centrally. PMID:2472843

  8. Affective and Neuroendocrine Effects of Withdrawal from Chronic, Long-Acting Opiate Administration

    PubMed Central

    Hamilton, Kathryn L.; Harris, Andrew C.; Gewirtz, Jonathan C.

    2013-01-01

    Although the long-acting opiate methadone is commonly used to treat drug addiction, relatively little is known about effects of withdrawal from this drug in preclinical models. The current study examined affective, neuroendocrine, and somatic signs of withdrawal from the longer-acting methadone derivative l-alpha-acetylmethydol (LAAM) in rats. Anxiety-like behavior during both spontaneous and antagonist-precipitated withdrawal was measured by potentiation of the startle reflex. Withdrawal elevated corticosterone and somatic signs and blunted circadian variations in baseline startle responding. In addition, fear to an explicit, Pavlovian conditioned stimulus (fear-potentiated startle) was enhanced. These data suggest that anxiety-like behavior as measured using potentiated startle responding does not emerge spontaneously during withdrawal from chronic opiate exposure – in contrast to withdrawal from acute drug exposure – but rather is manifested as exaggerated fear in response to explicit threat cues. PMID:24076207

  9. Withdrawal strategies for outpatients

    PubMed Central

    Mezciems, Edgar

    1996-01-01

    This article discusses outpatient withdrawal strategies for patients addicted to alcohol, benzodiazepines, barbiturates, and opiates and describes some practical ways to support recovery. PMID:8828877

  10. [Laryngeal and larynx-associated reflexes].

    PubMed

    Ptok, M; Kühn, D; Miller, S; Jungheim, M; Schroeter, S

    2016-06-01

    The laryngeal adductor reflex and the pharyngoglottal closure reflex protect the trachea and lower respiratory tract against the entrance of foreign material. The laryngeal expiration reflex and the cough reflex serve to propel foreign material, which has penetrated in the cranial direction. The inspiration reflex, the sniff reflex, and the swallowing reflex are further larynx-associated reflexes. In patients with dysphagia the laryngeal adductor reflex can be clinically tested with air pulses. The water swallow test serves to show the integrity of the cough reflex. The sniff reflex is useful to test the abduction function of the vocal folds. Future studies should address laryngeal reflexes more specifically, both for a better understanding of these life-supporting mechanisms and to improve diagnostic procedures in patients with impaired laryngeal function. PMID:27240793

  11. Patterning of somatosympathetic reflexes

    NASA Technical Reports Server (NTRS)

    Kerman, I. A.; Yates, B. J.

    1999-01-01

    In a previous study, we reported that vestibular nerve stimulation in the cat elicits a specific pattern of sympathetic nerve activation, such that responses are particularly large in the renal nerve. This patterning of vestibulosympathetic reflexes was the same in anesthetized and decerebrate preparations. In the present study, we report that inputs from skin and muscle also elicit a specific patterning of sympathetic outflow, which is distinct from that produced by vestibular stimulation. Renal, superior mesenteric, and lumbar colonic nerves respond most strongly to forelimb and hindlimb nerve stimulation (approximately 60% of maximal nerve activation), whereas external carotid and hypogastric nerves were least sensitive to these inputs (approximately 20% of maximal nerve activation). In contrast to vestibulosympathetic reflexes, the expression of responses to skin and muscle afferent activation differs in decerebrate and anesthetized animals. In baroreceptor-intact animals, somatosympathetic responses were strongly attenuated (to <20% of control in every nerve) by increasing blood pressure levels to >150 mmHg. These findings demonstrate that different types of somatic inputs elicit specific patterns of sympathetic nerve activation, presumably generated through distinct neural circuits.

  12. Freshwater withdrawals in Texas, 1985

    USGS Publications Warehouse

    Lurry, Dee L.; Barber, Nancy L.

    1990-01-01

    Freshwater withdrawal data was compiled for the 254 counties in Texas for 1985. Major categories of withdrawal are presented by county on maps of the State. Withdrawals are also shown by source, aquifer, and major river basin. Total freshwater withdrawals in Texas during 1985 were about 20, 100 million gal/day. Surface-water withdrawals were about 12,900 million gal/day or 64% of the total, and groundwater withdrawals were about 7,190 million gal/day or 36% of the total. More water was withdrawn for irrigation than for any other purpose, accounting for 40% of total freshwater withdrawals and for 75% of groundwater withdrawals. (USGS)

  13. Abdominal aortic aneurysm

    MedlinePlus

    ... to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ... blood pressure Male gender Genetic factors An abdominal aortic aneurysm is most often seen in males over age ...

  14. Abdominal x-ray

    MedlinePlus

    ... More Abdominal aortic aneurysm Abdominal pain Acute cholecystitis Acute kidney failure Addison disease Adenomyosis Annular pancreas Aplastic anemia Appendicitis Ascariasis Atheroembolic renal disease Biliary atresia Blind loop syndrome Cholangitis Chronic ...

  15. [Clozapine withdrawal. A review].

    PubMed

    Szafrański, T; Gmurkowski, K

    1999-01-01

    The article describes the symptoms of withdrawal of clozapine and their possible causes as well as research on switching from clozapine to another antipsychotic drug. A computerised search was conducted using MEDLINE (1966-1997) to retrieve reports of clozapine withdrawal. Fifteen case reports and sixteen withdrawal studies (only one of them double-blind and two single-blind) were identified. Clozapine multi-receptors profile seems to be responsible for withdrawal symptoms--several specific mechanisms are suggested: cholinergic supersensitivity, dopaminergic supersensivity, special role of D4 receptors, possibilities of serotonergic, noradrenergic and GABA-ergic involvement. Risk of relapse after withdrawal of clozapine seems to be greater than after withdrawal of classical neuroleptics. Some patients might become de novo neuroleptic resistant for at least several weeks after withdrawal. Therefore, clozapine should be stopped only due to strong clinical indications, and if only possible, the withdrawal should be slow (50 mg/week). To prevent relapse of psychosis some experts advocate starting new antipsychotic drugs in therapeutic dosage before withdrawal of clozapine is completed. In case of emergency, when clozapine (high dosage) must be withdrawn immediately, patient must be hospitalised and cholinergics might be considered to prevent, cholinergic rebound". There are no established guidelines which antipsychotic to choose after withdrawal of clozapine. In general, classical antipsychotics are ineffective. Thioridazine is suggested because of its prominent anticholinergic activity, but there is no clinical evidence of advantage of this treatment in comparison to classical drugs. Risperidon and especially olanzapine are promising possibilities, but initial data are disappointing. Benzamides might be another possibility but clinical data are scarce. These important issues require further studies. PMID:10786215

  16. Brain lesions affect penile reflexes.

    PubMed

    Monaghan, E P; Arjomand, J; Breedlove, S M

    1993-03-01

    Electrolytic lesions of several potential brain afferents to the spinal nucleus of the bulbocavernosus (SNB) affect the display of penile reflexes. Ablation of the median and pontine raphe areas significantly potentiates the expression of cups and flips. Animals with a bilateral lesion of the paraventricular nucleus of the hypothalamus have a shorter latency to the first erection but otherwise display normal reflex behavior. Although bilateral destruction of the lateral vestibular nucleus (LVN) completely eliminated penile reflex activity, it also caused significant motor impairment thus clouding conclusions concerning the normal role of the LVN in penile reflex behavior. These and other results support the hypothesis that these brain regions which project to the SNB region normally modulate spinal reflex behavior of the rat penis. PMID:8440513

  17. [Reflex seizures, cinema and television].

    PubMed

    Olivares-Romero, Jesús

    2015-12-16

    In movies and television series are few references to seizures or reflex epilepsy even though in real life are an important subgroup of total epileptic syndromes. It has performed a search on the topic, identified 25 films in which they appear reflex seizures. Most seizures observed are tonic-clonic and visual stimuli are the most numerous, corresponding all with flashing lights. The emotions are the main stimuli in higher level processes. In most cases it is not possible to know if a character suffers a reflex epilepsy or suffer reflex seizures in the context of another epileptic syndrome. The main conclusion is that, in the movies, the reflex seizures are merely a visual reinforcing and anecdotal element without significant influence on the plot. PMID:26662874

  18. Abdominal Compartment Hypertension and Abdominal Compartment Syndrome.

    PubMed

    Maluso, Patrick; Olson, Jody; Sarani, Babak

    2016-04-01

    Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare but potentially morbid diagnoses. Clinical index of suspicion for these disorders should be raised following massive resuscitation, abdominal wall reconstruction/injury, and in those with space-occupying disorders in the abdomen. Gold standard for diagnosis involves measurement of bladder pressure, with a pressure greater than 12 mm Hg being consistent with IAH and greater than 25 mm Hg being consistent with ACS. Decompressive laparotomy is definitive therapy but paracentesis can be equally therapeutic in properly selected patients. Left untreated, ACS can lead to multisystem organ failure and death. PMID:27016163

  19. Abdominal Circulatory Interactions.

    PubMed

    Dagar, Gaurav; Taneja, Amit; Nanchal, Rahul S

    2016-04-01

    The abdominal compartment is separated from the thoracic compartment by the diaphragm. Under normal circumstances, a large portion of the venous return crosses the splanchnic and nonsplanchnic abdominal regions before entering the thorax and the right side of the heart. Mechanical ventilation may affect abdominal venous return independent of its interactions at the thoracic level. Changes in pressure in the intra-abdominal compartment may have important implications for organ function within the thorax, particularly if there is a sustained rise in intra-abdominal pressure. It is important to understand the consequences of abdominal pressure changes on respiratory and circulatory physiology. This article elucidates important abdominal-respiratory-circulatory interactions and their clinical effects. PMID:27016167

  20. [Reflexes, instincts, emotions and passions].

    PubMed

    Sánchez, Alberto Portera

    2008-01-01

    In animals of the same species, the reflexes, having evolved similarly, in a few milliseconds, automatically activate the corresponding reflex arch and without the intervention of the animal generate the adequate response: medullary, mesencephalic or trans-hemispheric. These neurophysiological functions have allowed the animals to be free from predators and increasy their longevity and, as a consequence, the appearance of numerous species during millions of years. A further step in the reflexes evolution, the instincts emerged and their activity, a result of neuro-hormonal functions, stimulates the male's sexual appetite when the females are receptive for their copulation and fecundation. PMID:18924359

  1. Withdrawing Nutrition, Hydration

    Cancer.gov

    Module eleven of the EPEC-O Self-Study Original Version discusses the general aspects of withholding or withdrawing of life-sustaining therapies, and presents a specific application to artificial nutrition and hydration.

  2. The vestibulosympathetic reflex in humans: neural interactions between cardiovascular reflexes

    NASA Technical Reports Server (NTRS)

    Ray, Chester A.; Monahan, Kevin D.

    2002-01-01

    1. Over the past 5 years, there has been emerging evidence that the vestibular system regulates sympathetic nerve activity in humans. We have studied this issue in humans by using head-down rotation (HDR) in the prone position. 2. These studies have clearly demonstrated increases in muscle sympathetic nerve activity (MSNA) and calf vascular resistance during HDR. These responses are mediated by engagement of the otolith organs and not the semicircular canals. 3. However, differential activation of sympathetic nerve activity has been observed during HDR. Unlike MSNA, skin sympathetic nerve activity does not increase with HDR. 4. Examination of the vestibulosympathetic reflex with other cardiovascular reflexes (i.e. barorereflexes and skeletal muscle reflexes) has shown an additive interaction for MSNA. 5. The additive interaction between the baroreflexes and vestibulosympathetic reflex suggests that the vestibular system may assist in defending against orthostatic challenges in humans by elevating MSNA beyond that of the baroreflexes. 6. In addition, the further increase in MSNA via otolith stimulation during isometric handgrip, when arterial pressure is elevated markedly, indicates that the vestibulosympathetic reflex is a powerful activator of MSNA and may contribute to blood pressure and flow regulation during dynamic exercise. 7. Future studies will help evaluate the importance of the vestibulosympathetic reflex in clinical conditions associated with orthostatic hypotension.

  3. Soleus stretch reflex during cycling.

    PubMed

    Grey, M J; Pierce, C W; Milner, T E; Sinkjaer, T

    2001-01-01

    The modulation and strength of the human soleus short latency stretch reflex was investigated by mechanically perturbing the ankle during an unconstrained pedaling task. Eight subjects pedaled at 60 rpm against a preload of 10 Nm. A torque pulse was applied to the crank at various positions during the crank cycle, producing ankle dorsiflexion perturbations of similar trajectory. The stretch reflex was greatest during the power phase of the crank cycle and was decreased to the level of background EMG during recovery. Matched perturbations were induced under static conditions at the same crank angle and background soleus EMG as recorded during the power phase of active pedaling. The magnitude of the stretch reflex was not statistically different from that during the static condition throughout the power phase of the movement. The results of this study indicate that the stretch reflex is not depressed during active cycling as has been shown with the H-reflex. This lack of depression may reflect a decreased susceptibility of the stretch reflex to inhibition, possibly originating from presynaptic mechanisms. PMID:11232549

  4. Vestibulo-spinal reflex mechanisms

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.

    1981-01-01

    The specific objectives of experiments designed to investigate postural reflex behavior during sustained weightlessness are discussed. The first is to investigate, during prolonged weightlessness with Hoffmann response (H-reflex) measurement procedures, vestibulo-spinal reflexes associated with vestibular (otolith) responses evoked during an applied linear acceleration. This objective includes not only an evaluation of otolith-induced changes in a major postural muscle but also an investigation with this technique of the adaptive process of the vestibular system and spinal reflex mechanisms to this unique environment. The second objective is to relate space motion sickness to the results of this investigation. Finally, a return to the vestibulo-spinal and postural reflexes to normal values following the flight will be examined. The flight experiment involves activation of nerve tissue (tibial N) with electrical shock and the recording of resulting muscle activity (soleus) with surface electrodes. Soleus/spinal H-reflex testing procedures will be used in conjuction with linear acceleration through the subject's X-axis.

  5. [Reflex sympathetic dystrophy].

    PubMed

    Oliveira, Marta; Manuela, Manuela; Cantinho, Guilhermina

    2011-01-01

    Reflex Sympathetic Dystrophy is rare in pediatrics. It is a complex regional pain syndrome, of unknown etiology, usually post-traumatic, characterized by dysfunctions of the musculoskeletal, vascular and skin systems: severe persistent pain of a limb, sensory and vascular alterations, associated disability and psychosocial dysfunction. The diagnosis is based in high clinical suspection. In children and adolescents there are aspects that are different from the adult ones. Excessive tests may result in worsening of the clinical symptoms. Bone scintigraphy can help. Pain treatment is difficult, not specific. Physical therapies and relaxation technics give some relief. Depression must be treated. This syndrome includes fibromyalgia and complex regional pain syndrome type I. We present a clinical report of an adolescent girl, referred for pain, cold temperature, pallor and functional disability of an inferior limb, all signals disclosed by a minor trauma. She had been diagnosed depression the year before. The bone scintigraphy was a decisive test. The treatment with gabapentin, C vitamin, physiotherapy and pshycotherapy has been effective. PMID:22713207

  6. Abdominal CT scan

    MedlinePlus

    ... tumors, including cancer Infections or injury Kidney stones Appendicitis ... also be due to: Abdominal aortic aneurysm Abscesses Appendicitis Bowel wall thickening Retroperitoneal fibrosis Renal artery stenosis ...

  7. Abdominal aortic aneurysm.

    PubMed

    Keisler, Brian; Carter, Chuck

    2015-04-15

    Abdominal aortic aneurysm refers to abdominal aortic dilation of 3.0 cm or greater. The main risk factors are age older than 65 years, male sex, and smoking history. Other risk factors include a family history of abdominal aortic aneurysm, coronary artery disease, hypertension, peripheral artery disease, and previous myocardial infarction. Diagnosis may be made by physical examination, an incidental finding on imaging, or ultrasonography. The U.S. Preventive Services Task Force released updated recommendations for abdominal aortic aneurysm screening in 2014. Men 65 to 75 years of age with a history of smoking should undergo one-time screening with ultrasonography based on evidence that screening will improve abdominal aortic aneurysm-related mortality in this population. Men in this age group without a history of smoking may benefit if they have other risk factors (e.g., family history of abdominal aortic aneurysm, other vascular aneurysms, coronary artery disease). There is inconclusive evidence to recommend screening for abdominal aortic aneurysm in women 65 to 75 years of age with a smoking history. Women without a smoking history should not undergo screening because the harms likely outweigh the benefits. Persons who have a stable abdominal aortic aneurysm should undergo regular surveillance or operative intervention depending on aneurysm size. Surgical intervention by open or endovascular repair is the primary option and is typically reserved for aneurysms 5.5 cm in diameter or greater. There are limited options for medical treatment beyond risk factor modification. Ruptured abdominal aortic aneurysm is a medical emergency presenting with hypotension, shooting abdominal or back pain, and a pulsatile abdominal mass. It is associated with high prehospitalization mortality. Emergent surgical intervention is indicated for a rupture but has a high operative mortality rate. PMID:25884861

  8. Inpatient alcohol withdrawal syndrome.

    PubMed

    Monte-Secades, R; Rabuñal-Rey, R; Guerrero-Sande, H

    2015-03-01

    A 55-year-old man was admitted for a femur fracture; an alcohol fetor was noted on admission. The following day, the patient began to experience tremors and nervousness. Intravenous haloperidol was administered. Shortly afterwards, the patient experienced two generalized seizures and then began to experience delirium and uncontrollable agitation. The patient was diagnosed with alcohol withdrawal syndrome; high doses of intravenous midazolam were prescribed and infused. A few hours later, the patient presented signs of respiratory depression, requiring a transfer to the intensive care unit. After a review of the medical history, it was determined that the patient had been admitted on 3 previous occasions due to alcohol withdrawal and had progressed to delirium tremens after experiencing seizures. Can the risk of alcohol withdrawal syndrome and the need for prophylactic treatment be assessed on admission? Were appropriate monitoring and treatment measures employed? Would it have been possible to change his outcome? PMID:25559647

  9. [Abdominal pregnancy, institutional experience].

    PubMed

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy. PMID:9737070

  10. Recurrent Abdominal Pain

    ERIC Educational Resources Information Center

    Banez, Gerard A.; Gallagher, Heather M.

    2006-01-01

    The purpose of this article is to provide an empirically informed but clinically oriented overview of behavioral treatment of recurrent abdominal pain. The epidemiology and scope of recurrent abdominal pain are presented. Referral process and procedures are discussed, and standardized approaches to assessment are summarized. Treatment protocols…

  11. The alcohol withdrawal syndrome.

    PubMed

    McKeon, A; Frye, M A; Delanty, Norman

    2008-08-01

    The alcohol withdrawal syndrome (AWS) is a common management problem in hospital practice for neurologists, psychiatrists and general physicians alike. Although some patients have mild symptoms and may even be managed in the outpatient setting, others have more severe symptoms or a history of adverse outcomes that requires close inpatient supervision and benzodiazepine therapy. Many patients with AWS have multiple management issues (withdrawal symptoms, delirium tremens, the Wernicke-Korsakoff syndrome, seizures, depression, polysubstance abuse, electrolyte disturbances and liver disease), which requires a coordinated, multidisciplinary approach. Although AWS may be complex, careful evaluation and available treatments should ensure safe detoxification for most patients. PMID:17986499

  12. A new objective method for acquisition and quantification of reflex receptive fields.

    PubMed

    Jensen, Michael Brun; Manresa, José Biurrun; Andersen, Ole Kæseler

    2015-03-01

    The nociceptive withdrawal reflex (NWR) is a polysynaptic spinal reflex correlated with pain perception. Assessment of this objective physiological measure constitutes the core of existing methods for quantification of reflex receptive fields (RRFs), which however still suffer from a certain degree of subjective involvement. This article proposes a strictly objective methodology for RRF quantification based on automated identification of NWR thresholds (NWR-Ts). Nociceptive withdrawal reflex thresholds were determined for 10 individual stimulation sites using an interleaved up-down staircase method. Reflexes were detected from electromyography by evaluation of interval peak z scores and application of conduction velocity analysis. Reflex receptive field areas were quantified from interpolated mappings of NWR-Ts and compared with existing RRF quantifications. A total of 3 repeated measures were performed in 2 different sessions to evaluate the test-retest reliability of the various quantifications, using coefficients of repeatability (CRs) and hypothetical sample sizes. The novel quantifications based on identification of NWR-Ts showed a similar level of reliability within and between sessions, whereas existing quantifications all demonstrated worse between-session than within-session reliability. The NWR-T-based quantifications required a smaller sample size than any of the existing RRF measures to detect a clinically relevant effect in a crossover study design involving more than 1 session. Of all measures, quantification from mapping of inversed NWR-Ts demonstrated superior reliability both within (CR, 0.25) and between sessions (CR, 0.28). The study presents a more reliable and robust quantification of the RRF to be used as biomarker of pain hypersensitivity in clinical and experimental research. PMID:25599237

  13. Alcohol Abuse: Alcohol Withdrawal Syndrome

    MedlinePlus

    ... they quit drinking. What are the symptoms of alcohol withdrawal syndrome? Symptoms can be mild or severe, and may include: Shakiness Sweats Anxiety Irritability Fatigue Depression Headaches Insomnia Nightmares Decreased appetite More severe withdrawal symptoms ...

  14. Asthma as an axon reflex.

    PubMed

    Barnes, P J

    1986-02-01

    In asthma, damage to airway epithelium, possibly caused by eosinophil products, exposes C-fibre afferent nerve endings. Stimulation of these endings by inflammatory mediators such as bradykinin may result in an axon (local) reflex with antidromic conduction down afferent nerve collaterals and release of sensory neuropeptides such as substance P, neurokinin A, and calcitonin gene-related peptide. These peptides are potent inducers of airway smooth muscle contraction, bronchial oedema, extravasation of plasma, mucus hypersecretion, and possibly inflammatory cell infiltration and secretion. Thus, axon reflexes could account for at least some of the pathophysiology of asthma and this concept might lead to new strategies for treatment. PMID:2418322

  15. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X- ... use high frequency sound waves to produce an image and do not expose the individual to radiation. ...

  16. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  17. Abdominal exploration - series (image)

    MedlinePlus

    ... surgical exploration of the abdomen, also called an exploratory laparotomy, may be recommended when there is abdominal ... blunt trauma"). Diseases that may be discovered by exploratory laparotomy include: inflammation of the appendix (acute appendicitis) ...

  18. Abdominal aortic aneurysm

    MedlinePlus

    ... main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs ... dissection). Symptoms of rupture include: Pain in the abdomen or back. The pain may be severe, sudden, ...

  19. Abdominal x-ray

    MedlinePlus

    An abdominal x-ray is an imaging test to look at organs and structures in the abdomen. Organs include the spleen, stomach, and intestines. When the test is done to look at the bladder and kidney structures, ...

  20. Abdominal aortic aneurysm.

    PubMed

    Setacci, Francesco; Galzerano, Giuseppe; De Donato, Gianmarco; Benevento, Domenico; Guerrieri, Massimiliano W; Ruzzi, Umberto; Borrelli, Maria P; Setacci, Carlo

    2016-02-01

    Endovascular repair of abdominal aortic aneurysms has become a milestone in the treatment of patients with abdominal aortic aneurysm. Technological improvement allows treatment in more and more complex cases. This review summarizes all grafts available on the market. A complete review of most important trial on this topic is provided to the best of our knowledge, and technical tips and tricks for standard cases are also included. PMID:26771730

  1. Social Withdrawal in Childhood

    PubMed Central

    Rubin, Kenneth H.; Coplan, Robert J.; Bowker, Julie C.

    2013-01-01

    Socially withdrawn children frequently refrain from social activities in the presence of peers. The lack of social interaction in childhood may result from a variety of causes, including social fear and anxiety or a preference for solitude. From early childhood through to adolescence, socially withdrawn children are concurrently and predictively at risk for a wide range of negative adjustment outcomes, including socio-emotional difficulties (e.g., anxiety, low self-esteem, depressive symptoms, and internalizing problems), peer difficulties (e.g., rejection, victimization, poor friendship quality), and school difficulties (e.g., poor-quality teacher-child relationships, academic difficulties, school avoidance). The goals of the current review are to (a) provide some definitional, theoretical, and methodological clarity to the complex array of terms and constructs previously employed in the study of social withdrawal; (b) examine the predictors, correlates, and consequences of child and early-adolescent social withdrawal; and (c) present a developmental framework describing pathways to and from social withdrawal in childhood. PMID:18851686

  2. Social withdrawal in childhood.

    PubMed

    Rubin, Kenneth H; Coplan, Robert J; Bowker, Julie C

    2009-01-01

    Socially withdrawn children frequently refrain from social activities in the presence of peers. The lack of social interaction in childhood may result from a variety of causes, including social fear and anxiety or a preference for solitude. From early childhood through to adolescence, socially withdrawn children are concurrently and predictively at risk for a wide range of negative adjustment outcomes, including socio-emotional difficulties (e.g., anxiety, low self-esteem, depressive symptoms, and internalizing problems), peer difficulties (e.g., rejection, victimization, poor friendship quality), and school difficulties (e.g., poor-quality teacher-child relationships, academic difficulties, school avoidance). The goals of the current review are to (a) provide some definitional, theoretical, and methodological clarity to the complex array of terms and constructs previously employed in the study of social withdrawal; (b) examine the predictors, correlates, and consequences of child and early-adolescent social withdrawal; and (c) present a developmental framework describing pathways to and from social withdrawal in childhood. PMID:18851686

  3. Transitions in viscous withdrawal

    NASA Astrophysics Data System (ADS)

    Zhang, Wendy W.

    2008-11-01

    A process analogous to flow-focusing occurs in extended and stably stratified layers of immiscible, viscous liquids. In viscous withdrawal, an axisymmetric converging flow is imposed in the upper layer. When the upper layer flow is weak, the interface forms a hump. No liquid from the lower layer is entrained. When the upper layer flow is strong, liquid from the lower layer is entrained and the interface becomes a spout. Here I summarize recent results on the fundamental mechanisms controlling these regimes. For selective withdrawal, a clear picture has emerged, with good agreement between theory, simulation and experiment. The regime ends when the viscous stress exerted by the upper layer flow overcomes surface tension, creating a saddle-node bifurcation in the hump solution. Less is understood about viscous entrainment. A long-wavelength model including only local information is degenerate, possessing many solutions for the same withdrawal condition. Including information about the global geometry removes this degeneracy but also makes the surprising prediction that global geometry can change the nature of the transition. First-order, weakly first-order or continuous transitions are all possible. How these results relate to the variety of experimental phenomena, such as stable, micron-sized spouts, intricate patterns of hysteresis and multiple stable spout states under the same condition, is at present unclear. (Includes material from joint works with Blanchette, Cohen, Kleine Berkenbusch, and Schmidt.)

  4. Toward reflexive climate adaptation research

    DOE PAGESBeta

    Preston, Benjamin L.; Rickards, Lauren; Fünfgeld, Hartmut; Keenan, Rodney J.

    2015-06-22

    Climate adaptation research is expanding very quickly within an increasingly reflexive society where the relationship between academia and other social institutions is in a state of flux. Tensions exist between the two dominant research orientations of research about and research for adaptation. In particular, the research community is challenged to develop processes for successfully executing transdisciplinary research for adaptation when academic institutions and researchers are largely structured around traditional, disciplinary expertise and funding models. One tool for helping to manage this tension is a third, more reflexive, orientation toward adaptation research that is emerging in the literature. Finally, this newmore » ‘research on adaptation research’ promises to help enhance understanding of the research enterprise itself and how it can become more adaptive.« less

  5. Toward reflexive climate adaptation research

    SciTech Connect

    Preston, Benjamin L.; Rickards, Lauren; Fünfgeld, Hartmut; Keenan, Rodney J.

    2015-06-22

    Climate adaptation research is expanding very quickly within an increasingly reflexive society where the relationship between academia and other social institutions is in a state of flux. Tensions exist between the two dominant research orientations of research about and research for adaptation. In particular, the research community is challenged to develop processes for successfully executing transdisciplinary research for adaptation when academic institutions and researchers are largely structured around traditional, disciplinary expertise and funding models. One tool for helping to manage this tension is a third, more reflexive, orientation toward adaptation research that is emerging in the literature. Finally, this new ‘research on adaptation research’ promises to help enhance understanding of the research enterprise itself and how it can become more adaptive.

  6. Vestibular reflexes of otolith origin

    NASA Technical Reports Server (NTRS)

    Wilson, Victor J.

    1988-01-01

    The vestibular system and its role in the maintenance of posture and in motion sickness is investigated using cats as experimental subjects. The assumption is that better understanding of the physiology of vestibular pathways is not only of intrinsic value, but will help to explain and eventually alleviate the disturbances caused by vestibular malfunction, or by exposure to an unusual environment such as space. The first project deals with the influence on the spinal cord of stimulation of the vestibular labyrinth, particularly the otoliths. A second was concerned with the properties and neural basis of the tonic neck reflex. These two projects are related, because vestibulospinal and tonic neck reflexes interact in the maintenance of normal posture. The third project began with an interest in mechanisms of motion sickness, and eventually shifted to a study of central control of respiratory muscles involved in vomiting.

  7. Human stretch reflex pathways reexamined

    PubMed Central

    Yavuz, Ş. Utku; Mrachacz-Kersting, Natalie; Sebik, Oğuz; Berna Ünver, M.; Farina, Dario

    2013-01-01

    Reflex responses of tibialis anterior motor units to stretch stimuli were investigated in human subjects. Three types of stretch stimuli were applied (tap-like, ramp-and-hold, and half-sine stretch). Stimulus-induced responses in single motor units were analyzed using the classical technique, which involved building average surface electromyogram (SEMG) and peristimulus time histograms (PSTH) from the discharge times of motor units and peristimulus frequencygrams (PSF) from the instantaneous discharge rates of single motor units. With the use of SEMG and PSTH, the tap-like stretch stimulus induced five separate reflex responses, on average. With the same single motor unit data, the PSF technique indicated that the tap stimulus induced only three reflex responses. Similar to the finding using the tap-like stretch stimuli, ramp-and-hold stimuli induced several peaks and troughs in the SEMG and PSTH. The PSF analyses displayed genuine increases in discharge rates underlying the peaks but not underlying the troughs. Half-sine stretch stimuli induced a long-lasting excitation followed by a long-lasting silent period in SEMG and PSTH. The increase in the discharge rate, however, lasted for the entire duration of the stimulus and continued during the silent period. The results are discussed in the light of the fact that the discharge rate of a motoneuron has a strong positive linear association with the effective synaptic current it receives and hence represents changes in the membrane potential more directly and accurately than the other indirect measures. This study suggests that the neuronal pathway of the human stretch reflex does not include inhibitory pathways. PMID:24225537

  8. Abdominal Dual Energy Imaging

    NASA Astrophysics Data System (ADS)

    Sommer, F. Graham; Brody, William R.; Cassel, Douglas M.; Macovski, Albert

    1981-11-01

    Dual energy scanned projection radiography of the abdomen has been performed using an experimental line-scanned radiographic system. Digital images simultaneously obtained at 85 and 135 kVp are combined, using photoelectric/Compton decomposition algorithms to create images from which selected materials are cancelled. Soft tissue cancellation images have proved most useful in various abdominal imaging applications, largely due to the elimination of obscuring high-contrast bowel gas shadows. These techniques have been successfully applied to intravenous pyelography, oral cholecystography, intravenous abdominal arteriog-raphy and the imaging of renal calculi.

  9. The Acute Abdominal Aorta.

    PubMed

    Mellnick, Vincent M; Heiken, Jay P

    2015-11-01

    Acute disorders of the abdominal aorta are potentially lethal conditions that require prompt evaluation and treatment. Computed tomography (CT) is the primary imaging method for evaluating these conditions because of its availability and speed. Volumetric CT acquisition with multiplanar reconstruction and three-dimensional analysis is now the standard technique for evaluating the aorta. MR imaging may be useful for select applications in stable patients in whom rupture has been excluded. Imaging is indispensable for diagnosis and treatment planning, because management has shifted toward endoluminal repair. Acute abdominal aortic conditions most commonly are complications of aneurysms and atherosclerosis. PMID:26526434

  10. Abdominal Vascular Catastrophes.

    PubMed

    Singh, Manpreet; Koyfman, Alex; Martinez, Joseph P

    2016-05-01

    Abdominal vascular catastrophes are among the most challenging and time sensitive for emergency practitioners to recognize. Mesenteric ischemia remains a highly lethal entity for which the history and physical examination can be misleading. Laboratory tests are often unhelpful, and appropriate imaging must be quickly obtained. A multidisciplinary approach is required to have a positive impact on mortality rates. Ruptured abdominal aortic aneurysm likewise may present in a cryptic fashion. A specific type of ruptured aneurysm, the aortoenteric fistula, often masquerades as the more common routine gastrointestinal bleed. The astute clinician recognizes that this is a more lethal variant of gastrointestinal hemorrhage. PMID:27133247

  11. Abdominal Aortic Aneurysms

    PubMed Central

    Fortner, George; Johansen, Kaj

    1984-01-01

    Aneurysms are common in our increasingly elderly population, and are a major threat to life and limb. Until the advent of vascular reconstructive techniques, aneurysm patients were subject to an overwhelming risk of death from exsanguination. The first successful repair of an abdominal aortic aneurysm using an interposed arterial homograft was reported by Dubost in 1952. A milestone in the evolution of vascular surgery, this event and subsequent diagnostic, operative and prosthetic graft refinements have permitted patients with an unruptured abdominal aortic aneurysm to enjoy a better prognosis than patients with almost any other form of major systemic illness. Images PMID:6702193

  12. Abdominal pain of spinal origin. Value of intercostal block.

    PubMed

    Ashby, E C

    1977-05-01

    A prospective study was made of 73 patients presenting in one year with abdominal pain provisionally diagnosed as of spinal origin. The criteria for audit of diagnosis and treatment are defined. The diagnosis was confirmed in 53 patients, 49 of whom had been treated with a lignocaine intercostal block in the relevant segment. Thirty-three of these (67.3%) had both complete and prolonged relief. It is suggested that the block causes interruption of a vicious circle of pain and muscle spasm in a 'spinal reflex pain syndrome'. PMID:860866

  13. [Reflexivity: a critical issue in qualitative research].

    PubMed

    de la Cuesta-Benjumea, Carmen

    2011-01-01

    Reflexivity is an English term that Spanish speaking people have to assign a technical meaning. Reflexivity expresses the conscience of researchers conscience and refers to their connection with the study's situation. It is a process by which researchers step back to critically exam the effect they have on the study and the impact of their interactions with participants. The reflexive process is embedded in all research levels and is present in all the research phases, from the research question to fieldwork, from data analysis to writing the final report. Nevertheless, the question is not so much to engage in reflective activities but to be a reflexive researcher. Reflexivity is a human ability that is present during social interactions. For this reason it is present in qualitative research. A self inquirer can be addressed as it is constructed by the relationships and interactions that are established with study participants. Reflexivity has an educational character that continues after the study is completed. PMID:21531602

  14. Abdominal Pain, Long-Term

    MedlinePlus

    MENU Return to Web version Abdominal Pain, Long-term See complete list of charts. Ongoing or recurrent abdominal pain, also called chronic pain, may be difficult to diagnose, causing frustration for ...

  15. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    Understanding Task Force Recommendations Screening for Abdominal Aortic Aneurysm The U.S. Preventive Services Task Force (Task Force) ... final recommendation statement on Screening for Abdominal Aortic Aneurysm. This final recommendation statement applies to adults ages ...

  16. Portraying Reflexivity in Health Services Research.

    PubMed

    Rae, John; Green, Bill

    2016-09-01

    A model is proposed for supporting reflexivity in qualitative health research, informed by arguments from Bourdieu and Finlay. Bourdieu refers to mastering the subjective relation to the object at three levels-the overall social space, the field of specialists, and the scholastic universe. The model overlays Bourdieu's levels of objectivation with Finlay's three stages of research (pre-research, data collection, and data analysis). The intersections of these two ways of considering reflexivity, displayed as cells of a matrix, pose questions and offer prompts to productively challenge health researchers' reflexivity. Portraiture is used to show how these challenges and prompts can facilitate such reflexivity, as illustrated in a research project. PMID:26935721

  17. Generalized versus partial reflex seizures: a review.

    PubMed

    Italiano, Domenico; Ferlazzo, Edoardo; Gasparini, Sara; Spina, Edoardo; Mondello, Stefania; Labate, Angelo; Gambardella, Antonio; Aguglia, Umberto

    2014-08-01

    In this review we assess our currently available knowledge about reflex seizures with special emphasis on the difference between "generalized" reflex seizures induced by visual stimuli, thinking, praxis and language tasks, and "focal" seizures induced by startle, eating, music, hot water, somatosensory stimuli and orgasm. We discuss in particular evidence from animal, clinical, neurophysiological and neuroimaging studies supporting the concept that "generalized" reflex seizures, usually occurring in the setting of IGE, should be considered as focal seizures with quick secondary generalization. We also review recent advances in genetic and therapeutic approach of reflex seizures. PMID:24766826

  18. Development of the Stretch Reflex in the Newborn: Reciprocal Excitation and Reflex Irradiation.

    ERIC Educational Resources Information Center

    Myklebust, Barbara M.; Gottlieb, Gerald L.

    1993-01-01

    When tendon jerk reflexes were tested in seven newborns from one- to three-days old, stretch reflex responses in all major muscle groups of the lower limb were elicited. This "irradiation of reflexes" is a normal phenomenon in newborns, with the pathway becoming suppressed during normal maturation. In individuals with cerebral palsy, however, the…

  19. Component separation in abdominal trauma.

    PubMed

    Rawstorne, Edward; Smart, Christopher J; Fallis, Simon A; Suggett, Nigel

    2014-01-01

    Component separation is established for complex hernia repairs. This case presents early component separation and release of the anterior and posterior sheath to facilitate closure of the abdominal wall following emergency laparotomy, reinforcing the repair with a biological mesh. On Day 11 following an emergency laparotomy for penetrating trauma, this patient underwent component separation and release of the anterior and posterior sheath. An intra-abdominal biological mesh was secured, and the fascia and skin closed successfully. Primary abdominal closure can be achieved in patients with penetrating abdominal trauma with the use of component separation and insertion of intra-abdominal biological mesh, where standard closure is not possible. PMID:24876334

  20. Reflexivity: Towards a Theory of Lifelong Learning.

    ERIC Educational Resources Information Center

    Edwards, Richard; Ranson, Stewart; Strain, Michael

    2002-01-01

    The current notion of lifelong learning in policy and practice is dominated by behaviorist, adaptive accumulation of skills and qualifications. An alternative is reflexive lifelong learning, developed through social learning networks within the context of dislocation and uncertainty. It involves the reflexive practices of metacognitive analysis…

  1. Creating a Complex Schedule with "REFLEX."

    ERIC Educational Resources Information Center

    Kren, George M.; Christakes, George

    1991-01-01

    Discusses "REFLEX," a software package for scheduling. Explores the program's applications in preparing a departmental class schedule. Explains that "REFLEX" includes a filter function and some attributes of a spreadsheet but lacks the ability to interact with other databases. Concludes that the program can make scheduling easier and more…

  2. Voluntary modulation of human stretch reflexes.

    PubMed

    Ludvig, Daniel; Cathers, Ian; Kearney, Robert E

    2007-11-01

    It has been postulated that the central nervous system (CNS) can tune the mechanical behavior of a joint by altering reflex stiffness in a task-dependant manner. However, most of the evidence supporting this hypothesis has come from the analysis of H-reflexes or electromyogram (EMG) responses. Changes in overall stiffness have been documented but, as yet, there is no direct evidence that the CNS can control reflex stiffness independently of the intrinsic stiffness. We have used a novel identification algorithm to estimate intrinsic and reflex stiffness and feed it back to subjects in real-time. Using this biofeedback, subjects could learn to control reflex stiffness independently of intrinsic stiffness. At low torque levels, subjects could vary their reflex stiffness gain by a factor of 4, while maintaining elastic stiffness and torque constant. EMG measurements confirmed that the contraction levels of the ankle muscles remained constant. Further experiments showed that subjects could change their reflexes rapidly on command. Thus, we conclude that the CNS can control reflex stiffness independently and so has great flexibility in adjusting the mechanical properties of a joint to meet functional requirements. PMID:17628793

  3. Abdominal pain related to mitochondrial neurogastrointestinal encephalomyopathy syndrome may benefit from splanchnic nerve blockade.

    PubMed

    Celebi, Nalan; Sahin, Altan; Canbay, Ozgür; Uzümcügil, Filiz; Aypar, Ulkü

    2006-10-01

    Patients diagnosed with abdominal pain related to mitochondrial neurogastrointestinal encephalopathy (MNGIE) may benefit from splanchnic nerve blockade. MNGIE, varying in age of onset and rate of progression, is caused by loss of function mutation in thymidine phosphorylase gene. Gastrointestinal dysmotility, pseudo-obstruction and demyelinating sensorimotor peripheral neuropathy (stocking-glove sensory loss, absent tendon reflexes, distal limb weakness, and wasting) are the most prominent manifestations. Patients usually die in early adulthood (mean 37.6 years; range 26-58 years). We report a case of an 18-year-old patient with MNGIE. Our patient's abdominal pain was relieved after splanchnic nerve blockade. PMID:16972839

  4. Abdominal trauma by ostrich

    PubMed Central

    Usurelu, Sergiu; Bettencourt, Vanessa; Melo, Gina

    2015-01-01

    Introduction Ostriches typically avoid humans in the wild, since they correctly assess humans as potential predators, and, if approached, often run away. However, ostriches may turn aggressive rather than run when threatened, especially when cornered, and may also attack when they feel the need to defend their offspring or territories. Presentation of case A 71-year-old male patient presented with intra abdominal injury sustained from being kicked in the abdominal wall by an ostrich. During laparotomy, were found free peritoneal effusion and perforation of the small intestine. Discussion The clinical history and physical examination are extremely important for diagnostic and therapeutic decision making. CT-scan is the most accurate exam for making diagnosis. Surgery is the treatment of choice, and is always indicated when there is injury to the hollow viscera. In general it is possible to suture the defect. Conclusion In cases of blunt abdominal trauma by animals is necessary to have a low threshold of suspicion for acute abdomen. PMID:25685344

  5. [Complex profile of the reflex diving response].

    PubMed

    Wierzba, Tomasz H; Ropiak, Arkadiusz

    2011-01-01

    Breath-holding coupled with face cooling triggers a set of the reflex cardiovascular responses, defined as a diving reflex. The major reflex responses include a decrease in heart rate and peripheral vasoconstriction with an increase of arterial pressure to evoke central blood pooling with preferential provision of the brain and heart perfusion. Due to high individual variability and situational dependence the individual course of the reflex response is hardly predictable. Heart rhythm disturbances are the major, sometimes fatal complications of the response. This review is an outline of causing factors, circumstances, mechanisms and the effects of the diving reflex and their practical implications, including risk factors of the critical arrhythmias occurred in diving. PMID:22125213

  6. 5 CFR 1650.11 - Withdrawal elections.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Withdrawal elections. 1650.11 Section 1650.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.11 Withdrawal elections....

  7. 5 CFR 1650.11 - Withdrawal elections.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Withdrawal elections. 1650.11 Section 1650.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.11 Withdrawal elections....

  8. 5 CFR 1650.11 - Withdrawal elections.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Withdrawal elections. 1650.11 Section 1650.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.11 Withdrawal elections....

  9. 5 CFR 1650.11 - Withdrawal elections.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Withdrawal elections. 1650.11 Section 1650.11 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.11 Withdrawal elections....

  10. 40 CFR 74.18 - Withdrawal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... opt-in source may request to withdraw from the Acid Rain Program by submitting an administrative... paragraph (f)(1) of this section. (b) Requesting withdrawal. To withdraw from the Acid Rain Program, the...-in source's prior violations. An opt-in source that withdraws from the Acid Rain Program shall...

  11. 40 CFR 74.18 - Withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Withdrawal. 74.18 Section 74.18 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) SULFUR DIOXIDE OPT-INS Permitting Procedures § 74.18 Withdrawal. (a) Withdrawal through administrative amendment. An opt-in source may request to withdraw...

  12. 40 CFR 74.18 - Withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... opt-in source may request to withdraw from the Acid Rain Program by submitting an administrative... paragraph (f)(1) of this section. (b) Requesting withdrawal. To withdraw from the Acid Rain Program, the...-in source's prior violations. An opt-in source that withdraws from the Acid Rain Program shall...

  13. 40 CFR 74.18 - Withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... opt-in source may request to withdraw from the Acid Rain Program by submitting an administrative... paragraph (f)(1) of this section. (b) Requesting withdrawal. To withdraw from the Acid Rain Program, the...-in source's prior violations. An opt-in source that withdraws from the Acid Rain Program shall...

  14. 40 CFR 74.18 - Withdrawal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... opt-in source may request to withdraw from the Acid Rain Program by submitting an administrative... paragraph (f)(1) of this section. (b) Requesting withdrawal. To withdraw from the Acid Rain Program, the...-in source's prior violations. An opt-in source that withdraws from the Acid Rain Program shall...

  15. Withdrawal: Expanding a Key Addiction Construct.

    PubMed

    Piper, Megan E

    2015-12-01

    Withdrawal is an essential component of classical addiction theory; it is a vital manifestation of dependence and motivates relapse. However, the traditional conceptualization of withdrawal as a cohesive collection of symptoms that emerge during drug deprivation and decline with either the passage of time or reinstatement of drug use, may be inadequate to explain scientific findings or fit with modern theories of addiction. This article expands the current understanding of tobacco withdrawal by examining: (1) withdrawal variability; (2) underlying causes of withdrawal variability, including biological and person factors, environmental influences, and the influence of highly routinized behavioral patterns; (3) new withdrawal symptoms that allow for enhanced characterization of the withdrawal experience; and (4) withdrawal-related cognitive processes. These topics provide guidance regarding the optimal assessment of withdrawal and illustrate the potential impact modern withdrawal conceptualization and assessment could have on identifying treatment targets. PMID:25744958

  16. Restlessness related to SSRI withdrawal.

    PubMed

    Hirose, S

    2001-02-01

    There are reports that abrupt withdrawal of various selective serotonin re-uptake inhibitors, such as fluvoxamine, can elicit in patients various withdrawal symptoms. Fluvoxamine has been widely used in Japan for approximately 1 year. However, there have been no case reports of withdrawal symptoms following abrupt fluvoxamine discontinuation in Japan. The author reports a case where the abrupt discontinuation of fluvoxamine produced restlessness in a depressed patient. The restlessness disappeared soon after the reinstatement of treatment with fluvoxamine. This case report suggests that clinicians should carefully scrutinize a patient's compliance to fluvoxamine as the withdrawal symptoms observed following abrupt discontinuation might be regarded as a relapse of depression or side-effects of the medicine. PMID:11235863

  17. Water withdrawals in Florida, 2012

    USGS Publications Warehouse

    Marella, Richard L.

    2015-01-01

    The largest percentage of freshwater withdrawals was from the South Florida Water Management District (46 percent), followed by the St. Johns River Water Management District (20 percent), Southwest Florida Water Management District (19 percent), Northwest Florida Water Management District (9 percent), and Suwannee River Water Management District (6 percent). The South Florida Water Management District accounted for the largest percentage of freshwater withdrawals for public-supply use (46 percent), commercial-industrial-mining self-supplied use (24 percent), agricultural self-supplied use (59 percent), and recreational-landscape irrigation use (63 percent). The Northwest Florida Water Management District accounted for the largest percentage of freshwater withdrawals for power-generation use (44 percent), and the Southwest Florida Water Management District accounted for the largest percentage of saline-water withdrawals for power-generation use (58 percent).

  18. Achilles tendon reflex measuring system

    NASA Astrophysics Data System (ADS)

    Szebeszczyk, Janina; Straszecka, Joanna

    1995-06-01

    The examination of Achilles tendon reflex is widely used as a simple, noninvasive clinical test in diagnosis and pharmacological therapy monitoring in such diseases as: hypothyroidism, hyperthyroidism, diabetic neuropathy, the lower limbs obstructive angiopathies and intermittent claudication. Presented Achilles tendon reflect measuring system is based on the piezoresistive sensor connected with the cylinder-piston system. To determinate the moment of Achilles tendon stimulation a detecting circuit was used. The outputs of the measuring system are connected to the PC-based data acquisition board. Experimental results showed that the measurement accuracy and repeatability is good enough for diagnostics and therapy monitoring purposes. A user friendly, easy-to-operate measurement system fulfills all the requirements related to recording, presentation and storing of the patients' reflexograms.

  19. Cutaneous reflex modulation and self-induced reflex attenuation in cerebellar patients

    PubMed Central

    Van Calenbergh, Frank; Swinnen, Stephan P.; Duysens, Jacques

    2014-01-01

    Modulation of cutaneous reflexes is important in the neural control of walking, yet knowledge about underlying neural pathways is still incomplete. Recent studies have suggested that the cerebellum is involved. Here we evaluated the possible roles of the cerebellum in cutaneous reflex modulation and in attenuation of self-induced reflexes. First we checked whether leg muscle activity during walking was similar in patients with focal cerebellar lesions and in healthy control subjects. We then recorded cutaneous reflex activity in leg muscles during walking. Additionally, we compared reflexes after standard (computer triggered) stimuli with reflexes after self-induced stimuli for both groups. Biceps femoris and gastrocnemius medialis muscle activity was increased in the patient group compared with the control subjects, suggesting a coactivation strategy to reduce instability of gait. Cutaneous reflex modulation was similar between healthy control subjects and cerebellar patients, but the latter appeared less able to attenuate reflexes to self-induced stimuli. This suggests that the cerebellum is not primarily involved in cutaneous reflex modulation but that it could act in attenuation of self-induced reflex responses. The latter role in locomotion would be consistent with the common view that the cerebellum predicts sensory consequences of movement. PMID:25392164

  20. Cutaneous reflex modulation and self-induced reflex attenuation in cerebellar patients.

    PubMed

    Hoogkamer, Wouter; Van Calenbergh, Frank; Swinnen, Stephan P; Duysens, Jacques

    2015-02-01

    Modulation of cutaneous reflexes is important in the neural control of walking, yet knowledge about underlying neural pathways is still incomplete. Recent studies have suggested that the cerebellum is involved. Here we evaluated the possible roles of the cerebellum in cutaneous reflex modulation and in attenuation of self-induced reflexes. First we checked whether leg muscle activity during walking was similar in patients with focal cerebellar lesions and in healthy control subjects. We then recorded cutaneous reflex activity in leg muscles during walking. Additionally, we compared reflexes after standard (computer triggered) stimuli with reflexes after self-induced stimuli for both groups. Biceps femoris and gastrocnemius medialis muscle activity was increased in the patient group compared with the control subjects, suggesting a coactivation strategy to reduce instability of gait. Cutaneous reflex modulation was similar between healthy control subjects and cerebellar patients, but the latter appeared less able to attenuate reflexes to self-induced stimuli. This suggests that the cerebellum is not primarily involved in cutaneous reflex modulation but that it could act in attenuation of self-induced reflex responses. The latter role in locomotion would be consistent with the common view that the cerebellum predicts sensory consequences of movement. PMID:25392164

  1. Astronomical Data Reduction Workflows with Reflex

    NASA Astrophysics Data System (ADS)

    Ballester, P.; Bramich, D.; Forchi, V.; Freudling, W.; Garcia-Dabó, C. E.; klein Gebbinck, M.; Modigliani, A.; Moehler, S.; Romaniello, M.

    2014-05-01

    Reflex (http://www.eso.org/reflex) is an environment that provides an easy and flexible way to reduce VLT/VLTI science data using the ESO. Its top-level functionalities are: (1) Reflex allows to graphically specify the sequence in which the data reduction steps are executed, including conditional stops, loops and conditional branches, (2) Reflex makes it easy to inspect the intermediate and final data products and to repeat selected processing steps to optimize the data reduction, (3) the data organization necessary to reduce the data is built into the system and is fully automatic, (4) advanced users can plug-in their own Python or IDL modules and steps into the data reduction sequence, and (5) Reflex supports the development of data reduction workflows based on the ESO Common Pipeline Library. Reflex is based on the concept of a scientific workflow, whereby the data reduction cascade is rendered graphically and data seamlessly flow from one processing step to the next. It is distributed with a number of complete test datasets so that users can immediately start experimenting and familiarize themselves with the system (http://www.eso.org/pipelines). In this demo, we present the latest version of Reflex and its applications for astronomical data reduction processes.

  2. [Differential diagnosis of abdominal pain].

    PubMed

    Frei, Pascal

    2015-09-01

    Despite the frequency of functional abdominal pain, potentially dangerous causes of abdominal pain need to be excluded. Medical history and clinical examination must focus on red flags and signs for imflammatory or malignant diseases. See the patient twice in the case of severe and acute abdominal pain if lab parameters or radiological examinations are normal. Avoid repeated and useless X-ray exposure whenever possible. In the case of subacute or chronic abdominal pain, lab tests such as fecal calprotectin, helicobacter stool antigen and serological tests for celiac disease are very useful. Elderly patients may show atypical or missing clinical signs. Take care of red herrings and be skeptical whether your initial diagnosis is really correct. Abdominal pain can frequently be an abdominal wall pain. PMID:26331201

  3. Abdominal imaging: An introduction

    SciTech Connect

    Frick, M.P.; Feinberg, S.B.

    1986-01-01

    This nine-chapter book gives an overview of the integrated approach to abdominal imaging. Chapter 1 provides an introduction to the physics used in medical imaging; chapter 2 is on the selection of imaging modalities. These are followed by four chapters that deal, respectively, with plain radiography, computed tomographic scanning, sonography, and nuclear imaging, as applied to the abdomen. Two chapters then cover contrast material-enhanced studies of the gastrointestinal (GI) tract: one focusing on technical considerations; the other, on radiologic study of disease processes. The final chapter is a brief account of different interventional procedures.

  4. Lower Abdominal Pain.

    PubMed

    Carlberg, David J; Lee, Stephen D; Dubin, Jeffrey S

    2016-05-01

    Although most frequently presenting with lower abdominal pain, appendicitis, colitis, and diverticulitis can cause pain throughout the abdomen and can cause peritoneal and retroperitoneal symptoms. Evaluation and management of lower intestinal disease requires a nuanced approach by the emergency physician, sometimes requiring computed tomography, ultrasonography, MRI, layered imaging, shared decision making, serial examination, and/or close follow-up. Once a presumed or confirmed diagnosis is made, appropriate treatment is initiated, and may include surgery, antibiotics, and/or steroids. Appendicitis patients should be admitted. Diverticulitis and inflammatory bowel disease can frequently be managed on an outpatient basis, but may require admission and surgical consultation. PMID:27133242

  5. [Research progress of rectoanal inhibitory reflex].

    PubMed

    Yin, Shuhui; Zhao, Ke

    2015-12-01

    The understanding of rectoanal inhibitory reflex (RAIR) is progressing for the latest 100 years. From the discovery of its important role in diagnosis of Hirschsprung's disease to all aspects of its development, reflex pathways, neural regulation and physiological functions, there have been more in-depth explorations. It is now recognized that a number of other diseases also have a more specific performance of RAIR. It has become an important and indispensable part to anorectal manometry. Research progress of rectoanal inhibitory reflex is reviewed in this article. PMID:26704013

  6. Hypnosis for functional abdominal pain.

    PubMed

    Gottsegen, David

    2011-07-01

    Chronic abdominal pain is a common pediatric condition affecting 20% of the pediatric population worldwide. Most children with this disorder are found to have no specific organic etiology and are given the diagnosis of functional abdominal pain. Well-designed clinical trials have found hypnotherapy and guided imagery to be the most efficacious treatments for this condition. Hypnotic techniques used for other somatic symptoms are easily adaptable for use with functional abdominal pain. The author discusses 2 contrasting hypnotic approaches to functional abdominal pain and provides implications for further research. These approaches may provide new insights into this common and complex disorder. PMID:21922712

  7. Changes in the Achilles tendon reflexes following Skylab missions

    NASA Technical Reports Server (NTRS)

    Baker, J. T.; Nicogossian, A. E.; Hoffler, G. W.; Johnson, R. L.; Hordinsky, J. R.

    1977-01-01

    Postflight measurements of Achilles tendon reflex duration on Skylab crewmen indicate a state of disequilibrium between the flexor and extensor muscle groups with an initial decrease in reflex duration. As the muscles regain strength and mass there occurs an overcompensation reflected by increased reflex duration. Finally, when a normal neuromuscular state is reached the reflex duration returns to baseline value.

  8. Who withdraws? Psychological individual differences and employee withdrawal behaviors.

    PubMed

    Zimmerman, Ryan D; Swider, Brian W; Woo, Sang Eun; Allen, David G

    2016-04-01

    Psychological individual differences, such as personality, affectivity, and general mental ability, have been shown to predict numerous work-related behaviors. Although there is substantial research demonstrating relationships between psychological individual differences and withdrawal behaviors (i.e., lateness, absenteeism, and turnover), there is no integrative framework providing scholars and practitioners a guide for conceptualizing how, why, and under what circumstances we observe such relationships. In this integrative conceptual review we: (a) utilize the Cognitive-Affective Processing System framework (Mischel & Shoda, 1995) to provide an overarching theoretical basis for how psychological individual differences affect withdrawal behaviors; (b) create a theoretical model of the situated person that summarizes the existing empirical literature examining the effect of psychological differences on withdrawal behavior; and (c) identify future research opportunities based on our review and integrative framework. (PsycINFO Database Record PMID:26595754

  9. Axon reflexes in human cold exposed fingers.

    PubMed

    Daanen, H A; Ducharme, M B

    2000-02-01

    Exposure of fingers to severe cold induces cold induced vasodilatation (CIVD). The mechanism of CIVD is still debated. The original theory states that an axon reflex causes CIVD. To test this hypothesis, axon reflexes were evoked by electrical stimulation of the middle fingers of hands immersed in water at either 5 degrees C or 35 degrees C. Axon reflexes were pronounced in the middle finger of the hand in warm water, but absent from the hand in cold water, even though the stimulation was rated as "rather painful" to "painful". These results showed that axon reflexes do not occur in a cold-exposed hand and thus are unlikely to explain the CIVD phenomenon. PMID:10638384

  10. The legacy of care as reflexive learning

    PubMed Central

    García, Marta Rodríguez; Moya, Jose Luis Medina

    2016-01-01

    Abstract Objective: to analyze whether the tutor's use of reflexive strategies encourages the students to reflect. The goal is to discover what type of strategies can help to achieve this and how tutors and students behave in the practical context. Method: a qualitative and ethnographic focus was adopted. Twenty-seven students and 15 tutors from three health centers participated. The latter had received specific training on reflexive clinical tutoring. The analysis was developed through constant comparisons of the categories. Results: the results demonstrate that the tutors' use of reflexive strategies such as didactic questioning, didactic empathy and pedagogical silence contributes to encourage the students' reflection and significant learning. Conclusions: reflexive practice is key to tutors' training and students' learning. PMID:27305180

  11. Stretch reflex oscillations and essential tremor.

    PubMed Central

    Elble, R J; Higgins, C; Moody, C J

    1987-01-01

    Using a computer-controlled torque motor and manipulandum, 50 ms torque pulses and 70 second trains of binary pseudorandom torque disturbances were applied to the wrists of 10 adult controls and 22 patients with essential tremor in order to study the interaction between mechanically-induced stretch-reflex oscillations and essential tremor. These two oscillations were separated by applying inertial and spring loads to the wrist. There was no evidence of increased or unstable stretch-reflex activity in the essential tremor patients, and stretch-reflex latencies did not correlate with the frequency of essential tremor. Essential tremor and mechanically-induced stretch-reflex oscillations are separate phenomena capable of complex interaction. PMID:3612149

  12. On the Second Language Acquisition of Spanish Reflexive Passives and Reflexive Impersonals by French- and English-Speaking Adults

    ERIC Educational Resources Information Center

    Tremblay, Annie

    2006-01-01

    This study, a partial replication of Bruhn de Garavito (1999a; 1999b), investigates the second language (L2) acquisition of Spanish reflexive passives and reflexive impersonals by French- and English-speaking adults at an advanced level of proficiency. The L2 acquisition of Spanish reflexive passives and reflexive impersonals by native French and…

  13. Reflex sympathetic dystrophy following traumatic myelopathy.

    PubMed

    Wainapel, S F

    1984-04-01

    Two cases of reflex sympathetic dystrophy in the upper extremity of patients with traumatic cervical spinal cord injuries are reported. Both patients had very incomplete lesions with early neurological recovery, suggesting an underlying central cord syndrome. Although reflex sympathetic dystrophy is often seen following stroke, it has only rarely been documented in traumatic myelopathy, and it should be considered in the differential diagnosis of unexplained pain syndromes in the extremities of paraplegic or quadriplegic patients. PMID:6728500

  14. Sexual reflexes in male and female rats.

    PubMed

    Chung, S K; McVary, K T; McKenna, K E

    1988-12-01

    A novel preparation for the study of male and female sexual function in anesthetized, acutely spinalized rats is reported. In both sexes, the coitus reflex (the neuromuscular concomitants of sexual climax) could be elicited by mechanical stimulation of the distal urethra. It is concluded that the spinal sexual circuitry is essentially similar in both sexes and that the coitus reflex is generated by a hormone-insensitive spinal pattern generator and is triggered by a simple peripheral stimulus. PMID:3205410

  15. The pupillary light reflex in normal subjects.

    PubMed Central

    Ellis, C J

    1981-01-01

    In 19 normal subjects the pupillary reflex to light was studied over a range of stimulus intensities by infrared electronic pupillography and analysed by a computer technique. Increasing stimulus intensity was associated with an increase in direct light reflex amplitude and maximum rate of constriction and redilatation. Latency from stimulus to onset of response-decreased with increasing stimulus intensity. The normal range for each of these parameters is given and the significance of these results in clinical pupillary assessment discussed. PMID:7326222

  16. The Reflexes of the Fundus Oculi

    PubMed Central

    Ballantyne, A. J.

    1940-01-01

    The fundus reflexes reveal, in a manner not yet completely understood, the texture and contour of the reflecting surfaces and the condition of the underlying tissues. In this way they may play an important part in the biomicroscopy of the eye. The physiological reflexes are seen at their best in the eyes of young subjects, in well-pigmented eyes, with undilated pupils and with emmetropic refraction. Their absence during the first two decades, or their presence after the forties, their occurrence in one eye only, their appearance, disappearance or change of character should suggest the possibility of some pathological state. The investigation and interpretation of the reflexes are notably assisted by comparing the appearances seen with long and short wave lights such as those of the sodium and mercury vapour lamps, in addition to the usual ophthalmoscopic lights. Most of the surface reflexes disappear in the light of the sodium lamp, sometimes revealing important changes in the deeper layers of the retina and choroid. The physiological reflexes, chiefly formed on the surface of the internal limiting membrane, take the forms of the familiar watered silk or patchy reflexes, the peri-macular halo, the fan reflex in the macular depression and the reflex from the foveal pit. The watered silk or patchy reflexes often show a delicate striation which follows the pattern of the nerve-fibre layer, or there may be a granular or criss-cross texture. Reflexes which entirely lack these indications of “texture” should be considered as possibly pathological. This applies to the “beaten metal” reflexes and to those formed on the so-called hyaloid membrane. The occurrence of physiological reflexes in linear form is doubtful, and the only admittedly physiological punctate reflexes are the so-called Gunn's dots. Surface reflexes which are broken up into small points or flakes are pathological, and are most frequently seen in the central area of the fundus in cases of pigmentary

  17. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  18. Functional Abdominal Pain in Children

    MedlinePlus

    ... dominalPa in inCh ildre n What is functional abdominal pain, and why does it happen? Most otherwise-healthy ... stomachaches for two months or more have functional abdominal pain. The term “functional” refers to the fact that ...

  19. Reflex ring laser amplifier system

    DOEpatents

    Summers, M.A.

    1983-08-31

    The invention is a method and apparatus for providing a reflex ring laser system for amplifying an input laser pulse. The invention is particularly useful in laser fusion experiments where efficient production of high-energy and high power laser pulses is required. The invention comprises a large aperture laser amplifier in an unstable ring resonator which includes a combination spatial filter and beam expander having a magnification greater than unity. An input pulse is injected into the resonator, e.g., through an aperture in an input mirror. The injected pulse passes through the amplifier and spatial filter/expander components on each pass around the ring. The unstable resonator is designed to permit only a predetermined number of passes before the amplified pulse exits the resonator. On the first pass through the amplifier, the beam fills only a small central region of the gain medium. On each successive pass, the beam has been expanded to fill the next concentric non-overlapping region of the gain medium.

  20. Whole-body vibration-induced muscular reflex: Is it a stretch-induced reflex?

    PubMed Central

    Cakar, Halil Ibrahim; Cidem, Muharrem; Sebik, Oguz; Yilmaz, Gizem; Karamehmetoglu, Safak Sahir; Kara, Sadik; Karacan, Ilhan; Türker, Kemal Sıtkı

    2015-01-01

    [Purpose] Whole-body vibration (WBV) can induce reflex responses in muscles. A number of studies have reported that the physiological mechanisms underlying this type of reflex activity can be explained by reference to a stretch-induced reflex. Thus, the primary objective of this study was to test whether the WBV-induced muscular reflex (WBV-IMR) can be explained as a stretch-induced reflex. [Subjects and Methods] The present study assessed 20 healthy males using surface electrodes placed on their right soleus muscle. The latency of the tendon reflex (T-reflex) as a stretch-induced reflex was compared with the reflex latency of the WBV-IMR. In addition, simulations were performed at 25, 30, 35, 40, 45, and 50 Hz to determine the stretch frequency of the muscle during WBV. [Results] WBV-IMR latency (40.5 ± 0.8 ms; 95% confidence interval [CI]: 39.0–41.9 ms) was significantly longer than T-reflex latency (34.6 ± 0.5 ms; 95% CI: 33.6–35.5 ms) and the mean difference was 6.2 ms (95% CI of the difference: 4.7–7.7 ms). The simulations performed in the present study demonstrated that the frequency of the stretch signal would be twice the frequency of the vibration. [Conclusion] These findings do not support the notion that WBV-IMR can be explained by reference to a stretch-induced reflex. PMID:26310784

  1. Abdominal migraine in the differential diagnosis of acute abdominal pain.

    PubMed

    Cervellin, Gianfranco; Lippi, Giuseppe

    2015-06-01

    Although traditionally regarded as a specific pediatric disease, abdominal migraine may also be observed in adults. Unfortunately, however, this condition is frequently overlooked in the differential diagnosis of abdominal pain in the emergency department (ED). A 30-year-old woman presented to our ED complaining of abdominal pain and vomiting, lasting for 12 hours. The pain was periumbilical, continuous, and not associated with fever or diarrhea. The physical examination and the results of conventional blood tests were normal. The patient was treated with intravenous ketoprofen, metoclopramide, and ranitidine, obtaining a prompt relief of symptoms. She had a history of similar episodes in the last 15 years, with several ED visits, blood test examinations, ultrasonography of the abdomen, and upper gastrointestinal endoscopies. Celiac disease, porphyry, sickle cell disease, and inflammatory bowel disease were all excluded. In July 2012, she became pregnant, and she delivered a healthy baby on April 2013. Until November 2014, she has remained asymptomatic. Based on the clinical characteristics of the abdominal pain episodes, the exclusion of any alternative diagnosis, and the relief of symptoms during and after pregnancy, a final diagnosis of abdominal migraine could be established. A skilled emergency physician should always consider abdominal migraine in the differential diagnosis of patients admitted to the ED with abdominal pain, especially when the attacks are recurrent and no alternative diagnosis can be clearly established. PMID:25616589

  2. Variability in Hoffmann and tendon reflexes in healthy male subjects

    NASA Technical Reports Server (NTRS)

    Good, E.; Do, S.; Jaweed, M.

    1992-01-01

    There is a time dependent decrease in amplitude of H- and T-reflexes during Zero-G exposure and subsequently an increase in the amplitude of the H-reflex 2-4 hours after return to a 1-G environment. These alterations have been attributed to the adaptation of the human neurosensory system to gravity. The Hoffman reflex (H-reflex) is an acknowledged method to determine the integrity of the monosynaptic reflex arc. However deep tendon reflexes (DTR's or T-reflexes), elicited by striking the tendon also utilize the entire reflex arc. The objective of this study was to compare the variability in latency and amplitude of the two reflexes in healthy subjects. Methods: Nine healthy male subjects, 27-43 years in age, 161-175 cm in height plus 60-86 Kg in weight, underwent weekly testing for four weeks with a Dan-Tec EMG counterpoint EMG system. Subjects were studied prone and surface EMG electrodes were placed on the right and left soleus muscles. The H-reflex was obtained by stimulating the tibial nerve in the politeal fossa with a 0.2 msec square wave pulse delivered at 2 Hz until the maximum H-reflex was obtained. The T-reflex was invoked by tapping the achilles tendon with a self triggering reflex hammer connected to the EMG system. The latencies and amplitudes for the H- and T-reflexes were measured. Results: These data indicate that the amplitudes of these reflexes varied considerably. However, latencies to invoked responses were consistent. The latency of the T-reflex was approximately 3-5 msec longer than the H-reflex. Conclusion: The T-reflex is easily obtained, requires less time, and is more comfortable to perform. Qualitative data can be obtained by deploying self triggering, force plated reflex hammers both in the 1-G and Zero-G environment.

  3. Jaw, blink and corneal reflex latencies in multiple sclerosis.

    PubMed Central

    Sanders, E A; Ongerboer de Visser, B W; Barendswaard, E C; Arts, R J

    1985-01-01

    Jaw, blink and corneal reflexes, which all involve the trigeminal system, were recorded in 54 patients with multiple sclerosis; thirty-seven of these patients were classified as having definite multiple sclerosis and 17 as indefinite multiple sclerosis, according to Schumacher's criteria. The jaw reflex was abnormal less frequently than either of the other two reflexes, but in four cases it was the only abnormal reflex found. Testing a combination of two or three trigeminal reflexes did not yield a higher incidence of abnormalities than testing the blink or corneal reflex alone. Nine patients showed abnormal reflexes which were unexpected on the basis of clinical symptoms. The combined recordings demonstrate at least one abnormal reflex in 74% of the patients. The various types of reflex abnormalities reflect major damage to different parts of the trigeminal system and may therefore make an important contribution to the diagnosis of multiple sclerosis. PMID:4087004

  4. 29 CFR 4219.18 - Withdrawal in a plan year in which substantially all employers withdraw.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Withdrawal in a plan year in which substantially all employers withdraw. 4219.18 Section 4219.18 Labor Regulations Relating to Labor (Continued) PENSION BENEFIT GUARANTY CORPORATION WITHDRAWAL LIABILITY FOR MULTIEMPLOYER PLANS NOTICE, COLLECTION, AND REDETERMINATION OF WITHDRAWAL LIABILITY Redetermination...

  5. Audiogenic reflex seizures in cats

    PubMed Central

    Lowrie, Mark; Bessant, Claire; Harvey, Robert J; Sparkes, Andrew; Garosi, Laurent

    2015-01-01

    Objectives This study aimed to characterise feline audiogenic reflex seizures (FARS). Methods An online questionnaire was developed to capture information from owners with cats suffering from FARS. This was collated with the medical records from the primary veterinarian. Ninety-six cats were included. Results Myoclonic seizures were one of the cardinal signs of this syndrome (90/96), frequently occurring prior to generalised tonic–clonic seizures (GTCSs) in this population. Other features include a late onset (median 15 years) and absence seizures (6/96), with most seizures triggered by high-frequency sounds amid occasional spontaneous seizures (up to 20%). Half the population (48/96) had hearing impairment or were deaf. One-third of cats (35/96) had concurrent diseases, most likely reflecting the age distribution. Birmans were strongly represented (30/96). Levetiracetam gave good seizure control. The course of the epilepsy was non-progressive in the majority (68/96), with an improvement over time in some (23/96). Only 33/96 and 11/90 owners, respectively, felt the GTCSs and myoclonic seizures affected their cat’s quality of life (QoL). Despite this, many owners (50/96) reported a slow decline in their cat’s health, becoming less responsive (43/50), not jumping (41/50), becoming uncoordinated or weak in the pelvic limbs (24/50) and exhibiting dramatic weight loss (39/50). These signs were exclusively reported in cats experiencing seizures for >2 years, with 42/50 owners stating these signs affected their cat’s QoL. Conclusions and relevance In gathering data on audiogenic seizures in cats, we have identified a new epilepsy syndrome named FARS with a geriatric onset. Further studies are warranted to investigate potential genetic predispositions to this condition. PMID:25916687

  6. The trigeminocardiac reflex – a comparison with the diving reflex in humans

    PubMed Central

    Lemaitre, Frederic; Schaller, Bernhard

    2015-01-01

    The trigeminocardiac reflex (TCR) has previously been described in the literature as a reflexive response of bradycardia, hypotension, and gastric hypermotility seen upon mechanical stimulation in the distribution of the trigeminal nerve. The diving reflex (DR) in humans is characterized by breath-holding, slowing of the heart rate, reduction of limb blood flow and a gradual rise in the mean arterial blood pressure. Although the two reflexes share many similarities, their relationship and especially their functional purpose in humans have yet to be fully elucidated. In the present review, we have tried to integrate and elaborate these two phenomena into a unified physiological concept. Assuming that the TCR and the DR are closely linked functionally and phylogenetically, we have also highlighted the significance of these reflexes in humans. PMID:25995761

  7. Control of abdominal and expiratory intercostal muscle activity during vomiting - Role of ventral respiratory group expiratory neurons

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.; Tan, L. K.; Suzuki, Ichiro

    1987-01-01

    The role of ventral respiratory group (VRG) expiratory (E) neurons in the control of abdominal and internal intercostal muscle activity during vomiting was investigated in cats. Two series of experiments were performed: in one, the activity of VRG E neurons was recorded during fictive vomiting in cats that were decerebrated, paralyzed, and artificially ventilated; in the second, the abdominal muscle activity during vomiting was compared before and after sectioning the axons of descending VRG E neurons in decerebrate spontaneously breathing cats. The results show that about two-thirds of VRG E neurons that project at least as far caudally as the lower thoracic cord contribute to internal intercostal muscle activity during vomiting. The remaining VRG E neurons contribute to abdominal muscle activation. As shown by severing the axons of the VRG E neurons, other, as yet unidenified, inputs (either descending from the brain stem or arising from spinal reflexes) can also produce abdominal muscle activation.

  8. A Detection Model of College Withdrawal

    ERIC Educational Resources Information Center

    Pleskac, Timothy J.; Keeney, Jessica; Merritt, Stephanie M.; Schmitt, Neal; Oswald, Frederick L.

    2011-01-01

    Many students during their college careers consider withdrawing from their respective college or university. Understanding why some students decide to withdraw yet others persist has implications for both the well being of students as well as for institutes of higher education. The present study develops a model of the decision to withdraw drawing…

  9. 5 CFR 1604.7 - Withdrawals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Withdrawals. A service member may withdraw all or a portion of his or her account under the rules in 5 CFR... exception to them) are explained at 5 CFR part 1650. (c) Combat zone contributions. If a service member account contains combat zone contributions, the withdrawal will be distributed pro rata from all...

  10. Penetrating abdominal trauma.

    PubMed

    Henneman, P L

    1989-08-01

    The management of patients with penetrating abdominal trauma is outlined in Figure 1. Patients with hemodynamic instability, evisceration, significant gastrointestinal bleeding, peritoneal signs, gunshot wounds with peritoneal violation, and type 2 and 3 shotgun wounds should undergo emergency laparotomy. The initial ED management of these patients includes airway management, monitoring of cardiac rhythm and vital signs, history, physical examination, and placement of intravenous lines. Blood should be obtained for initial hematocrit, type and cross-matching, electrolytes, and an alcohol level or drug screen as needed. Initial resuscitation should utilize crystalloid fluid replacement. If more than 2 liters of crystalloid are needed to stabilize an adult (less in a child), blood should be given. Group O Rh-negative packed red blood cells should be immediately available for a patient in impending arrest or massive hemorrhage. Type-specific blood should be available within 15 minutes. A patient with penetrating thoracic and high abdominal trauma should receive a portable chest x-ray, and a hemo- or pneumothorax should be treated with tube thoracostomy. An unstable patient with clinical signs consistent with a pneumothorax, however, should receive a tube thoracostomy prior to obtaining roentgenographic confirmation. If time permits, a nasogastric tube and Foley catheter should be placed, and the urine evaluated for blood (these procedures can be performed in the operating room). If kidney involvement is suspected because of hematuria or penetrating trauma in the area of a kidney or ureter in a patient requiring surgery, a single-shot IVP should be performed either in the ED or the operating room. An ECG is important in patients with possible cardiac involvement and in patients over the age of 40 going to the operating room. Tetanus status should be updated, and appropriate antibiotics covering bowel flora should be given. Operative management should rarely be delayed

  11. Economics of abdominal wall reconstruction.

    PubMed

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias. PMID:24035086

  12. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  13. Micromanaging abdominal aortic aneurysms.

    PubMed

    Maegdefessel, Lars; Spin, Joshua M; Adam, Matti; Raaz, Uwe; Toh, Ryuji; Nakagami, Futoshi; Tsao, Philip S

    2013-01-01

    The contribution of abdominal aortic aneurysm (AAA) disease to human morbidity and mortality has increased in the aging, industrialized world. In response, extraordinary efforts have been launched to determine the molecular and pathophysiological characteristics of the diseased aorta. This work aims to develop novel diagnostic and therapeutic strategies to limit AAA expansion and, ultimately, rupture. Contributions from multiple research groups have uncovered a complex transcriptional and post-transcriptional regulatory milieu, which is believed to be essential for maintaining aortic vascular homeostasis. Recently, novel small noncoding RNAs, called microRNAs, have been identified as important transcriptional and post-transcriptional inhibitors of gene expression. MicroRNAs are thought to "fine tune" the translational output of their target messenger RNAs (mRNAs) by promoting mRNA degradation or inhibiting translation. With the discovery that microRNAs act as powerful regulators in the context of a wide variety of diseases, it is only logical that microRNAs be thoroughly explored as potential therapeutic entities. This current review summarizes interesting findings regarding the intriguing roles and benefits of microRNA expression modulation during AAA initiation and propagation. These studies utilize disease-relevant murine models, as well as human tissue from patients undergoing surgical aortic aneurysm repair. Furthermore, we critically examine future therapeutic strategies with regard to their clinical and translational feasibility. PMID:23852016

  14. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-01-01

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer. PMID:25398912

  15. Alcohol Withdrawal and Cerebellar Mitochondria.

    PubMed

    Jung, Marianna E

    2015-08-01

    Cerebellar disorders trigger the symptoms of movement problems, imbalance, incoordination, and frequent fall. Cerebellar disorders are shown in various CNS illnesses including a drinking disorder called alcoholism. Alcoholism is manifested as an inability to control drinking in spite of adverse consequences. Human and animal studies have shown that cerebellar symptoms persist even after complete abstinence from drinking. In particular, the abrupt termination (ethanol withdrawal) of long-term excessive ethanol consumption has shown to provoke a variety of neuronal and mitochondrial damage to the cerebellum. Upon ethanol withdrawal, excitatory neurotransmitter molecules such as glutamate are overly released in brain areas including cerebellum. This is particularly relevant to the cerebellar neuronal network as glutamate signals are projected to Purkinje neurons through granular cells that are the most populated neuronal type in CNS. This excitatory neuronal signal may be elevated by ethanol withdrawal stress, which promotes an increase in intracellular Ca(2+) level and a decrease in a Ca(2+)-binding protein, both of which result in the excessive entry of Ca(2+) to the mitochondria. Subsequently, mitochondria undergo a prolonged opening of mitochondrial permeability transition pore and the overproduction of harmful free radicals, impeding adenosine triphosphate (ATP)-generating function. This in turn provokes the leakage of mitochondrial molecule cytochrome c to the cytosol, which triggers a cascade of adverse cytosol reactions. Upstream to this pathway, cerebellum under the condition of ethanol withdrawal has shown aberrant gene modifications through altered DNA methylation, histone acetylation, or microRNA expression. Interplay between these events and molecules may result in functional damage to cerebellar mitochondria and consequent neuronal degeneration, thereby contributing to motoric deficit. Mitochondria-targeting research may help develop a powerful new

  16. Estimated freshwater withdrawals in Texas, 1990

    USGS Publications Warehouse

    Lurry, Dee L.

    1994-01-01

    Freshwater withdrawals in Texas during 1990 were estimated as part of the U.S. Geological Survey's National Water Use Information Program. Estimates of freshwater withdrawals were made for five categories of use: irrigation, thermoelectric- power generation, water supply, industrial and mining, and domestic/commercial/livestock. Total freshwater withdrawals for the State were estimated to be 20,100 Mgal/d (million gallons per day). Ground water was estimated to account for 37 percent (7,390 Mgal/d), and surface water was estimated to account for 63 percent (12,700 Mgal/d) of total withdrawals. The largest withdrawals of freshwater were for irrigation purposes.

  17. JAMA Patient Page: Abdominal Hernia

    MedlinePlus

    ... an operation. Umbilical hernia Abdominal wall Intestinal loop Peritoneum Skin Peritoneum Umbilical annulus SYMPTOMS The first symptom of a ... vomiting, or constipation. Inguinal hernia Indirect inguinal hernia Peritoneum Deep inguinal ring Inguinal canal Superficial inguinal ring ...

  18. Functional Abdominal Pain in Children

    MedlinePlus

    ... At low doses, these medicines can be excellent pain relievers for some children. A fearful, anxious, or depressed child however should be fully assessed by a psychiatrist or psychologist. Some psychological treatments that help children cope with functional abdominal pain ...

  19. Laryngeal Reflexes: Physiology, Technique and Clinical Use

    PubMed Central

    Ludlow, Christy L.

    2015-01-01

    This review examines the current level of knowledge and techniques available for the study of laryngeal reflexes. Overall, the larynx is under constant control of several systems (including respiration, swallowing and cough) as well as sensory-motor reflex responses involving glossopharyngeal, pharyngeal, laryngeal and tracheobronchial sensory receptors. Techniques for the clinical assessment of these reflexes are emerging and need to be examined for sensitivity and specificity in identifying laryngeal sensory disorders. Quantitative assessment methods for the diagnosis of sensory reductions as well as sensory hypersensitivity may account for laryngeal disorders such as chronic cough, paradoxical vocal fold disorder and muscular tension dysphonia. The development of accurate assessment techniques could improve our understanding of the mechanisms involved in these disorders. PMID:26241237

  20. Reflex: Graphical workflow engine for data reduction

    NASA Astrophysics Data System (ADS)

    ESO Reflex development Team

    2014-01-01

    Reflex provides an easy and flexible way to reduce VLT/VLTI science data using the ESO pipelines. It allows graphically specifying the sequence in which the data reduction steps are executed, including conditional stops, loops and conditional branches. It eases inspection of the intermediate and final data products and allows repetition of selected processing steps to optimize the data reduction. The data organization necessary to reduce the data is built into the system and is fully automatic; advanced users can plug their own modules and steps into the data reduction sequence. Reflex supports the development of data reduction workflows based on the ESO Common Pipeline Library. Reflex is based on the concept of a scientific workflow, whereby the data reduction cascade is rendered graphically and data seamlessly flow from one processing step to the next. It is distributed with a number of complete test datasets so users can immediately start experimenting and familiarize themselves with the system.

  1. Sudden infant death triggered by dive reflex.

    PubMed

    Matturri, L; Ottaviani, G; Lavezzi, A M

    2005-01-01

    The dive reflex is the reflex mechanism most frequently considered in the aetiopathogenesis of sudden infant death syndrome (SIDS). This seems to persist in human beings as an inheritance from diver birds and amphibians. It has been reported that washing the face with cold water or plunging into cold water can provoke cardiac deceleration through the intervention of the ambiguus and the vagal dorsal nuclei. This report describes a case of SIDS that offers a unique insight into the role of the dive reflex in determining a lethal outcome. Examination of the brainstem on serial sections revealed severe bilateral hypoplasia of the arcuate nucleus and gliosis of the other cardiorespiratory medullary nuclei. The coronary and cardiac conduction arteries presented early atherosclerotic lesions. The possible role of parental cigarette smoking in the pathogenesis of arcuate nucleus hypoplasia and early coronary atherosclerotic lesions is also discussed. PMID:15623488

  2. Visual reflex seizures induced by complex stimuli.

    PubMed

    Zifkin, Benjamin G; Inoue, Yushi

    2004-01-01

    Visual reflex seizures induced by complex stimuli may be triggered by patterned and flashing displays that are now ubiquitous. The seizures may be clinically generalized, but unilateral and bilateral myoclonic attacks also may be triggered, especially in patients with juvenile myoclonic epilepsy, and recently, clearly focal reflex occipital lobe seizures have been described. Some seizure-triggering properties of video displays can be identified, such as perceived brightness, pattern, flicker frequency, and color. Knowledge of these is useful in planning individual treatment and in designing regulations for screen content of television broadcasts or for other video displays. Some subjects will also be sensitive to cognitive or action-programming activation, especially when playing video games, and this can increase the chance of seizure triggering. Nonspecific factors such as sleep deprivation, prolonged exposure, and drug or alcohol use also may play a role in reflex seizure occurrence. PMID:14706042

  3. A reflex resonance model of vocal vibrato

    NASA Astrophysics Data System (ADS)

    Titze, Ingo R.; Story, Brad; Smith, Marshall; Long, Russel

    2002-05-01

    A reflex mechanism with a long latency (>40 ms) is implicated as a plausible cause of vocal vibrato. At least one pair of agonist-antagonist muscles that can change vocal-fold length is needed, such as the cricothyroid muscle paired with the thyroarytenoid muscle, or the cricothyroid muscle paired with the lateral cricoarytenoid muscle or a strap muscle. Such an agonist-antagonist muscle pair can produce negative feedback instability in vocal-fold length with this long reflex latency, producing oscillations on the order of 5-7 Hz. It is shown that singers appear to increase the gain in the reflex loop to cultivate the vibrato, which grows out of a spectrum of 0-15-Hz physiologic tremors in raw form.

  4. Abdominal emergencies in the geriatric patient

    PubMed Central

    2014-01-01

    Abdominal pain is one of the most frequent reasons that elderly people visit the emergency department (ED). In this article, we review the deadliest causes of abdominal pain in this population, including mesenteric ischemia, abdominal aortic aneurysm, and appendicitis and potentially lethal non-abdominal causes. We also highlight the pitfalls in diagnosing, or rather misdiagnosing, these clinical entities. PMID:25635203

  5. Abdominal intrauterine vacuum aspiration.

    PubMed

    Tjalma, W A A

    2014-01-01

    Evaluating and "cleaning" of the uterine cavity is probably the most performed operation in women. It is done for several reasons: abortion, evaluation of irregular bleeding in premenopausal period, and postmenopausal bleeding. Abortion is undoubtedly the number one procedure with more than 44 million pregnancies terminated every year. This procedure should not be underestimated and a careful preoperative evaluation is needed. Ideally a sensitive pregnancy test should be done together with an ultrasound in order to confirm a uterine pregnancy, excluding extra-uterine pregnancy, and to detect genital and/or uterine malformations. Three out of four abortions are performed by surgical methods. Surgical methods include a sharp, blunt, and suction curettage. Suction curettage or vacuum aspiration is the preferred method. Despite the fact that it is a relative safe procedure with major complications in less than one percent of cases, it is still responsible for 13% of all maternal deaths. All the figures have not declined in the last decade. Trauma, perforation, and bleeding are a danger triage. When there is a perforation, a laparoscopy should be performed immediately, in order to detect intra-abdominal lacerations and bleeding. The bleeding should be stopped as soon as possible in order to not destabilize the patient. When there is a perforation in the uterus, this "entrance" can be used to perform the curettage. This is particularly useful if there is trauma of the isthmus and uterine wall, and it is difficult to identify the uterine canal. A curettage is a frequent performed procedure, which should not be underestimated. If there is a perforation in the uterus, then this opening can safely be used for vacuum aspiration. PMID:25134300

  6. Snout and Visual Rooting Reflexes in Infantile Autism. Brief Report.

    ERIC Educational Resources Information Center

    Minderaa, Ruud B.; And Others

    1985-01-01

    The authors conducted extensive neurological evaluations of 42 autistic individuals and were surprised to discover a consistently positive snout reflex in most of them. Difficulties with assessing the reflex are noted. The authors then reassessed the Ss for a series of primitive reflexes which are interpreted as signs of diffuse cortical brain…

  7. On Reflection: Is Reflexivity Necessarily Beneficial in Intercultural Education?

    ERIC Educational Resources Information Center

    Blasco, Maribel

    2012-01-01

    This article explores how the concept of reflexivity is used in intercultural education. Reflexivity is often presented as a key learning goal in acquiring intercultural competence (ICC). Yet, reflexivity can be defined in different ways, and take different forms across time and space, depending on the concepts of selfhood that prevail and how…

  8. Antennae in the hawkmoth Manduca sexta (Lepidoptera, Sphingidae) mediate abdominal flexion in response to mechanical stimuli.

    PubMed

    Hinterwirth, Armin J; Daniel, Thomas L

    2010-12-01

    Flying insects rely on the integration of feedback signals from multiple sensory modalities. Thus, in addition to the visual input, mechanosensory information from antennae is crucial for stable flight in the hawkmoth Manduca sexta. However, the nature of compensatory reflexes mediated by mechanoreceptors on the antennae is unknown. In this study we describe an abdominal flexion response mediated by the antennal mechanosensory input during mechanical body rotations. Such reflexive abdominal motions lead to shifts in the animal's center of mass, and therefore changes in flight trajectory. Moths respond with abdominal flexion both to visual and mechanical rotations, but the mechanical response depends on the presence of the mass of the flagellum. In addition, the mechanically mediated flexion response is about 200° out of phase with the visual response and adds linearly to it. Phase-shifting feedback signals in such a manner can lead to a more stable behavioral output response when the animal is faced with turbulent perturbations to the flight path. PMID:20820787

  9. Experimental research of the pupil light reflex

    NASA Astrophysics Data System (ADS)

    Szczepanowska, Wioletta; Kasprzak, Henryk T.; Hachol, Andrzej

    2003-11-01

    This paper reports the method of recording the Pupil Light Reflex with using a CCD linear sensor as a detector. The system allows to obtain a linear resolution 0,005 mm and a temporary resolution 11 ins. The principle of measuring method and example results of PLR study are presented.

  10. Doing Reflexivity: Moments of Unbecoming and Becoming

    ERIC Educational Resources Information Center

    Fox, Alison; Allan, Julie

    2014-01-01

    This paper offers an account of a reflexive "trip" undertaken by a professional doctoral student and her supervisor. It presents a series of vignettes which offer an account of unbecomings and becomings encountered by the student. Making use of a dialogic approach in which the supervisor responds to the student, we suggest this method of…

  11. Dilemmas and Deliberations in Reflexive Ethnographic Research

    ERIC Educational Resources Information Center

    Robinson, Janean Valerie

    2014-01-01

    This paper traces insights into the challenges and dilemmas experienced whilst researching students' interpretations and understandings of the Behaviour Management in Schools policy in Western Australia. Journal records, supported by student transcripts, are woven together in a reflexive ethnographic journey--from the beginning phase of…

  12. Biological Motion Cues Trigger Reflexive Attentional Orienting

    ERIC Educational Resources Information Center

    Shi, Jinfu; Weng, Xuchu; He, Sheng; Jiang, Yi

    2010-01-01

    The human visual system is extremely sensitive to biological signals around us. In the current study, we demonstrate that biological motion walking direction can induce robust reflexive attentional orienting. Following a brief presentation of a central point-light walker walking towards either the left or right direction, observers' performance…

  13. Taking Control of Reflexive Social Attention

    ERIC Educational Resources Information Center

    Ristic, Jelena; Kingstone, Alan

    2005-01-01

    Attention is shifted reflexively to where other people are looking. It has been argued by a number of investigators that this social attention effect reflects the obligatory bottom-up activation of domain-specific modules within the inferior temporal (IT) cortex that are specialized for processing face and gaze information. However, it is also the…

  14. Reflex Anuria After Renal Tumor Embolization

    SciTech Connect

    Kervancioglu, Selim Sirikci, Akif; Erbagci, Ahmet

    2007-04-15

    We report a case of reflex anuria after transarterial embolization of a renal tumor. Anuria developed immediately after embolization and resolved 74 hr following the procedure. We postulate that reflux anuria in our case was related to mechanoreceptors, chemoreceptors, or both, as these are stimulated by the occluded blood vessels, ischemia, and edema of the normal renal tissue of an embolized kidney.

  15. The reflexive self and culture: a critique.

    PubMed

    Adams, Matthew

    2003-06-01

    This article attempts to engage with a tendency in the theorization of social change and self-identity, evident in the work of a number of contemporary social theorists, to place an extended process of reflexivity at the heart of modern identity. As symptomatic of 'neo-modern' accounts of selfhood, critical readings of Giddens, Beck, Castells and some aspects of social theory more generally, and their account of modern reflexivity's relationship to culture, are assessed. In light of these criticisms, ways in which culture might still play an important part in the shaping of identity are considered. The relationship between language, culture and reflexivity, drawing from philosophy, sociology and G. H. Mead's own brand of social psychology, are all utilized in establishing a critique of the role Giddens and others designate for culture in the constitution of the contemporary self. By potentially repositioning self-identity in its connection to culture, the overall bearing of reflexivity upon the processes of self-identity is thus questioned. It is argued that a culturally-situated, yet fluid and multifarious account of self-identity is a necessary analytical and normative alternative. PMID:12945868

  16. The Reflexive Modernization of Australian Universities

    ERIC Educational Resources Information Center

    Pick, David

    2004-01-01

    The profound changes occurring in Australian higher education are viewed here in the context of the social, cultural, political and economic effects of globalization. Particular attention is paid to providing a theoretical foundation for understanding these effects using the reflexive modernization perspective. Highlighted are some of the…

  17. Reflectivity, Reflexivity and Situated Reflective Practice

    ERIC Educational Resources Information Center

    Malthouse, Richard; Roffey-Barentsen, Jodi; Watts, Mike

    2014-01-01

    This paper describes an aspect of reflective practice referred to as situated reflective practice. The overarching theory is derived from social theories of structuration and reflexivity. In particular, from Giddens' theory of structuration, which sees social life as an interplay of agency and structure. Discussion of the research reported…

  18. Plasma quiescence in a reflex discharge

    SciTech Connect

    Jerde, L.; Friedman, S.; Carr, W.; Seidl, M.

    1980-02-01

    A thermionic cathode reflex discharge and the plasma it produces are studied. It is found that extremely quiescent plasmas can be produced when the electron-loss rate due to classical diffusion is equal to the ion-loss rate. Particle and power balances for the quiescent plasma are obtained, and the average electron energy loss per ion produced is determined.

  19. The Brain-Gut Axis in Abdominal Pain Syndromes

    PubMed Central

    Mayer, Emeran A.; Tillisch, Kirsten

    2013-01-01

    The importance of bidirectional brain-gut interactions in gastrointestinal (GI) illness is increasingly recognized, most prominently in the area of functional GI syndromes such as irritable bowel syndrome (IBS), functional dyspepsia, and functional chest pain. The brain receives a constant stream of interoceptive input from the GI tract, integrates this information with other interoceptive information from the body and with contextual information from the environment, and sends an integrated response back to various target cells within the GI tract. This system is optimized to assure homeostasis of the GI tract during physiological perturbations and to adapt GI function to the overall state of the organism. In health, the great majority of interoceptive information reaching the brain is not consciously perceived but serves primarily as input to autonomic reflex pathways. In patients with functional abdominal pain syndromes, conscious perception of interoceptive information from the GI tract, or recall of interoceptive memories of such input, can occur in the form of constant or recurrent discomfort or pain. This is often associated with alterations in autonomic nervous system output and with emotional changes. A model is proposed that incorporates reported peripheral and central abnormalities in patients with IBS, extrapolates similar alterations in brain-gut interactions to patients with other chronic abdominal pain syndromes, and provides novel treatment targets. PMID:21090962

  20. [Extension of the concept of withdrawal signs].

    PubMed

    Kato, Shin

    2015-12-01

    If the conditions including normal-dose dependence in which withdrawal signs are observed in the absence of definite psychic dependence are classified as dependence, this classification should be regarded as inappropriate extension of the concept of drug dependence. These conditions should be diagnosed as 'withdrawal' as specified by the DSM-5 or ICD-10. Advancements of research have clarified that an increased number of drugs cause withdrawal signs. Some Japanese researchers use the concept of 'withdrawal signs of psychic dependence.' Their definition of drug dependence and concept of withdrawal signs, however, are different from the definition established by the WHO and the researchers specializing in this field. Thus, the concept of 'withdrawal signs of psychic dependence' raises a lot of questions. PMID:26964289

  1. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  2. Estimated freshwater withdrawals in Washington, 2010

    USGS Publications Warehouse

    Lane, Ron C.; Welch, Wendy B.

    2015-01-01

    The amount of public- and self-supplied water used for domestic, irrigation, livestock, aquaculture, industrial, mining, and thermoelectric power was estimated for state, county, and eastern and western regions of Washington during calendar year 2010. Withdrawals of freshwater for offstream uses were estimated to be about 4,885 million gallons per day. The total estimated freshwater withdrawals for 2010 was approximately 15 percent less than the 2005 estimate because of decreases in irrigation and thermoelectric power withdrawals.

  3. 29 CFR 4219.12 - Employers liable upon mass withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 29 Labor 9 2011-07-01 2011-07-01 false Employers liable upon mass withdrawal. 4219.12 Section 4219... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.12 Employers liable upon mass withdrawal. (a... experiences successive mass withdrawals, an employer that has been determined to be liable under this...

  4. 29 CFR 4219.12 - Employers liable upon mass withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 29 Labor 9 2013-07-01 2013-07-01 false Employers liable upon mass withdrawal. 4219.12 Section 4219... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.12 Employers liable upon mass withdrawal. (a... experiences successive mass withdrawals, an employer that has been determined to be liable under this...

  5. 29 CFR 4219.12 - Employers liable upon mass withdrawal.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 29 Labor 9 2012-07-01 2012-07-01 false Employers liable upon mass withdrawal. 4219.12 Section 4219... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.12 Employers liable upon mass withdrawal. (a... experiences successive mass withdrawals, an employer that has been determined to be liable under this...

  6. 29 CFR 4219.12 - Employers liable upon mass withdrawal.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 29 Labor 9 2014-07-01 2014-07-01 false Employers liable upon mass withdrawal. 4219.12 Section 4219... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.12 Employers liable upon mass withdrawal. (a... experiences successive mass withdrawals, an employer that has been determined to be liable under this...

  7. 29 CFR 4219.12 - Employers liable upon mass withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 29 Labor 9 2010-07-01 2010-07-01 false Employers liable upon mass withdrawal. 4219.12 Section 4219... Redetermination of Withdrawal Liability Upon Mass Withdrawal § 4219.12 Employers liable upon mass withdrawal. (a... experiences successive mass withdrawals, an employer that has been determined to be liable under this...

  8. Treatment of Abdominal Segmental Hernia, Constipation, and Pain Following Herpes Zoster with Paravertebral Block.

    PubMed

    Kim, Saeyoung; Jeon, Younghoon

    2015-01-01

    Herpes zoster (HZ) most commonly occurs in elderly patients and involves sensory neurons resulting in pain and sensory changes. Clinically significant motor deficits and visceral neuropathies are thought to be relatively rare. A 72-year-old man presented with abdominal segmental hernia, constipation, and pain following HZ in the left T9-10 dermatome. Sixteen days before presentation, he had developed a painful herpetic rash in the left upper abdominal quadrant. Approximately 10 days after the onset of the rash, constipation occurred and was managed with daily oral medication with bisacodyl 5 mg. In addition, 14 days after the onset of HZ, the patient noticed a protrusion of the left upper abdominal wall. Abdominal x-ray, ultrasound of the abdomen, and electrolyte analysis showed no abnormalities. General physical examination revealed a reducible bulge in his left upper quadrant and superficial abdominal reflexes were diminished in the affected region. Electromyographic testing revealed denervational changes limited to the left thoracic paraspinal muscles and supraumbilical muscles, corresponding to the affected dermatomes. He was prescribed with 500 mg of famciclovir 3 times a day for 7 days, and pregabalin 75 mg twice a day and acetaminophen 650 mg 3 times a day for 14 days. However, his pain was rated at an intensity of 5 on the numerical analogue scale from 0 (no pain) to 10 (worst pain imaginable). A paravertebral block was performed at T9-10 with a mixture of 0.5% lidocaine 3 mL and triamcinolone 40 mg. One day after the procedure, the abdominal pain disappeared. In addition, 5 days after the intervention, the abdominal protrusion and constipation were resolved. He currently remains symptom free at a 6 month follow-up. PMID:26431148

  9. Abdominal pain with a twist

    PubMed Central

    2011-01-01

    Malrotation in children is due to either an incomplete or non-rotation of the foetal mid-gut during perinatal development. Presentation is usually in the first few weeks of life, often with life-threatening volvulus and ischaemia. However, it can be a rare cause of abdominal pain in older children and young adults. We present such a case, as a reminder to emergency physicians that malrotation should be considered in the differential diagnosis of recurrent or chronic abdominal pain not only in children but also in adolescents. PMID:21635723

  10. Ultrasonographic diagnosis in abdominal tuberculosis.

    PubMed

    Sheikh, M; Moosa, I; Hussein, F M; Qurttom, M A; Behbehani, A I

    1999-05-01

    Sonographic findings were retrospectively analysed in 39 patients with proven abdominal tuberculosis (TB). The patients were treated over 15 years at a major teaching hospital, Mubarak Al-Kabber Hospital, in Kuwait. The findings included clear or complex ascites with fine strands, loculations and debris. The other findings were lymphadenopathy, bowel wall thickening, omental mass, focal lesions in the liver and spleen and psoas abscess. The sonographic findings in abdominal TB are not specific but may give valuable information to prevent unnecessary laparotomy. PMID:10901897

  11. Recurrent abdominal pain in children.

    PubMed

    Buch, Niyaz A; Ahmad, Sheikh Mushtaq; Ahmed, S Zubair; Ali, Syed Wazid; Charoo, B A; Hassan, Masood Ul

    2002-09-01

    Eighty five children with recurrent abdominal pain(RAP) were studied. Organic cause was noticed in 70 cases and non-organic in 15 cases. Giardiasis was the commonest organic cause in 57 (67.0 percent), either alone or with other parasitic infestations. Other organic causes include gallstones (4.7 percent), urinary infections (4.7 percent), esophagitis/gastritis (3.5 percent) and abdominal tuberculosis (2.3 percent). Single parent, school phobia, sibling rivalry, RAP in other family members and nocturnal enuresis are significant factors associated with nonorganic causes PMID:12368527

  12. Secondary abdominal appendicular ectopic pregnancy.

    PubMed

    Nama, Vivek; Gyampoh, Bright; Karoshi, Mahantesh; McRae, Reynold; Opemuyi, Isaac

    2007-01-01

    Although the case fatality rate for ectopic pregnancies has decreased to 0.08% in industrialized countries, it still represents 3.8% of maternal mortality in the United States alone. In developing countries, the case fatality rate varies from 3% to 27%. Laparoscopic management of tubal pregnancies is now the standard form of treatment where this technology is available. Abdominal pregnancies are rare, and secondary implantation of tubal ectopic pregnancies is the most common cause of abdominal gestations. We present an interesting case of secondary implantation of a tubal ectopic pregnancy to highlight the appendix as a possible secondary implantation site after a tubal ectopic pregnancy. PMID:17630175

  13. Modulation of the initial light reflex during affective picture viewing.

    PubMed

    Henderson, Robert R; Bradley, Margaret M; Lang, Peter J

    2014-09-01

    An initial reflexive constriction of the pupil to stimulation-the light reflex-is primarily modulated by brightness, but is attenuated when participants are under threat of shock (i.e., fear-inhibited light reflex). The present study assessed whether the light reflex is similarly attenuated when viewing emotional pictures. Pupil diameter was recorded while participants viewed erotic, violent, and neutral scenes that were matched in brightness; scrambled versions identical in brightness were also presented as an additional control. Compared to viewing neutral scenes, the light reflex was reliably modulated by hedonic content, with significant attenuation both when viewing unpleasant as well as pleasant pictures. No differences in the light reflex were found among scrambled versions. Thus, emotional modulation of the initial light reflex is not confined to a context of fear and is not indicative of brightness differences when viewing pictures of natural scenes. PMID:24849784

  14. Improving Nursing Knowledge of Alcohol Withdrawal

    PubMed Central

    Berl, Kimberly; Collins, Michelle L.; Melson, Jo; Mooney, Ruth; Muffley, Cheryl; Wright-Glover, Angela

    2015-01-01

    Christiana Care Health System implemented a Care Management Guideline for Alcohol Withdrawal Symptom Management, which provided direction for inpatient screening for alcohol withdrawal risk, assessment, and treatment. Nurses educated on its use expressed confusion with the use of the assessment tools, pharmacokinetics, and pathophysiology of alcohol withdrawal and delirium tremens. Reeducation was provided by nursing professional development specialists. Pre- and postsurveys revealed that nurses were more confident in caring for patients with alcohol withdrawal. (See CE Video, Supplemental Digital Content 1, http://links.lww.com/JNPD/A9) PMID:25816126

  15. Withdrawing benzodiazepines in primary care.

    PubMed

    Lader, Malcolm; Tylee, Andre; Donoghue, John

    2009-01-01

    assisting in the discontinuation of benzodiazepines but the available data are insufficient for recommendations to be made regarding its use. Antidepressants can help if the patient is depressed before withdrawal or develops a depressive syndrome during withdrawal. The clearest strategy was to taper the medication; abrupt cessation can only be justified if a very serious adverse effect supervenes during treatment. No clear evidence suggests the optimum rate of tapering, and schedules vary from 4 weeks to several years. Our recommendation is to aim for withdrawal in <6 months, otherwise the withdrawal process can become the morbid focus of the patient's existence. Substitution of diazepam for another benzodiazepine can be helpful, at least logistically, as diazepam is available in a liquid formulation.Psychological interventions range from simple support through counselling to expert cognitive-behavioural therapy (CBT). Group therapy may be helpful as it at least provides support from other patients. The value of counselling is not established and it can be quite time consuming. CBT needs to be administered by fully trained and experienced personnel but seems effective, particularly in obviating relapse.The outcome of successful withdrawal is gratifying, both in terms of improved functioning and abstinence from the benzodiazepine usage. Economic benefits also ensue.Some of the principles of withdrawing benzodiazepines are listed. Antidepressants may be helpful, as may some symptomatic remedies. Care must be taken not to substitute one drug dependence problem for the original one. PMID:19062773

  16. Oxidative Stress During Alcohol Withdrawal and its Relationship with Withdrawal Severity

    PubMed Central

    Parthasarathy, Ramamourty; Kattimani, Shivanand; Sridhar, M. G.

    2015-01-01

    Background: Oxidative parameters are altered during alcohol withdrawal and are said to contribute towards withdrawal symptoms in alcoholic patients. Aims: To study levels of five selected oxidative parameters during alcohol withdrawal state and after treatment of the withdrawal state and to assess the association of the oxidative parameters with the severity of alcohol withdrawal. Materials and Methods: This was a case-control study done in a De-addiction clinic of a tertiary teaching centre, Southern India. 50 persons having alcohol withdrawal symptoms were included. The oxidative stress parameters malondialdehyde, protein carbonyl, glutathione peroxidase, superoxide dismutase and catalase were assessed in during the withdrawal phase and again after the withdrawal had subsided. The same oxidative stress parameters were measured in the control group. Statistical analysis: Statistical analysis was done using SPSS version 17.0. One way ANOVA and Pearson correlation test were used for finding the association between the oxidative stress parameters levels and the severity of alcohol withdrawal. Multiple linear regression analysis done to predict variables associated with level of oxidative parameters. Results: During alcohol withdrawal the pro-oxidant malondialdehyde was elevated compared to that in the control group. Among the antioxidant enzymes the superoxide dismutase was higher and catalase was lower than the control group levels. After remission of the alcohol withdrawal both malondialdehyde remained higher and superoxide dismutase lower than in the control group. The levels of oxidative stress parameters not correlated with the severity of alcohol withdrawal. Conclusions: oxidative stress parameters show changes during alcohol withdrawal and during the remission of withdrawal. However, levels of oxidative stress parameters not correlated with the severity of withdrawal. PMID:25969603

  17. Withdrawal

    MedlinePlus

    ... for Kids for Teens Teens Home Body Mind Sexual Health Food & Fitness Diseases & Conditions Infections Q&A School & Jobs Drugs & Alcohol Staying Safe Recipes En Español Making a Change – Your Personal Plan Hot Topics Meningitis Choosing Your Mood Prescription Drug Abuse Healthy School Lunch ...

  18. Withdrawing method of the stiffening tube incidentally inserted into the descending colon.

    PubMed

    Fukuda, Shinsaku; Mikami, Tatsuya; Shimoyama, Tadashi; Hanabata, Norihiro; Iwamura, Hideki; Munakata, Akihiro

    2005-09-14

    We experienced a very rare complication of colonoscopy, a migration of stiffening tube into the colorectum. We herein introduce a withdrawing method of migrating stiffening tube incidentally inserted into the colorectum. A 65-year-old Japanese woman underwent colonoscopy because of abdominal discomfort. We used stiffening tube to insert the scope to the proximal colon because of her redundant sigmoid colon. When withdrawing the scope, we realized that the tube was fully inside the colorectum. We could not remove the tube instantly, and it reached the splenic flexure, finally. We reinserted the scope through the migrating tube, straightened the scope, and withdrew it holding a slight angle of the scope over the proximal end of the tube. Then, we could safely remove the tube along with the scope through the anus. PMID:16149153

  19. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe it to you. Here are different kinds of pain: ...

  20. The effects of exercise and training on human cardiovascular reflex control.

    PubMed

    O'Sullivan, S E; Bell, C

    2000-07-01

    During physical activity, there is a graded withdrawal of vagal cardiac tone and a graded increase in sympathetic cardiac and vasomotor tone, initiated through both central command from the somatic motor cortex and muscle chemoreceptive and mechanoreceptive inputs. In parallel, there is an upward resetting of the operating point of the arterial baroreflex, with preserved reflex sensitivity. In contrast to the traditional interpretation that blood flow through exercising muscle is independent of vasomotor neural influences because of the dominance of local dilator metabolites, recent evidence suggests that both constrictor and dilator sympathetic neural influences may be involved in determining absolute levels of perfusion. Post-exercise, there is a period of relative hypotension that is associated with decreased peripheral resistance. Some, but not all, evidence indicates a causal role for reduced sympathetic drive. Chronic exercise training appears to reduce resting sympathetic activity, with parallel changes in the gain of a variety of cardiovascular autonomic reflexes initiated from cardiovascular sites. These changes may be attributable at least partly to masking of arterial baroreflexes by the impact of elevated blood volume on low-pressure baroreceptors. The reductions in sympathetic drive that follow training are more pronounced in patients with essential hypertension than in normotensive individuals and are likely to underlie the anti-hypertensive effect of exercise. PMID:10869695

  1. Photic sneeze reflex in nephropathic cystinosis.

    PubMed

    Katz, B; Melles, R B; Swenson, M R; Schneider, J A

    1990-12-01

    Photic induced sneeze is a reflex that occurs in certain individuals after exposure to bright light. Cystinosis is an autosomal recessive inborn error of metabolism in which nonprotein cystine accumulates within lysosomes. The pathognomonic ocular manifestation of cystinosis is corneal crystal deposition. We observed photic induced sneezes during ophthalmoscopic examination in five of 19 patients with nephropathic cystinosis (26%). We report on this observation and discuss possible pathophysiological mechanisms for photic induced sneezing in cystinosis. PMID:2275931

  2. Photic sneeze reflex in nephropathic cystinosis.

    PubMed Central

    Katz, B; Melles, R B; Swenson, M R; Schneider, J A

    1990-01-01

    Photic induced sneeze is a reflex that occurs in certain individuals after exposure to bright light. Cystinosis is an autosomal recessive inborn error of metabolism in which nonprotein cystine accumulates within lysosomes. The pathognomonic ocular manifestation of cystinosis is corneal crystal deposition. We observed photic induced sneezes during ophthalmoscopic examination in five of 19 patients with nephropathic cystinosis (26%). We report on this observation and discuss possible pathophysiological mechanisms for photic induced sneezing in cystinosis. PMID:2275931

  3. The spinal reflex cannot be perceptually separated from voluntary movements.

    PubMed

    Ghosh, Arko; Haggard, Patrick

    2014-01-01

    Both voluntary and involuntary movements activate sensors in the muscles, skin, tendon and joints. As limb movement can result from a mixture of spinal reflexes and voluntary motor commands, the cortical centres underlying conscious proprioception might either aggregate or separate the sensory inputs generated by voluntary movements from those generated by involuntary movements such as spinal reflexes. We addressed whether healthy volunteers could perceive the contribution of a spinal reflex during movements that combined both reflexive and voluntary contributions. Volunteers reported the reflexive contribution in leg movements that were partly driven by the knee-jerk reflex induced by a patellar tendon tap and partly by voluntary motor control. In one condition, participants were instructed to kick back in response to a tendon tap. The results were compared to reflexes in a resting baseline condition without voluntary movement. In a further condition, participants were instructed to kick forwards after a tap. Volunteers reported the perceived reflex contribution by repositioning the leg to the perceived maximum displacement to which the reflex moved the leg after each tendon tap. In the resting baseline condition, the reflex was accurately perceived. We found a near-unity slope of linear regressions of perceived on actual reflexive displacement. Both the slope value and the quality of regression fit in individual volunteers were significantly reduced when volunteers were instructed to generate voluntary backward kicks as soon as they detected the tap. In the kick forward condition, kinematic analysis showed continuity of reflex and voluntary movements, but the reflex contribution could be estimated from electromyography (EMG) recording on each trial. Again, participants' judgements of reflexes showed a poor relation to reflex EMG, in contrast to the baseline condition. In sum, we show that reflexes can be accurately perceived from afferent information. However

  4. The effect of distraction strategies on pain perception and the nociceptive flexor reflex (RIII reflex).

    PubMed

    Ruscheweyh, Ruth; Kreusch, Annette; Albers, Christoph; Sommer, Jens; Marziniak, Martin

    2011-11-01

    Distraction from pain reduces pain perception, and imaging studies have suggested that this may at least partially be mediated by activation of descending pain inhibitory systems. Here, we used the nociceptive flexor reflex (RIII reflex) to directly quantify the effects of different distraction strategies on basal spinal nociception and its temporal summation. Twenty-seven healthy subjects participated in 3 distraction tasks (mental imagery, listening to preferred music, spatial discrimination of brush stimuli) and, in a fourth task, concentrated on the painful stimulus. Results show that all 3 distraction tasks reduced pain perception, but only the brush task also reduced the RIII reflex. The concentration-on-pain task increased both pain perception and the RIII reflex. The extent of temporal summation of pain perception and the extent of temporal summation of the RIII reflex were not affected by any of the tasks. These results suggest that some, but not all, forms of pain reduction by distraction rely on descending pain inhibition. In addition, pain reduction by distraction seems to preferentially affect mechanisms of basal nociceptive transmission, not of temporal summation. PMID:21925793

  5. Acute withdrawal: diagnosis and treatment.

    PubMed

    Brust, John C M

    2014-01-01

    Symptoms of alcohol withdrawal range in severity from mild "hangover" to fatal delirium tremens (DTs). Tremor, hallucinosis, and seizures usually occur within 48 hours of abstinence. Seizures tend to be generalized without focality, occurring singly or in a brief cluster, but status epilepticus is not unusual. DTs usually appears after 48 hours of abstinence and consists of marked inattentiveness, agitation, hallucinations, fluctuating level of alertness, marked tremulousness, and sympathetic overactivity. The mainstay of treatment for alcohol withdrawal is benzodiazepine pharmacotherapy, which can be used to control mild early symptoms, to prevent progression to DTs, or to treat DTs itself. Alternative less evidence-based pharmacotherapies include phenobarbital, anticonvulsants, baclofen, gamma-hydroxybutyric acid, beta-blockers, alpha-2-agonists, and N-methyl-d-aspartate receptor blockers. Treatment of DTs is a medical emergency requiring heavy sedation in an intensive care unit, with close attention to autonomic instability, fever, fluid loss, and electrolyte imbalance. Frequent comorbid disorders include hypoglycemia, liver failure, pancreatitis, sepsis, meningitis, intracranial hemorrhage, and Wernicke-Korsakoff syndrome. PMID:25307572

  6. Basic Gravitational Reflexes in the Larval Frog

    NASA Technical Reports Server (NTRS)

    Cochran, Stephen L.

    1996-01-01

    This investigation was designed to determine how a primitive vertebrate, the bullfrog tadpole, is able to sense and process gravitational stimuli. Because of the phylogenetic similarities of the vestibular systems in all vertebrates, the understanding of the gravitational reflexes in this relatively simple vertebrate should elucidate a skeletal framework on a elementary level, upon which the more elaborate reflexes of higher vertebrates may be constructed. The purpose of this study was to understand how the nervous system of the larval amphibian processes gravitational information. This study involved predominantly electrophysiological investigations of the isolated, alert (forebrain removed) bullfrog tadpole head. The focus of these experiments is threefold: (1) to understand from whole extraocular nerve recordings the signals sent to the eye following static gravitational tilt of the head; (2) to localize neuronal centers responsible for generating these signals through reversible pharmacological ablation of these centers; and (3) to record intracellularly from neurons within these centers in order to determine the single neuron's role in the overall processing of the center. This study has provided information on the mechanisms by which a primitive vertebrate processes gravitational reflexes.

  7. 27 CFR 28.153 - Withdrawal procedure.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ....153 Section 28.153 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS EXPORTATION OF ALCOHOL Withdrawal of Specially Denatured Spirits, Free of Tax, for Exportation or Transfer to a Foreign-Trade Zone § 28.153 Withdrawal procedure. The...

  8. 27 CFR 28.153 - Withdrawal procedure.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ....153 Section 28.153 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS EXPORTATION OF ALCOHOL Withdrawal of Specially Denatured Spirits, Free of Tax, for Exportation or Transfer to a Foreign-Trade Zone § 28.153 Withdrawal procedure. The...

  9. 27 CFR 28.153 - Withdrawal procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ....153 Section 28.153 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY LIQUORS EXPORTATION OF ALCOHOL Withdrawal of Specially Denatured Spirits, Free of Tax, for Exportation or Transfer to a Foreign-Trade Zone § 28.153 Withdrawal procedure. The...

  10. 27 CFR 28.153 - Withdrawal procedure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ....153 Section 28.153 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL EXPORTATION OF ALCOHOL Withdrawal of Specially Denatured Spirits, Free of Tax, for Exportation or Transfer to a Foreign-Trade Zone § 28.153 Withdrawal procedure. The...

  11. 27 CFR 28.153 - Withdrawal procedure.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ....153 Section 28.153 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU, DEPARTMENT OF THE TREASURY ALCOHOL EXPORTATION OF ALCOHOL Withdrawal of Specially Denatured Spirits, Free of Tax, for Exportation or Transfer to a Foreign-Trade Zone § 28.153 Withdrawal procedure. The...

  12. 42 CFR 1008.40 - Withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 5 2013-10-01 2013-10-01 false Withdrawal. 1008.40 Section 1008.40 Public Health OFFICE OF INSPECTOR GENERAL-HEALTH CARE, DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES ADVISORY OPINIONS BY THE OIG Submission of a Formal Request for an Advisory Opinion § 1008.40 Withdrawal....

  13. New mechanisms and perspectives in nicotine withdrawal

    PubMed Central

    Jackson, K.J.; Muldoon, P.P.; De Biasi, M.; Damaj, M.I.

    2014-01-01

    Diseases associated with tobacco use constitute a major health problem worldwide. Upon cessation of tobacco use, an unpleasant withdrawal syndrome occurs in dependent individuals. Avoidance of the negative state produced by nicotine withdrawal represents a motivational component that promotes continued tobacco use and relapse after smoking cessation. With the modest success rate of currently available smoking cessation therapies, understanding mechanisms involved in the nicotine withdrawal syndrome are crucial for developing successful treatments. Animal models provide a useful tool for examining neuroadaptative mechanisms and factors influencing nicotine withdrawal, including sex, age, and genetic factors. Such research has also identified an important role for nicotinic receptor subtypes in different aspects of the nicotine withdrawal syndrome (e.g., physical vs. affective signs). In addition to nicotinic receptors, the opioid and endocannabinoid systems, various signal transduction pathways, neurotransmitters, and neuropeptides have been implicated in the nicotine withdrawal syndrome. Animal studies have informed human studies of genetic variants and potential targets for smoking cessation therapies. Overall, the available literature indicates that the nicotine withdrawal syndrome is complex, and involves a range of neurobiological mechanisms. As research in nicotine withdrawal progresses, new pharmacological options for smokers attempting to quit can be identified, and treatments with fewer side effects that are better tailored to the unique characteristics of patients may become available. PMID:25433149

  14. 46 CFR 391.5 - Qualified withdrawals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 8 2011-10-01 2011-10-01 false Qualified withdrawals. 391.5 Section 391.5 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS UNDER PUBLIC LAW 91-469 FEDERAL INCOME TAX ASPECTS OF THE CAPITAL CONSTRUCTION FUND § 391.5 Qualified withdrawals. (a) In general. (1)...

  15. 46 CFR 391.5 - Qualified withdrawals.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 8 2013-10-01 2013-10-01 false Qualified withdrawals. 391.5 Section 391.5 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS UNDER PUBLIC LAW 91-469 FEDERAL INCOME TAX ASPECTS OF THE CAPITAL CONSTRUCTION FUND § 391.5 Qualified withdrawals. (a) In general. (1)...

  16. 46 CFR 391.5 - Qualified withdrawals.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 8 2014-10-01 2014-10-01 false Qualified withdrawals. 391.5 Section 391.5 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS UNDER PUBLIC LAW 91-469 FEDERAL INCOME TAX ASPECTS OF THE CAPITAL CONSTRUCTION FUND § 391.5 Qualified withdrawals. (a) In general. (1)...

  17. 46 CFR 391.5 - Qualified withdrawals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 8 2010-10-01 2010-10-01 false Qualified withdrawals. 391.5 Section 391.5 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION REGULATIONS UNDER PUBLIC LAW 91-469 FEDERAL INCOME TAX ASPECTS OF THE CAPITAL CONSTRUCTION FUND § 391.5 Qualified withdrawals. (a) In general. (1)...

  18. 42 CFR 457.170 - Withdrawal process.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 42 Public Health 4 2011-10-01 2011-10-01 false Withdrawal process. 457.170 Section 457.170 Public... Plans for Child Health Insurance Programs and Outreach Strategies § 457.170 Withdrawal process. (a... amendment, or any portion of a proposed State plan or plan amendment, at any time during the review...

  19. 42 CFR 457.170 - Withdrawal process.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Withdrawal process. 457.170 Section 457.170 Public... Plans for Child Health Insurance Programs and Outreach Strategies § 457.170 Withdrawal process. (a... amendment, or any portion of a proposed State plan or plan amendment, at any time during the review...

  20. 14 CFR 93.223 - Slot withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES Allocation of Commuter and Air Carrier IFR... essential air service operations or eliminating slots. Before withdrawing any slots under this section to... service operations shall be exempt from withdrawal for use for other international or essential...

  1. 14 CFR 93.223 - Slot withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES Allocation of Commuter and Air Carrier IFR... essential air service operations or eliminating slots. Before withdrawing any slots under this section to... service operations shall be exempt from withdrawal for use for other international or essential...

  2. 49 CFR 107.111 - Withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 2 2013-10-01 2013-10-01 false Withdrawal. 107.111 Section 107.111 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION... PROCEDURES Special Permits § 107.111 Withdrawal. An application may be withdrawn at any time before...

  3. 49 CFR 107.111 - Withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 2 2010-10-01 2010-10-01 false Withdrawal. 107.111 Section 107.111 Transportation Other Regulations Relating to Transportation PIPELINE AND HAZARDOUS MATERIALS SAFETY ADMINISTRATION... PROCEDURES Special Permits § 107.111 Withdrawal. An application may be withdrawn at any time before...

  4. 42 CFR 1008.40 - Withdrawal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... OPINIONS BY THE OIG Submission of a Formal Request for an Advisory Opinion § 1008.40 Withdrawal. The requestor of an advisory opinion may withdraw the request prior to the issuance of a formal advisory opinion... withdrawn, the requestor must pay the costs expended by the OIG in processing the opinion, as discussed...

  5. 42 CFR 1008.40 - Withdrawal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... OPINIONS BY THE OIG Submission of a Formal Request for an Advisory Opinion § 1008.40 Withdrawal. The requestor of an advisory opinion may withdraw the request prior to the issuance of a formal advisory opinion... withdrawn, the requestor must pay the costs expended by the OIG in processing the opinion, as discussed...

  6. 42 CFR 1008.40 - Withdrawal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... OPINIONS BY THE OIG Submission of a Formal Request for an Advisory Opinion § 1008.40 Withdrawal. The requestor of an advisory opinion may withdraw the request prior to the issuance of a formal advisory opinion... withdrawn, the requestor must pay the costs expended by the OIG in processing the opinion, as discussed...

  7. 42 CFR 1008.40 - Withdrawal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... OPINIONS BY THE OIG Submission of a Formal Request for an Advisory Opinion § 1008.40 Withdrawal. The requestor of an advisory opinion may withdraw the request prior to the issuance of a formal advisory opinion... withdrawn, the requestor must pay the costs expended by the OIG in processing the opinion, as discussed...

  8. 49 CFR 365.123 - Applicant withdrawal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 5 2013-10-01 2013-10-01 false Applicant withdrawal. 365.123 Section 365.123 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY... APPLICATIONS FOR OPERATING AUTHORITY How To Apply for Operating Authority § 365.123 Applicant withdrawal....

  9. Treatment of acute opioid withdrawal with ibogaine.

    PubMed

    Alper, K R; Lotsof, H S; Frenken, G M; Luciano, D J; Bastiaans, J

    1999-01-01

    Ibogaine is an alkaloid with putative effect in acute opioid withdrawal. Thirty-three cases of treatments for the indication of opioid detoxification performed in non-medical settings under open label conditions are summarized involving an average daily use of heroin of .64 +/- .50 grams, primarily by the intravenous route. Resolution of the signs of opioid withdrawal without further drug seeking behavior was observed within 24 hours in 25 patients and was sustained throughout the 72-hour period of posttreatment observation. Other outcomes included drug seeking behavior without withdrawal signs (4 patients), drug abstinence with attenuated withdrawal signs (2 patients), drug seeking behavior with continued withdrawal signs (1 patient), and one fatality possibly involving surreptitious heroin use. The reported effectiveness of ibogaine in this series suggests the need for systematic investigation in a conventional clinical research setting. PMID:10506904

  10. Neonatal withdrawal syndrome after chronic maternal consumption of 4-methylethcathinone.

    PubMed

    Pichini, Simona; Rotolo, Maria Concetta; García, Jordi; Girona, Noelia; Leal, Lorna; García-Algar, Oscar; Pacifici, Roberta

    2014-12-01

    Synthetic cathinones have been markedly present in the Spanish drug market in recent years. These substances can be easily obtained in "smart shops", smoke shops, gas stations and web sites where they can be bought and received anonymously avoiding normal law controls. For the first time we present a case of a neonatal withdrawal syndrome in a baby born to a woman who was a chronic consumer of 4-methylethcathinone. The newborn presented with increased jitteriness and irritability, highpitched cry, hypertonia in the limbs and brisk tendon reflexes. 4-Methylethcathinone was identified and quantified by liquid chromatography tandem mass spectrometry in the four subsequent 3cm segments of maternal hair (4.3, 4.0, 4.0 and 3.9ng/mg hair starting from most proximal segment) accounting for maternal consumption during the whole pregnancy and before and in neonatal meconium (0.7ng/g) confirming fetal exposure during intrauterine life. Methadone and its metabolite were also measured in maternal and neonatal matrices. Counseling pregnant women and women who may become pregnant on the consequences of fetal drug exposure to new designer drugs like 4-methylethcathinone is critical to preventing poor neonatal outcomes. This case report is informative to those studying designer drugs and those clinically involved with pregnant women abusing psychoactive substances. PMID:25453781

  11. Ethical reflections: examining reflexivity through the narrative paradigm.

    PubMed

    Bishop, Emily C; Shepherd, Marie L

    2011-09-01

    Being reflexive and providing these reflections for public scrutiny is often considered a key element of ethical, rigorous qualitative research. Prevalent conceptualizations of reflexivity, however, need interrogating and sharpening. We aim to contribute to this by examining reflexive practice, and in particular researchers' reflexive accounts, through the lens of the narrative paradigm. Our aim is to demonstrate that acknowledging the role of narrative reconstruction in reflexivity creates more ethical research, and that it is therefore crucial for researchers to more explicitly recognize this. Both authors present an analysis of one particular exchange between interviewer and participant. This analysis highlights that despite our best efforts at "doing reflexivity," both immediately following and when reflecting back on an interview, there are influential factors that escape our gaze. Reflections of the past are particularly imperfect. Without fully recognizing this, we are not utilizing all the tools available for ensuring honest, ethical research. PMID:21508253

  12. Assessment of Hyperactive Reflexes in Patients with Spinal Cord Injury

    PubMed Central

    Yang, Chung-Yong

    2015-01-01

    Hyperactive reflexes are commonly observed in patients with spinal cord injury (SCI) but there is a lack of convenient and quantitative characterizations. Patellar tendon reflexes were examined in nine SCI patients and ten healthy control subjects by tapping the tendon using a hand-held instrumented hammer at various knee flexion angles, and the tapping force, quadriceps EMG, and knee extension torque were measured to characterize patellar tendon reflexes quantitatively in terms of the tendon reflex gain (Gtr), contraction rate (Rc), and reflex loop time delay (td). It was found that there are significant increases in Gtr and Rc and decrease in td in patients with spinal cord injury as compared to the controls (P < 0.05). This study presented a convenient and quantitative method to evaluate reflex excitability and muscle contraction dynamics. With proper simplifications, it can potentially be used for quantitative diagnosis and outcome evaluations of hyperreflexia in clinical settings. PMID:25654084

  13. Abdominal Distension and Vascular Collapse.

    PubMed

    Cosentino, Gina; Uwaifo, Gabriel I

    2016-04-01

    We present the case of a 43-year-old gentleman who presented to the emergency room with acute abdominal distension, confusion and vascular collapse. The emergent radiologic imaging obtained showed massive bilateral adrenal enlargement, but despite the initial clinical suspicion of possible overwhelming sepsis and/or massive abdominal/intralesional hemorrhage, lab tests based obtained rapidly confirmed the diagnosis of acute Addisonian crisis which responded dramatically to adrenocorticoid hormone replacement therapy and aggressive fluid resuscitation. The patient's established history of metastatic lung cancer confirmed this as a case of metastatic massive bilateral adrenal metastases with an initial presentation of acute adrenal insufficiency which is uncommon in the setting of metastatic carcinomatosis but more typically associated with lymphomas. Recognition of this clinical possibility is vital to enable rapid diagnosis and consequent life saving therapy. PMID:27328473

  14. [Abdominal bruit associated with hypertension].

    PubMed

    Fontseré, N; Bonet, J; Bonal, J; Romero, R

    2004-01-01

    First cause of secondary hypertension is renovascular hypertension which presents abdominal bruit in 16 to 20% of cases. This clinical sign is also associated with other vascular disease of the abdomen such as celiac trunk stenosis and/or aneurysms located on the pancreaticoduodenal or gastroduodenal arcs level, with little representation among aneurysm. They usually appear on a context of digestive complications like neoplasias, chronic pancreatitis or gastric obstructions possibly with obstructive icterus, hemorrhage and acute abdomen episodes. Its presentation in other contexts is rare and constitutes a diagnostic challenge. Diagnosis is made by abdominal arteriography which is the best method because you can locate the problem as well as intervene therapeutically with embolization of the aneurysme. We would like to emphasize the importance of a quick diagnosis due to the risk of rupture and the high morbi-mortality associated. PMID:15219082

  15. Amphetamine withdrawal and sleep disturbance.

    PubMed

    Gossop, M R; Bradley, B P; Brewis, R K

    1982-01-01

    Sleep duration and indices of disturbed sleep, such as night-time waking and day-time sleep, were investigated in amphetamine users following hospital admission and withdrawal from the drug. Compared to controls, the amphetamine group showed an initial period of oversleeping and, towards the end of the first week, they showed a considerable degree of reduced sleep which persisted for the 20 days of this study. There was greater variability in sleep duration within the amphetamine group on almost all nights, and the variability in sleep duration from one night to the next was also greater. More night-time sleep disturbance was evident among the amphetamine ex-users. These results are discussed with respect to previous work and the pattern is seen to be more complex than had been imagined. A tentative neurochemical model is suggested and clinical implications are considered. PMID:7166130

  16. Management of voluminous abdominal incisional hernia.

    PubMed

    Bouillot, J-L; Poghosyan, T; Pogoshian, T; Corigliano, N; Canard, G; Veyrie, N

    2012-10-01

    Incisional hernia is one of the classic complications after abdominal surgery. The chronic, gradual increase in size of some of these hernias is such that the hernia ring widens to a point where there is a loss of substance in the abdominal wall, herniated organs can become incarcerated or strangulated while poor abdominal motility can alter respiratory function. The surgical treatment of small (<5 cm) incisional hernias is safe and straightforward, by either laparotomy or laparoscopy. For large hernias, surgical repair is often difficult. After reintegration of herniated viscera into the abdominal cavity, the abdominal wall defect must be closed anatomically in order to restore the function to the abdominal wall. Prosthetic reinforcement of the abdominal wall is mandatory for long-term successful repair. There are multiple techniques for prosthetic hernia repair, but placement of Dacron mesh in the retromuscular plane is our preference. PMID:23137643

  17. [A case of abdominal wall actinomycosis].

    PubMed

    Kim, Kyung Hoon; Lee, Jin Soo; Cho, Hyeong Jun; Choi, Seung Bong; Cheung, Dae Young; Kim, Jin Il; Lee, In Kyu

    2015-04-01

    Actinomycosis is a chronic suppurative granulomatous infectious disease caused by actinomyces species that is characterized by formation of characteristic clumps called as sulfur granules. Abdominal actinomycosis is a rare disease and is often difficult to diagnose before operation. Abdominal actinomycosis infiltrating into the abdominal wall and adhering to the colon is even rarer. Most abdominal actinomycosis develops after operation, trauma or inflammatory bowel disease, and is also considered as an opportunistic infection in immunocompromised patient with underlying malignancy, diabetes mellitus, human immunodeficiency virus infection, etc. Actinomycosis is diagnosed based on histologic demonstration of sulfur granules in surgically resected specimen or pus, and treatment consists of long-term penicillin based antibiotics therapy with or without surgical resection. Herein, we report an unusual case of abdominal wall actinomycosis which developed in a patient after acupuncture and presented as abdominal wall mass that was first mistaken for abdominal wall invasion of diverticulum perforation. PMID:25896158

  18. Reflex Seizures Triggered by Diaper Change in Dravet Syndrome.

    PubMed

    Subki, Ahmed H; Alasmari, Aishah S; Jan, Fadi M; Moria, Feras A; Jan, Mohammed M

    2016-07-01

    Dravet syndrome (DS) is a severe epilepsy syndrome characterized by early onset of multiple types of seizures. We report the first case of reflex seizures triggered by diaper change in a girl at 9 months old and 2 years old with a mutation in the SCN1A gene causing DS. Reflex seizures have been reported in patients with DS provoked by increased body temperature or visual stimulation. The case we report widens the spectrum of triggers causing reflex seizures in children with DS. Cortical hyperexcitability resulting from the genetic defect explains the tendency to experience such reflex seizures. PMID:26889571

  19. Acute Abdominal Pain in Children.

    PubMed

    Reust, Carin E; Williams, Amy

    2016-05-15

    Acute abdominal pain accounts for approximately 9% of childhood primary care office visits. Symptoms and signs that increase the likelihood of a surgical cause for pain include fever, bilious vomiting, bloody diarrhea, absent bowel sounds, voluntary guarding, rigidity, and rebound tenderness. The age of the child can help focus the differential diagnosis. In infants and toddlers, clinicians should consider congenital anomalies and other causes, including malrotation, hernias, Meckel diverticulum, or intussusception. In school-aged children, constipation and infectious causes of pain, such as gastroenteritis, colitis, respiratory infections, and urinary tract infections, are more common. In female adolescents, clinicians should consider pelvic inflammatory disease, pregnancy, ruptured ovarian cysts, or ovarian torsion. Initial laboratory tests include complete blood count, erythrocyte sedimentation rate or C-reactive protein, urinalysis, and a pregnancy test. Abdominal radiography can be used to diagnose constipation or obstruction. Ultrasonography is the initial choice in children for the diagnosis of cholecystitis, pancreatitis, ovarian cyst, ovarian or testicular torsion, pelvic inflammatory disease, pregnancy-related pathology, and appendicitis. Appendicitis is the most common cause of acute abdominal pain requiring surgery, with a peak incidence during adolescence. When the appendix is not clearly visible on ultrasonography, computed tomography or magnetic resonance imaging can be used to confirm the diagnosis. PMID:27175718

  20. Taking control of reflexive social attention.

    PubMed

    Ristic, Jelena; Kingstone, Alan

    2005-01-01

    Attention is shifted reflexively to where other people are looking. It has been argued by a number of investigators that this social attention effect reflects the obligatory bottom-up activation of domain-specific modules within the inferior temporal (IT) cortex that are specialized for processing face and gaze information. However, it is also the case that top-down factors may modulate the activation of IT cells. Here we examined behaviorally whether reflexive social orienting is purely automatic or sensitive to top-down modulation. Participants were shown an ambiguous stimulus that could be perceived either as representing EYES or a CAR. In we demonstrated between groups that an automatic shift of attention, equivalent to that triggered by a schematic FACE, occurred only when the stimulus was referred to as possessing EYES. In all participants received the EYES and CAR conditions. When the stimulus was first referred to as a CAR and then as EYES, an attentional shift was only present for the EYES condition. However, when the stimulus was first referred to as possessing EYES, and then later as a CAR, attentional shifts were observed for both conditions. These data indicate that the emergence of a reflexive social attention effect is influenced by top-down mechanisms but in an asymmetrical manner. Top-down processes appear to be effective for triggering IT involvement, that is, for perceiving a stimulus as a face, which produces the social attention effect. But top-down mechanisms are ineffective once IT involvement has been triggered. That is, once a stimulus has been seen as having eyes, it continues to be seen that way, and accordingly, the social attention effect persists. PMID:15617667

  1. An Enabling Framework for Reflexive Learning: Experiential Learning and Reflexivity in Contemporary Modernity

    ERIC Educational Resources Information Center

    Dyke, Martin

    2009-01-01

    The paper presents an enabling framework for experiential learning that connects with reflexive modernity. This framework places an emphasis on learning with others and on the role of theory, practice and reflection. A sociological argument is constructed for an alternative framework for experiential learning that derives from social theory. It is…

  2. Bourdieu's Reflexive Sociology and "Spaces of Points of View": Whose Reflexivity, Which Perspective?

    ERIC Educational Resources Information Center

    Kenway, Jane; McLeod, Julie

    2004-01-01

    This paper considers Bourdieu's concepts of perspectivism and reflexivity, looking particularly at how he develops arguments about these in his recent work, The Weight of the World (1999) and Pascalian Meditations (2000b). We explicate Bourdieu's distinctive purposes and deployment of these terms and approaches, and discuss how this compares with…

  3. Employing mirtazapine to aid benzodiazepine withdrawal.

    PubMed

    Chandrasekaran, P K

    2008-06-01

    Insomnia and depression are frequently encountered in patients during withdrawal from substances. While there are no approved medications for treating them, off-label attempts to address these phenomena with mirtazapine have shown some promising results. This case describes the use of mirtazapine as an aid in benzodiazepine withdrawal and its potential benefits in alleviating insomnia and depression in a 32-year-old man. It was found to ameliorate sleep myoclonus that was thought to be associated with his withdrawal syndrome. It is hoped this report will generate interest and stimulate further research in this area of psychopharmacology. PMID:18581012

  4. Multi-MA reflex triode research.

    SciTech Connect

    Swanekamp, Stephen Brian; Commisso, Robert J.; Weber, Bruce V.; Riordan, John C.; Allen, Raymond J.; Goyer, John R.; Murphy, Donald P.; Mikkelson, Kenneth A.; Harper-Slaboszewicz, Victor Jozef

    2010-08-01

    The Reflex Triode can efficiently produce and transmit medium energy (10-100 keV) x-rays. Perfect reflexing through thin converter can increase transmission of 10-100 keV x-rays. Gamble II experiment at 1 MV, 1 MA, 60 ns - maximum dose with 25 micron tantalum. Electron orbits depend on the foil thickness. Electron orbits from LSP used to calculate path length inside tantalum. A simple formula predicts the optimum foil thickness for reflexing converters. The I(V) characteristics of the diode can be understood using simple models. Critical current dominates high voltage triodes, bipolar current is more important at low voltage. Higher current (2.5 MA), lower voltage (250 kV) triodes are being tested on Saturn at Sandia. Small, precise, anode-cathode gaps enable low impedance operation. Sample Saturn results at 2.5 MA, 250 kV. Saturn dose rate could be about two times greater. Cylindrical triode may improve x-ray transmission. Cylindrical triode design will be tested at 1/2 scale on Gamble II. For higher current on Saturn, could use two cylindrical triodes in parallel. 3 triodes in parallel require positive polarity operation. 'Triodes in series' would improve matching low impedance triodes to generator. Conclusions of this presentation are: (1) Physics of reflex triodes from Gamble II experiments (1 MA, 1 MV) - (a) Converter thickness 1/20 of CSDA range optimizes x-ray dose; (b) Simple model based on electron orbits predicts optimum thickness from LSP/ITS calculations and experiment; (c) I(V) analysis: beam dynamics different between 1 MV and 250 kV; (2) Multi-MA triode experiments on Saturn (2.5 MA, 250 kV) - (a) Polarity inversion in vacuum, (b) No-convolute configuration, accurate gap settings, (c) About half of current produces useful x-rays, (d) Cylindrical triode one option to increase x-ray transmission; and (3) Potential to increase Saturn current toward 10 MA, maintaining voltage and outer diameter - (a) 2 (or 3) cylindrical triodes in parallel, (b) Triodes

  5. Reduced emotional signs of opiate withdrawal in rats selectively bred for low (LoS) versus high (HiS) saccharin intake

    PubMed Central

    Radke, Anna K.; Holtz, Nathan A.; Gewirtz, Jonathan C.; Carroll, Marilyn E.

    2013-01-01

    Rationale Rats bred for high (HiS) and low (LoS) saccharin intake exhibit divergent behavioral responses to multiple drugs of abuse, with HiS rats displaying greater vulnerability to drug taking. Previous research indicates that this effect may be due to increased sensitivity to reward in HiS rats and to the aversive effects of acute drug administration in LoS rats. Objective The current study investigated whether HiS and LoS rats also exhibit different behavioral signs of withdrawal following one or repeated opiate exposures. Methods Emotional signs of opiate withdrawal were assessed with potentiation of the acoustic startle reflex and conditioned place aversion (CPA) in male and female HiS and LoS rats. Startle was measured before and 4 h after a 10 mg/kg injection of morphine on days 1, 2, and 7 of opiate exposure. CPA was induced with a two-day, naloxone-precipitated conditioning paradigm. Somatic signs of withdrawal and weight loss were used also measured. Results Male and female LoS rats exhibited lower startle potentiation than HiS rats on the seventh day of morphine exposure. LoS male rats also failed to develop a CPA to morphine withdrawal. No differences in physical withdrawal signs were observed between HiS and LoS rats, but males of both lines had more physical signs of withdrawal than females. Conclusions These results suggest that LoS rats are less vulnerable to the negative emotional effects of morphine withdrawal than HiS rats. A less severe withdrawal syndrome may contribute to decreased levels of drug taking in the LoS line. PMID:23254375

  6. Superposition of H reflexes on steady contractions in man.

    PubMed Central

    Rüegg, D G; Krauer, R; Drews, H

    1990-01-01

    1. The aim of the investigation was to study the influence of steady isometric contractions on H reflexes of human soleus muscle. 2. Stimulating and recording conditions were hardly affected by plantar flexions which subjects maintained in a force matching task. 3. If the interval between a preceding control and the test stimulus was less than 8 s the test H reflex was depressed in the relaxed subject. The depression was diminished or removed if the test reflex was superimposed on a background activity. The interval between control and test H reflex was at least 8 s in the following experiments. 4. H reflexes were nearly independent of steady plantar flexions on which they were superimposed. In some subjects, there was a slight increase with increasing torque. During dorsal flexions, H reflexes in all subjects were inhibited with increasing torque. 5. The relationship between test H reflexes, control H reflexes and background activity was evaluated by varying pseudo-randomly stimulus intensity and steady flexion torque. The surface defined by this three-dimensional relation approximated a plane suggesting linear properties of the H reflex. In some subjects threshold intensity decreased slightly with torque, in others it was constant. 6. In response to a warning signal, human subjects initiated steady plantar or dorsal flexions in both feet and, at the same time, they started to concentrate on a light at the onset of which they performed a unilateral ballistic plantar contraction as fast as possible. The relations between H reflex and maintained flexion force during the warning period of the reaction time task were identical to those during force matching, showing that the behavioural context did not modulate the relations. 7. The relations were also the same if reflexes were evoked bi- or unilaterally, illustrating the absence of a mutual modification of simultaneously evoked H reflexes. 8. The relation was the same with ipsilateral matching and relaxed

  7. Monitoring of head injury by myotatic reflex evaluation

    PubMed Central

    Cozens, J; Miller, S.; Chambers, I.; Mendelow, A

    2000-01-01

    OBJECTIVES—(1) To establish the feasibility of myotatic reflex measurement in patients with head injury. (2) To test the hypothesis that cerebral dysfunction after head injury causes myotatic reflex abnormalities through disordered descending control. These objectives arise from a proposal to use reflex measurements in monitoring patients with head injury.
METHODS—The phasic stretch reflex of biceps brachii was elicited by a servo-positioned tendon hammer. Antagonist inhibition was evoked by vibration to the triceps. Using surface EMG, the amplitude of the unconditioned biceps reflex and percentage antagonist inhibition were measured. After standardisation in 16 normal adult subjects, the technique was applied to 36 patients with head injury across the range of severity. Objective (1) was addressed by attempting a measurement on each patient without therapeutic paralysis; three patients were also measured under partial paralysis. Objective (2) was addressed by preceding each of the 36 unparalysed measurements with an assessment of cerebral function using the Glasgow coma scale (GCS); rank correlation was employed to test a null hypothesis that GCS and reflex indices are unrelated.
RESULTS—In normal subjects, unconditioned reflex amplitude exhibited a positive skew requiring logarithmic transformation. Antagonist inhibition had a prolonged time course suggesting presynaptic mechanisms; subsequent measurements were standardised at 80 ms conditioning test interval (index termed "TI80").
 Measurements were obtained on all patients, even under therapeutic paralysis (objective (1)). The unconditioned reflex was absent in most patients with GCS less than 5; otherwise it varied little across the patient group. TI80 fell progressively with lower GCS, although patients' individual GCS could not be inferred from single measurements. Both reflex indices correlated with GCS (p<0.01), thereby dismissing the null hypothesis (objective (2)).

  8. Wh-filler-gap dependency formation guides reflexive antecedent search

    PubMed Central

    Frazier, Michael; Ackerman, Lauren; Baumann, Peter; Potter, David; Yoshida, Masaya

    2015-01-01

    Prior studies on online sentence processing have shown that the parser can resolve non-local dependencies rapidly and accurately. This study investigates the interaction between the processing of two such non-local dependencies: wh-filler-gap dependencies (WhFGD) and reflexive-antecedent dependencies. We show that reflexive-antecedent dependency resolution is sensitive to the presence of a WhFGD, and argue that the filler-gap dependency established by WhFGD resolution is selected online as the antecedent of a reflexive dependency. We investigate the processing of constructions like (1), where two NPs might be possible antecedents for the reflexive, namely which cowgirl and Mary. Even though Mary is linearly closer to the reflexive, the only grammatically licit antecedent for the reflexive is the more distant wh-NP, which cowgirl. (1). Which cowgirl did Mary expect to have injured herself due to negligence? Four eye-tracking text-reading experiments were conducted on examples like (1), differing in whether the embedded clause was non-finite (1 and 3) or finite (2 and 4), and in whether the tail of the wh-dependency intervened between the reflexive and its closest overt antecedent (1 and 2) or the wh-dependency was associated with a position earlier in the sentence (3 and 4). The results of Experiments 1 and 2 indicate the parser accesses the result of WhFGD formation during reflexive antecedent search. The resolution of a wh-dependency alters the representation that reflexive antecedent search operates over, allowing the grammatical but linearly distant antecedent to be accessed rapidly. In the absence of a long-distance WhFGD (Experiments 3 and 4), wh-NPs were not found to impact reading times of the reflexive, indicating that the parser's ability to select distant wh-NPs as reflexive antecedents crucially involves syntactic structure. PMID:26500579

  9. 12 CFR 925.26 - Voluntary withdrawal from membership.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Voluntary withdrawal from membership. 925.26... ASSOCIATES MEMBERS OF THE BANKS Withdrawal and Removal From Membership § 925.26 Voluntary withdrawal from membership. (a) In general. (1) Any institution may withdraw from membership by providing to the Bank...

  10. 19 CFR 144.31 - Right to withdraw.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) WAREHOUSE AND REWAREHOUSE ENTRIES AND WITHDRAWALS Withdrawals from Warehouse § 144.31 Right to withdraw. Withdrawals from bonded warehouse may be made only by the person primarily liable for the payment of duties on the merchandise being withdrawn, i.e., the importer of record on the warehouse...

  11. 19 CFR 144.27 - Withdrawal from warehouse by transferee.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Withdrawal from warehouse by transferee. 144.27...; DEPARTMENT OF THE TREASURY (CONTINUED) WAREHOUSE AND REWAREHOUSE ENTRIES AND WITHDRAWALS Transfer of Right To Withdraw Merchandise from Warehouse § 144.27 Withdrawal from warehouse by transferee. At any time...

  12. Abdominal vascular responses to changes in carbon dioxide tension in the cephalic circulation of anaesthetized dogs.

    PubMed

    Ford, R; Hainsworth, R; Rankin, A J; Soladoye, A O

    1985-01-01

    Dogs were anaesthetized with chloralose, the regions of both carotid sinuses were vascularly isolated and perfused with arterial blood and both cervical vagosympathetic trunks were cut above the nodose ganglia. The cephalic circulation was perfused through the brachiocephalic and left subclavian arteries with blood which was equilibrated with various levels of CO2. The abdomen was vascularly isolated, perfused through the aorta at constant flow and drained through the inferior vena cava at constant pressure. Changes in vascular resistance were determined from changes in abdominal aortic perfusion pressure and changes in capacitance from the integral of the changes in venous outflow. An increase in PCO2 in the cephalic perfusate resulted in an increase in abdominal vascular resistance and a decrease in capacitance. However, when carotid sinus pressure was high, the response of resistance to an increase in cephalic PCO2 was abolished and that of capacitance was significantly reduced. The reflex responses of both vascular resistance and capacitance to a change in carotid sinus pressure were enhanced when the cephalic PCO2 was raised. However, the effect on the reflex capacitance response from stimulation of baroreceptors was obtained only when PCO2 was changed below 5 kPa whereas the effect on resistance occurred at higher values of PCO2. The interaction between the effects of changes in cephalic PCO2 and the carotid sinus reflex and the differential effect on resistance and capacitance vessels have been explained in terms of the known difference in the sensitivities of these vessels to sympathetic nerve activity. PMID:3920388

  13. Successful Kidney and Lung Transplantation From a Deceased Donor With Blunt Abdominal Trauma and Intestinal Perforation

    PubMed Central

    van Smaalen, Tim C.; Krikke, Christina; Haveman, Jan Willem; van Heurn, L.W. Ernest

    2016-01-01

    The number of organ donors is limited by many contraindications for donation and poor quality of potential organ donors. Abdominal infection is a generally accepted contraindication for donation of abdominal organs. We present a 43-year-old man with lethal brain injury, blunt abdominal trauma, and intestinal perforation. After withdrawal of life-sustaining treatment and circulatory arrest, a minilaparotomy confirmed abdominal contamination with intestinal content. After closure of the abdomen, organs were preserved with in situ preservation with an aortic cannula inserted via the femoral artery. Thereafter, the kidneys were procured via bilateral lumbotomy to reduce the risk of direct bacterial contamination; lungs were retrieved following a standard practice. There was no bacterial or fungal growth in the machine preservation fluid of both kidneys. All organs were successfully transplanted, without postoperative infection, and functioned well after 6 months. We hereby show that direct contamination of organs can be avoided with the use of in situ preservation and retroperitoneal procurement. Intestinal perforation is not an absolute contraindication for donation, although the risk of bacterial or fungal transmission has to be evaluated per case.

  14. Successful Kidney and Lung Transplantation From a Deceased Donor With Blunt Abdominal Trauma and Intestinal Perforation.

    PubMed

    van Smaalen, Tim C; Krikke, Christina; Haveman, Jan Willem; van Heurn, L W Ernest

    2016-01-01

    The number of organ donors is limited by many contraindications for donation and poor quality of potential organ donors. Abdominal infection is a generally accepted contraindication for donation of abdominal organs. We present a 43-year-old man with lethal brain injury, blunt abdominal trauma, and intestinal perforation. After withdrawal of life-sustaining treatment and circulatory arrest, a minilaparotomy confirmed abdominal contamination with intestinal content. After closure of the abdomen, organs were preserved with in situ preservation with an aortic cannula inserted via the femoral artery. Thereafter, the kidneys were procured via bilateral lumbotomy to reduce the risk of direct bacterial contamination; lungs were retrieved following a standard practice. There was no bacterial or fungal growth in the machine preservation fluid of both kidneys. All organs were successfully transplanted, without postoperative infection, and functioned well after 6 months. We hereby show that direct contamination of organs can be avoided with the use of in situ preservation and retroperitoneal procurement. Intestinal perforation is not an absolute contraindication for donation, although the risk of bacterial or fungal transmission has to be evaluated per case. PMID:27500248

  15. IDENTIFICATION AND MANAGEMENT OF ALCOHOL WITHDRAWAL SYNDROME

    PubMed Central

    Mirijello, Antonio; D’Angelo, Cristina; Ferrulli, Anna; Vassallo, Gabriele; Antonelli, Mariangela; Caputo, Fabio; Leggio, Lorenzo; Gasbarrini, Antonio; Addolorato, Giovanni

    2016-01-01

    Symptoms of alcohol withdrawal syndrome may develop within 6–24 hours after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for alcohol withdrawal syndrome is represented by benzodiazepines. Among them, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as alpha2-agonists (clonidine and dexmetedomidine) and beta-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptics can help control hallucinations. Finally, other medications for the treatment for alcohol withdrawal syndrome have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin, and topiramate. The usefulness of these agents will be discussed in the text. PMID:25666543

  16. Estimated Freshwater Withdrawals in Oklahoma, 1990

    USGS Publications Warehouse

    Lurry, Dee L.; Tortorelli, Robert L.

    1996-01-01

    This report presents 1990 freshwater withdrawal estimates for Oklahoma by source and category. Withdrawal source is either ground water or surface water. Withdrawal categories include: irrigation, water supply, livestock, thermoelectric-power generation, domestic and commercial, and industrial and mining. Withdrawal data are aggregated by county, major aquifer, and principal river basin. Only the four major categories of irrigation, water supply, livestock, and thermoelectric-power generation are illustrated in this report, although data for all categories are tabulated. The U.S. Geological Survey (USGS) established the National Water-Use Information Program in 1977 to collect uniform, current, and reliable information on water use. The Oklahoma District of the USGS and the Oklahoma Water Resources Board participate in a cooperative program to collect and publish water-use information for Oklahoma. Data contained in this report were made available through the cooperative program.

  17. Airway reflexes, autonomic function, and cardiovascular responses.

    PubMed Central

    Widdicombe, J; Lee, L Y

    2001-01-01

    In this article, we review the cardiovascular responses to the inhalation of irritants and pollutants. Many sensory receptors in the respiratory system, from nose to alveoli, respond to these irritants and set up powerful reflex changes, including those in the cardiovascular system. Systemic hypotension or hypertension, pulmonary hypertension, bradycardia, tachycardia, and dysrhythmias have all been described previously. Most of the experiments have been acute and have been performed on anesthetized experimental animals. Experiments on humans suggest we have similar sensory systems and reflex responses. However, we must use caution when applying the animal results to humans. Most animal experiments, unlike those with humans, have been performed using general anesthesia, with irritants administered in high concentrations, and often to a restricted part of the respiratory tract. Species differences in the response to irritants are well established. We must be even more careful when applying the results of acute experiments in animals to the pathophysiologic changes observed in prolonged exposure to environmental pollution in humans. PMID:11544167

  18. Electrically induced blink reflex in horses.

    PubMed

    Añor, S; Espadaler, J M; Monreal, L; Mayhew, I G

    The electrically induced blink reflex was studied electromyographically in 21 healthy adult, detomidine-sedated horses. Using surface electrodes, the supraorbital nerve was electrically stimulated at the supraorbital foramen. The responses were recorded from the ipsilateral and contralateral orbicularis oculi muscles with concentric needle electrodes inserted in the lateral aspect of the ventral eyelids. Ipsilateral and contralateral recordings were made on successive stimulations of the same side of the face, maintaining a constant stimulus intensity. The electromyographically recorded responses consisted of an early R1 response in the orbicularis oculi muscle ipsilateral to the side of stimulation, a bilateral late response (ipsilateral R2 and contralateral Rc) and a third, R3 response, in the ipsilateral orbicularis oculi muscle. All the responses were polyphasic muscle potentials of variable duration and peak to peak amplitudes. The reflex latency of the R1 response was, as in man, fairly stable. The R2 response showed greater variability both within and between individual horses. The Rc response was recorded in only 13 of the 21 horses and showed a slightly longer latency than the corresponding R2. The R3 response, which is significantly related to pain sensation in man, appeared in 19 horses and showed the greatest variability in latency. PMID:9123787

  19. A Movement Account of Long-Distance Reflexives

    ERIC Educational Resources Information Center

    McKeown, Rebecca Katherine

    2013-01-01

    This thesis examines reflexive pronouns, such as Icelandic "sig" (Cf. Thrainsson 2007), which may be bound from outside of an infinitive clause (which I call MD "medium distance" binding) in addition to being bound locally. I propose that such reflexives are linked to their antecedents via sisterhood followed by movement: the…

  20. Reflexive Management Learning: An Integrative Review and a Conceptual Typology

    ERIC Educational Resources Information Center

    Cotter, Richard J.; Cullen, John G.

    2012-01-01

    The scale and reach of the recent global financial has created a fresh wave of interest in exploring more sustainable forms of management. A central thrust behind this trend in the practice of management development and education has been the accentuation of reflexivity. There are many variations in how reflexivity is understood, and this article…

  1. Bourdieu and Science Studies: Toward a Reflexive Sociology

    ERIC Educational Resources Information Center

    Hess, David J.

    2011-01-01

    Two of Bourdieu's fundamental contributions to science studies--the reflexive analysis of the social and human sciences and the concept of an intellectual field--are used to frame a reflexive study of the history and social studies of science and technology as an intellectual field in the United States. The universe of large, Ph.D.-granting…

  2. Iris Pigmentation and Fractionated Reaction and Reflex Time.

    ERIC Educational Resources Information Center

    Hale, Bruce D.; And Others

    Behavioral measures, fractionated reaction and reflex times by means of electromyography, were used to determine if the eye color differences are found in the central or peripheral regions of the nervous system. The purpose of this research was to determine the truth of the hypothesis that dark-eyed individuals have faster reflex and reaction time…

  3. [The development of I. P. Pavlov's conditioned reflex theory].

    PubMed

    Kim, O J

    1992-01-01

    This paper deals with the theory of Ivan Petrovich Pavlov (1849-1936), a Russian physiologist who presented for the first time the systematic theory of the function of the brain that controls the whole behavior of animals, i.e. higher nervous activity through experimental studies. This paper, principally based on Lectures on Conditioned Reflexes (1928), investigates the development of conditioned reflex theory from its beginning by dividing it into three periods. First, during the period from 1898 to 1906, the fundamental concept of conditioned reflex was established and the study of conditioned reflex became an independent discipline. From 1907 to 1916, the second period, Pavlov theorized on higher nervous activity on the basis of extensive data from his laboratory experiments of conditioned reflex. And Pavlov complemented conditioned reflex theory, during the third period from 1916 to 1928, and extended the boundaries of it through applications of conditioned reflex theory to psychopathology and typology. The study contributes to the understanding that conditioned reflex theory was historically developed, and not presented as a complete form from the beginning, and that Pavlov intended to study the higher nervous activity through the method of neurophysiology. PMID:11618531

  4. Role of stretch reflex in voluntary movements. [of human foot

    NASA Technical Reports Server (NTRS)

    Gottlieb, G. L.; Agarwal, G. C.

    1975-01-01

    The stretch reflex is often described as a spinal servomechanism, a device for assisting in the regulation of muscle length. Observation of the EMG response to mechanical interruption of voluntary movements fails to demonstrate a significant role for spinal reflexes at 40 msec latency. Two functional responses with latencies of 120 msec and 200 msec, implying supraspinal mediation, are observed.

  5. The proboscis extension reflex not elicited in Magachilid bees

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Honey bees (Apis mellifera L.) will reflexively extend their proboscis in response to antennal stimulation with sucrose solution. For decades, the proboscis extension reflex (PER) of honey bees has been used as a tool to further the understanding of their cognitive processes, such as learning and m...

  6. Anxiogenic effects of cocaine withdrawal in zebrafish.

    PubMed

    López-Patiño, Marcos A; Yu, Lili; Cabral, Howard; Zhdanova, Irina V

    2008-01-28

    Continued usage of cocaine is determined by genetic, conditioned and homeostatic factors, while it is reinforced by drug-induced reward and the emotionally negative state of drug withdrawal, which includes anxiety. The molecular mechanisms of these long-term behavioral and physiological alterations have yet to be fully elucidated. Here we demonstrate that in zebrafish, a wide range of non-anesthetic cocaine doses, 0.015-15 muM, does not result in acute alterations in locomotor activity, in spite of the high brain cocaine levels induced (7-120 pg/microg protein). Conversely, cocaine withdrawal causes hyperactivity associated with stereotypy. The behavioral hyperactivity is progressively increased during the initial period of withdrawal (24-72 h) and is maintained for at least 5 days. Such effect of cocaine withdrawal is aggravated by environmental stimulation and attenuated in the home environment. Administration of cocaine (1.5 microM) or a non-sedative dose of diazepam (5 microM, immersion) acutely counteracts withdrawal-associated hyperactivity and stereotypy in zebrafish, with the magnitude of these effects positively correlating with the degree of prior increase in basal activity. Administration of an anxiogenic benzodiazepine inverse agonist, FG-7142, results in zebrafish behavior similar to that observed during cocaine withdrawal. Together, the results suggest that cocaine withdrawal produces long-lasting behavioral effects in zebrafish which are consistent with an anxiety-like state. Thus, zebrafish, a powerful model for the study of vertebrate genetics, could provide insights into the molecular mechanisms of drug withdrawal. PMID:17889042

  7. Large Abdominal Wall Endometrioma Following Laparoscopic Hysterectomy

    PubMed Central

    Borncamp, Erik; Mehaffey, Philip; Rotman, Carlos

    2011-01-01

    Background: Endometriosis is a common condition in women that affects up to 45% of patients in the reproductive age group by causing pelvic pain. It is characterized by the presence of endometrial tissue outside the uterine cavity and is rarely found subcutaneously or in abdominal incisions, causing it to be overlooked in patients with abdominal pain. Methods: A 45-year-old woman presented with lower abdominal pain 2 years following a laparoscopic supracervical hysterectomy. She was found to have incidental cholelithiasis and a large abdominal mass suggestive of a significant ventral hernia on CT scan. Results: Due to the peculiar presentation, surgical intervention took place that revealed a large 9cm×7.6cm×6.2cm abdominal wall endometrioma. Conclusion: Although extrapelvic endometriosis is rare, it should be entertained in the differential diagnosis for the female patient who presents with an abdominal mass and pain and has a previous surgical history. PMID:21902990

  8. Blunt abdominal trauma in children.

    PubMed

    Tepas, J J

    1993-06-01

    The growing popularity of nonoperative treatment of children with splenic injuries has seduced some physicians into a false sense of security regarding care of the injured child. Although it has been established that hemodynamically stable children with splenic, hepatic, and even renal injuries can safely be treated "expectantly," this concept cannot be applied indiscriminately. Accurate diagnosis and effective care of the child with blunt abdominal trauma is an exercise of clinical precision that demands attention to detail and thorough evaluation. This review addresses this process in light of recent advances in diagnostic imaging and in consideration of recent reports analyzing different protocols for therapeutic decision making. PMID:8374651

  9. BIOMECHANICS OF ABDOMINAL AORTIC ANEURYSM

    PubMed Central

    Vorp, David A.

    2009-01-01

    Abdominal aortic aneurysm (AAA) is a condition whereby the terminal aorta permanently dilates to dangerous proportions, risking rupture. The biomechanics of AAA has been studied with great interest since aneurysm rupture is a mechanical failure of the degenerated aortic wall and is a significant cause of death in developed countries. In this review article, the importance of considering the biomechanics of AAA is discussed, and then the history and the state-of-the-art of this field is reviewed - including investigations into the biomechanical behavior of AAA tissues, modeling AAA wall stress and factors which influence it, and the potential clinical utility of these estimates in predicting AAA rupture. PMID:17254589

  10. [Abdominal pain, constipation and anemia].

    PubMed

    Barresi, Fabio; Kunz Caflish, Isabel; Bayly-Schinzel, Leena; Dressel, Holger

    2016-03-30

    We present the case of a 42-year old man who went to the emergency department because of spasmodic abdominal pain. The abdomen was soft. A gastroscopy and a colonoscopy were without pathological findings. The laboratory analyses indicated anemia. The differential blood count showed basophilic granules in the red blood cells. The blood lead level was elevated. A lead poisoning was diagnosed. The cause was the oral intake of an ayurvedic medication which the patient had received in Bangladesh to treat his vitiligo. PMID:27005735

  11. Withdrawing Benzodiazepines in Patients With Anxiety Disorders.

    PubMed

    Lader, Malcolm; Kyriacou, Andri

    2016-01-01

    The large class of CNS-depressant medications-the benzodiazepines-have been extensively used for over 50 years, anxiety disorders being one of the main indications. A substantial proportion (perhaps up to 20-30 %) of long-term users becomes physically dependent on them. Problems with their use became manifest, and dependence, withdrawal difficulties and abuse were documented by the 1980s. Many such users experience physical and psychological withdrawal symptoms on attempted cessation and may develop clinically troublesome syndromes even during slow tapering. Few studies have been conducted to establish the optimal withdrawal schedules. The usual management comprises slow withdrawal over weeks or months together with psychotherapy of various modalities. Pharmacological aids include antidepressants such as the SSRIs especially if depressive symptoms supervene. Other pharmacological agents such as the benzodiazepine antagonist, flumazenil, and the hormonal agent, melatonin, remain largely experimental. The purpose of this review is to analyse the evidence for the efficacy of the usual withdrawal regimes and the newer agents. It is concluded that little evidence exists outside the usual principles of drug withdrawal but there are some promising leads. PMID:26733324

  12. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond

    PubMed Central

    Sachdeva, Ankur; Chandra, Mina

    2015-01-01

    Alcohol dependence is an increasing and pervasive problem. Alcohol withdrawal symptoms are a part of alcohol dependence syndrome and are commonly encountered in general hospital settings, in most of the departments. Alcohol withdrawal syndrome ranges from mild to severe. The severe complicated alcohol withdrawal may present with hallucinations, seizures or delirium tremens. Benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal, and are considered the gold standard. Others, such as anticonvulsants, barbiturates, adrenergic drugs, and GABA agonists have been tried and have evidence. Supportive care and use of vitamins is essential in the management. Symptom triggered regime is favoured over fixed tapering dose regime, although monitoring through scales is cumbersome. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on ‘Alcohol withdrawal syndrome’ in humans during the last 10 years. A total of 1182 articles came up. Articles not relevant to clinical utility and management were excluded based on the titles and abstract available. Full text articles, meta-analyses, systematic reviews and randomized controlled trials were obtained from this list and were considered for review. PMID:26500991

  13. Antiepileptic Drug Withdrawal in Dogs with Epilepsy

    PubMed Central

    Gesell, Felix Kaspar; Hoppe, Sonja; Löscher, Wolfgang; Tipold, Andrea

    2015-01-01

    Epilepsy is one of the most common neurological disorders in dogs and is treated by chronic administration of antiepileptic drugs (AEDs). In human beings with epilepsy, it is common clinical practice to consider drug withdrawal after a patient has been in remission (seizure free) for three or more years, but withdrawal is associated with the risk of relapse. In the present study, the consequences of AED withdrawal were studied in dogs with epilepsy. Therefore, 200 owners of dogs with idiopathic or presumed idiopathic epilepsy were contacted by telephone interview, 138 cases could be enrolled. In 11 cases, the therapy had been stopped after the dogs had become seizure free for a median time of 1 year. Reasons for AED withdrawal were appearance or fear of adverse side effects, financial aspects, and the idea that the medication could be unnecessary. Following AED withdrawal, four of these dogs remained seizure free, seven dogs suffered from seizure recurrence, of which only three dogs could regain seizure freedom after resuming AED therapy. Due to the restricted case number, an exact percentage of dogs with seizure recurrence after AED withdrawal cannot be given. However, the present study gives a hint that similar numbers as in human patients are found, and the data can help owners of epileptic dogs and the responsible clinician to decide when and why to stop antiepileptic medication. PMID:26664952

  14. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond.

    PubMed

    Sachdeva, Ankur; Choudhary, Mona; Chandra, Mina

    2015-09-01

    Alcohol dependence is an increasing and pervasive problem. Alcohol withdrawal symptoms are a part of alcohol dependence syndrome and are commonly encountered in general hospital settings, in most of the departments. Alcohol withdrawal syndrome ranges from mild to severe. The severe complicated alcohol withdrawal may present with hallucinations, seizures or delirium tremens. Benzodiazepines have the largest and the best evidence base in the treatment of alcohol withdrawal, and are considered the gold standard. Others, such as anticonvulsants, barbiturates, adrenergic drugs, and GABA agonists have been tried and have evidence. Supportive care and use of vitamins is essential in the management. Symptom triggered regime is favoured over fixed tapering dose regime, although monitoring through scales is cumbersome. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on 'Alcohol withdrawal syndrome' in humans during the last 10 years. A total of 1182 articles came up. Articles not relevant to clinical utility and management were excluded based on the titles and abstract available. Full text articles, meta-analyses, systematic reviews and randomized controlled trials were obtained from this list and were considered for review. PMID:26500991

  15. Efficient Estimation of Time-Varying Intrinsic and Reflex Stiffness

    PubMed Central

    Ludvig, Daniel; Perreault, Eric J.; Kearney, Robert E.

    2013-01-01

    Dynamic joint stiffness defines the dynamic relationship between the position of the joint and the torque acting about it; hence it is important in the control of movement and posture. Joint stiffness consists of two components: intrinsic stiffness and reflex stiffness. Measuring intrinsic and reflex torques directly is not possible, thus estimating intrinsic and reflex stiffness is challenging. A further complication is that both intrinsic and reflex stiffness vary with joint position and torque. Thus, the measurement of dynamic joint stiffness during movement requires a time-varying algorithm. Recently we described an algorithm to estimate time-varying intrinsic and reflex stiffness and demonstrated its application. This paper describes modifications to that algorithm that significantly improves the accuracy of the estimates it generates while increasing its computational efficiency by a factor of seven. PMID:22255247

  16. Resuscitation and auto resuscitation by airway reflexes in animals.

    PubMed

    Tomori, Zoltan; Donic, Viliam; Benacka, Roman; Jakus, Jan; Gresova, Sona

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath - sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant - autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasping respiration. Nasopharyngeal stimulation in cats and most mammals evokes the aspiration reflex, characterized by spasmodic inspiration followed by passive expiration. On the contrary, expiration reflex from the larynx, or cough reflex from the pharynx and lower airways manifest by a forced expiration, which in cough is preceded by deep inspiration. These reflexes of distinct character activate the brainstem rhythm generators for inspiration and expiration strongly, but differently. They secondarily modulate the control mechanisms of various vital functions of the organism. During severe asphyxia the progressive respiratory insufficiency may induce a life-threatening cardio-respiratory failure. The sniff- and gasp-like aspiration reflex and similar spasmodic inspirations, accompanied by strong sympatho-adrenergic activation, can interrupt a severe asphyxia and reverse the developing dangerous cardiovascular and vasomotor dysfunctions, threatening with imminent loss of consciousness and death. During progressive asphyxia the reversal of gradually developing bradycardia and excessive hypotension by airway reflexes starts with reflex tachycardia and vasoconstriction, resulting in prompt hypertensive reaction, followed by renewal of cortical activity and gradual normalization of breathing. A combination of the aspiration reflex supporting venous return and the expiration or cough reflex increasing the cerebral perfusion by strong expirations, provides a powerful resuscitation and

  17. Resuscitation and auto resuscitation by airway reflexes in animals

    PubMed Central

    2013-01-01

    Various diseases often result in decompensation requiring resuscitation. In infants moderate hypoxia evokes a compensatory augmented breath – sigh and more severe hypoxia results in a solitary gasp. Progressive asphyxia provokes gasping respiration saving the healthy infant – autoresuscitation by gasping. A neonate with sudden infant death syndrome, however, usually will not survive. Our systematic research in animals indicated that airway reflexes have similar resuscitation potential as gasping respiration. Nasopharyngeal stimulation in cats and most mammals evokes the aspiration reflex, characterized by spasmodic inspiration followed by passive expiration. On the contrary, expiration reflex from the larynx, or cough reflex from the pharynx and lower airways manifest by a forced expiration, which in cough is preceded by deep inspiration. These reflexes of distinct character activate the brainstem rhythm generators for inspiration and expiration strongly, but differently. They secondarily modulate the control mechanisms of various vital functions of the organism. During severe asphyxia the progressive respiratory insufficiency may induce a life-threatening cardio-respiratory failure. The sniff- and gasp-like aspiration reflex and similar spasmodic inspirations, accompanied by strong sympatho-adrenergic activation, can interrupt a severe asphyxia and reverse the developing dangerous cardiovascular and vasomotor dysfunctions, threatening with imminent loss of consciousness and death. During progressive asphyxia the reversal of gradually developing bradycardia and excessive hypotension by airway reflexes starts with reflex tachycardia and vasoconstriction, resulting in prompt hypertensive reaction, followed by renewal of cortical activity and gradual normalization of breathing. A combination of the aspiration reflex supporting venous return and the expiration or cough reflex increasing the cerebral perfusion by strong expirations, provides a powerful resuscitation

  18. Abdominal wall reconstruction with implantable meshes.

    PubMed

    Masden, Derek; Felder, John M; Iorio, Matthew L; Bhanot, Parag; Attinger, Christopher E

    2011-01-01

    Abdominal wall defects present a difficult problem for the reconstructive surgeon. Over the years, numerous implantable materials have becomes available to aid the surgeon in recreating the abdominal wall. This spectrum of implants includes permanent synthetic meshes, absorbable meshes, composite meshes and biomaterials. This review includes the pros and cons for the commercially available abdominal wall implants as well as a review of the literature regarding outcomes for each material. This review will provide the surgeon with current evidence-based information on implantable abdominal materials to be able to make a more informed decision about which implant to use. PMID:21663579

  19. Absence of synergy for monosynaptic Group I inputs between abdominal and internal intercostal motoneurons

    PubMed Central

    Ford, T. W.; Meehan, C. F.

    2014-01-01

    Internal intercostal and abdominal motoneurons are strongly coactivated during expiration. We investigated whether that synergy was paralleled by synergistic Group I reflex excitation. Intracellular recordings were made from motoneurons of the internal intercostal nerve of T8 in anesthetized cats, and the specificity of the monosynaptic connections from afferents in each of the two main branches of this nerve was investigated. Motoneurons were shown by antidromic excitation to innervate three muscle groups: external abdominal oblique [EO; innervated by the lateral branch (Lat)], the region of the internal intercostal muscle proximal to the branch point (IIm), and muscles innervated from the distal remainder (Dist). Strong specificity was observed, only 2 of 54 motoneurons showing excitatory postsynaptic potentials (EPSPs) from both Lat and Dist. No EO motoneurons showed an EPSP from Dist, and no IIm motoneurons showed one from Lat. Expiratory Dist motoneurons fell into two groups. Those with Dist EPSPs and none from Lat (group A) were assumed to innervate distal internal intercostal muscle. Those with Lat EPSPs (group B) were assumed to innervate abdominal muscle (transversus abdominis or rectus abdominis). Inspiratory Dist motoneurons (assumed to innervate interchondral muscle) showed Dist EPSPs. Stimulation of dorsal ramus nerves gave EPSPs in 12 instances, 9 being in group B Dist motoneurons. The complete absence of heteronymous monosynaptic Group I reflex excitation between muscles that are synergistically activated in expiration leads us to conclude that such connections from muscle spindle afferents of the thoracic nerves have little role in controlling expiratory movements but, where present, support other motor acts. PMID:24920027

  20. Evaluation of spinal toxicity and long-term spinal reflex function following intrathecal levobupivacaine in the neonatal rat

    PubMed Central

    Hamurtekin, Emre; Fitzsimmons, Bethany L.; Shubayev, Veronica I.; Grafe, Marjorie R.; Deumens, Ronald; Yaksh, Tony L.; Walker, Suellen M.

    2013-01-01

    Background Neuraxial anesthesia is utilized in children of all ages. Local anesthetics produce dose-dependent toxicity in certain adult models, but the developing spinal cord may also be susceptible to drug-induced apoptosis. In postnatal rodents, we examined effects of intrathecal levobupivacaine on neuropathology and long-term sensorimotor outcomes. Methods Postnatal day 3 (P3) or P7 rat pups received intrathecal levobupivacaine 2.5mg/kg (0.5%) or saline. Mechanical withdrawal thresholds and motor block were assessed. Spinal cord tissue analysis included: apoptosis counts (activated-caspase-3, Fluoro-Jade C) at 24 h; glial reactivity at 7 days; and histopathology in cord and cauda equina at 24 h and 7 days. Long-term spinal function in young adults (P35) was assessed by hindlimb withdrawal thresholds, electromyography responses to suprathreshold stimuli, and gait analysis. Results Intrathecal levobupivacaine produced spinal anesthesia at P3 and P7. No increase in apoptosis or histopathological change was seen in the cord or cauda equina. In the P3 saline group, activated-caspase-3 (mean±SEM per lumbar cord section 6.1±0.3) and Fluoro-Jade C (12.1±1.2) counts were higher than at P7, but were not altered by levobupivacaine (P=0.62 and P=0.11, two-tailed Mann-Whitney test). At P35, mechanical withdrawal thresholds, thermal withdrawal latency and electromyographic reflex responses did not differ across P3 or P7 levobupivacaine or saline groups (one way ANOVA with Bonferroni comparisons). Intrathecal bupivacaine at P3 did not alter gait. Conclusion Single dose intrathecal levobupivacaine 0.5% did not increase apoptosis or produce spinal toxicity in neonatal rat pups. This study provides preclinical safety data relevant to neonatal use of neuraxial local anesthesia. PMID:23514721

  1. 19 CFR 19.6 - Deposits, withdrawals, blanket permits to withdraw and sealing requirements.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... withdrawal permit has been issued. Duty-paid or unconditionally duty-free merchandise which has been... withdrawal for transportation to another port by a duty-free sales enterprise which meets the requirements...-free merchandise intended for passengers' on-board purchases when expressly authorized in writing...

  2. Carisoprodol: abuse potential and withdrawal syndrome.

    PubMed

    Reeves, Roy R; Burke, Randy S

    2010-03-01

    Carisoprodol (N-isopropyl-2 methyl-2-propyl-1,3-propanediol dicarbamate; N-isopropylmeprobamate) is a centrally acting skeletal muscle relaxant whose primary active metabolite is meprobamate, a substance with well established abuse potential similar to that of benzodiazepines. A number of reports show that carisoprodol has been abused for its sedative and relaxant effects, to augment or alter the effects of other drugs, and by the intentional combination of carisoprodol and other noncontrolled medications because of the relative ease (as compared to controlled substances) of obtaining prescriptions. The diversion and abuse of carisoprodol and its adverse health effects appear to have dramatically increased over the last several years. Clinicians have begun to see a withdrawal syndrome consisting of insomnia, vomiting, tremors, muscle twitching, anxiety, and ataxia in patients who abruptly cease intake of large doses of carisoprodol. Hallucinations and delusions may also occur. The withdrawal symptoms are very similar to those previously described for meprobamate withdrawal, suggesting that what may actually be occurring is withdrawal from meprobamate accumulated as a result of intake of excessive amounts of carisoprodol. However carisoprodol itself is capable of modulating GABA(A) function, and this may contribute both to the drugs abuse potential and to the occurrence of a withdrawal syndrome with abrupt cessation of intake. Carisoprodol has been classified as a controlled substance in several states in the US and restrictions on the use of the drug have been imposed in some European countries. Carisoprodol is metabolized to a controlled substance, has clear evidence of abuse potential and increasing incidence of abuse, and has shown evidence of a withdrawal syndrome with abrupt cessation from intake. This article will discuss the abuse potential of carisoprodol and the associated withdrawal syndrome, and consider implications for future use of the drug. PMID

  3. Inflated reward value in early opiate withdrawal.

    PubMed

    Wassum, Kate M; Greenfield, Venuz Y; Linker, Kay E; Maidment, Nigel T; Ostlund, Sean B

    2016-03-01

    Through incentive learning, the emotional experience of a reward in a relevant need state (e.g. hunger for food) sets the incentive value that guides the performance of actions that earn that reward when the need state is encountered again. Opiate withdrawal has been proposed as a need state in which, through experience, opiate value can be increased, resulting in escalated opiate self-administration. Endogenous opioid transmission plays anatomically dissociable roles in the positive emotional experience of reward consumption and incentive learning. We, therefore, sought to determine if chronic opiate exposure and withdrawal produces a disruption in the fundamental incentive learning process such that reward seeking, even for non-opiate rewards, can become maladaptive, inconsistent with the emotional experience of reward consumption and irrespective of need. Rats trained to earn sucrose or water on a reward-seeking chain were treated with morphine (10-30 mg/kg, s.c.) daily for 11 days prior to testing in withdrawal. Opiate-withdrawn rats showed elevated reward-seeking actions, but only after they experienced the reward in withdrawal, an effect that was strongest in early (1-3 days), as opposed to late (14-16 days), withdrawal. This was sufficient to overcome a negative reward value change induced by sucrose experience in satiety and, in certain circumstances, was inconsistent with the emotional experience of reward consumption. Lastly, we found that early opiate withdrawal-induced inflation of reward value was blocked by inactivation of basolateral amygdala mu opioid receptors. These data suggest that in early opiate withdrawal, the incentive learning process is disrupted, resulting in maladaptive reward seeking. PMID:25081350

  4. Improving Alcohol Withdrawal Outcomes in Acute Care

    PubMed Central

    Melson, Jo; Kane, Michelle; Mooney, Ruth; McWilliams, James; Horton, Terry

    2014-01-01

    Context Excessive alcohol consumption is the nation’s third leading cause of preventable deaths. If untreated, 6% of alcohol-dependent patients experience alcohol withdrawal, with up to 10% of those experiencing delirium tremens (DT), when they stop drinking. Without routine screening, patients often experience DT without warning. Objective: Reduce the incidence of alcohol withdrawal advancing to DT, restraint use, and transfers to the intensive care unit (ICU) in patients with DT. Design: In October 2009, the alcohol withdrawal team instituted a care management guideline used by all disciplines, which included tools for screening, assessment, and symptom management. Data were obtained from existing datasets for three quarters before and four quarters after implementation. Follow-up data were analyzed and showed a great deal of variability in transfers to the ICU and restraint use. Percentage of patients who developed DT showed a downward trend. Main Outcome Measures: Incidence of alcohol withdrawal advancing to DT and, in patients with DT, restraint use and transfers to the ICU. Results: Initial data revealed a decrease in percentage of patients with alcohol withdrawal who experienced DT (16.4%–12.9%). In patients with DT, restraint use decreased (60.4%–44.4%) and transfers to the ICU decreased (21.6%–15%). Follow-up data indicated a continued downward trend in patients with DT. Changes were not statistically significant. Restraint use and ICU transfers maintained postimplementation levels initially but returned to preimplementation levels by third quarter 2012. Conclusion: Early identification of patients for potential alcohol withdrawal followed by a standardized treatment protocol using symptom-triggered dosing improved alcohol withdrawal management and outcomes. PMID:24867561

  5. Cultural Reflexivity in Health Research and Practice

    PubMed Central

    Aronowitz, Robert; Deener, Andrew; Keene, Danya; Schnittker, Jason

    2015-01-01

    Recent public health movements have invoked cultural change to improve health and reduce health disparities. We argue that these cultural discourses have sometimes justified and maintained health inequalities when those with power and authority designated their own social practices as legitimate and healthy while labeling the practices of marginalized groups as illegitimate or unhealthy. This “misrecognition,” which creates seemingly objective knowledge without understanding historical and social conditions, sustains unequal power dynamics and obscures the fact that what is deemed legitimate and healthy can be temporally, geographically, and socially relative. We use examples from research across multiple disciplines to illustrate the potential consequences of cultural misrecognition, highlight instances in which culture was invoked in ways that overcame misrecognition, and discuss how cultural reflexivity can be used to improve health research and practice. PMID:25905833

  6. [Uncommon reflex automatisms after brain death].

    PubMed

    Awada, A

    1995-10-01

    Two cases of unusual complex movements observed in brain dead patients are described. Rapid and sustained flexion of the neck induced slow abduction of the arms with flexion of the elbows, wrists and fingers over 5 to 10 seconds. These movements have been rarely described and although they have similar clinical patterns, they are pathophysiologically different from the Lazarus sign which is observed few minutes after respiratory support cessation. While Lazarus sign is supposed to be due to an agonal discharge of anoxic spinal neurons, the movements described in this article result probably from complex reflexes generated in a disinhibited spinal cord. It is however surprising that they have never been described in patients with high cervical spinal injuries. PMID:8594654

  7. Modeling of deep breath vasoconstriction reflex.

    PubMed

    Chalacheva, Patjanaporn; Khoo, Michael C K

    2015-08-01

    Deep breaths akin to sighs have been reported to cause peripheral vasoconstriction. Our previous simulation studies have shown that this phenomenon cannot be reproduced in existing circulatory control models without inclusion of a respiratory-vascular coupling mechanism. To better understand this "sigh-vasoconstriction reflex", we investigated the effect of spontaneous and passively induced sighs as well as spontaneous breathing on peripheral vasoconstriction during wakefulness and non-rapid eye movement sleep in human subjects. We found that both spontaneous and induced sighs caused vasoconstriction during wakefulness and sleep. The coupling between respiration and vasoconstriction is also present even in an absence of deep breaths. The coupling mechanism is largely linear with increased nonlinearity during induced sighs. Since peripheral vascular resistance modulation is known to be sympathetically mediated, investigation of this coupling could potentially allow us to assess sympathetic function through non-invasive measurements and simple interventions. PMID:26738099

  8. The Chinchilla's vestibulo-ocular reflex

    NASA Technical Reports Server (NTRS)

    Merwin, W. H., Jr.; Wall, Conrad, III; Tomko, D. L.

    1989-01-01

    The horizontal vestibulo-ocular reflex (VOR) was measured and characterized in seven adult chinchillas using 0.01 to 1.0 Hz angular velocity sinusoids. Gains were less than compensatory, and were variable from day to day, but phases were highly repeatable both within and between animals. The best fitting transfer function to the average data of all animals had a dominant time constant of 7.5 sec, and an adaptation operator with a time constant of 24.0 sec. There were certain nonlinearities in the horizontal VOR of this animal, and it was difficult to elicit a robust optokinetic response. Results are discussed in relation to similar measurements in other species.

  9. Vestibulospinal reflexes as a function of microgravity

    NASA Technical Reports Server (NTRS)

    Reschke, M. F.; Homick, J. L.; Anderson, D. J.

    1984-01-01

    Data from previous manned space flights suggest that an exposure to microgravity produces significant alterations in vestibular, neuromuscular, and related sensory system functions. It is possible that the observed changes are a function of adaptation induced by altered otolith input. An experiment in Spacelab 1 was conducted with the aim to study this adaptation as it occurred in flight and after flight, and to relate the observed changes to mechanisms underlying space motion sickness. The concept was explored by making use of the anatomic pathway which links the otolith organs and spinal motoneurons. The overall sensitivity of the spinal motoneurons was tested by two related methods. One method involves the electrical excitation of neural tissue and the recording of vestibulospinal reflexes in conjunction with a brief linear acceleration. The second method is concerned with measurements of dynamic postural ataxia. Results suggest that more than a single time constant may be involved in man's ability to return to baseline values.

  10. Vestibular-ocular accommodation reflex in man

    NASA Technical Reports Server (NTRS)

    Clark, B.; Randle, R. J.; Stewart, J. D.

    1975-01-01

    Stimulation of the vestibular system by angular acceleration produces widespread sensory and motor effects. The present paper studies a motor effect which has not been reported in the literature, i.e., the influence of rotary acceleration of the body on ocular accommodation. The accommodation of 10 young men was recorded before and after a high-level deceleration to zero velocity following 30 sec of rotating. Accommodation was recorded continuously on an infrared optometer for 110 sec under two conditions: while the subjects observed a target set at the far point, and while they viewed the same target through a 0.3-mm pinhole. Stimulation by high-level rotary deceleration produced positive accommodation or a pseudomyopia under both conditions, but the positive accommodation was substantially greater and lasted much longer during fixation through the pinhole. It is hypothesized that this increase in accommodation is a result of a vestibular-ocular accommodation reflex.

  11. Bremsstrahlung target optimization for reflex triodes

    SciTech Connect

    Swanekamp, S. B.; Weber, B. V.; Stephanakis, S. J.; Mosher, D.; Commisso, R. J.

    2008-08-15

    The anode (tantalum) foil thickness in a reflex triode was varied from 2.5 to 250 {mu}m to maximize the dose from bremsstrahlung produced by a 1 MV, 1 MA, 100 ns electron beam. Experiments and computer simulations show that the dose is maximized for a foil thickness of about 25 {mu}m, 1/18th of the electron range computed from the continuous slowing down approximation. For foils thicker than optimum, self-absorption in the foil attenuates 10-100 keV photons, reducing the dose. For foils thinner than optimum, the dose decreases as a result of electron migration to large radius. A simple formula that predicts the optimum thickness as a function of the beam current and voltage is derived that should be applicable to a large range of experimental parameters.

  12. Sudomotor function in sympathetic reflex dystrophy.

    PubMed

    Birklein, F; Sittl, R; Spitzer, A; Claus, D; Neundörfer, B; Handwerker, H O

    1997-01-01

    Sudomotor functions were studied in 27 patients suffering from reflex sympathetic dystrophy (RSD) according to the criteria established by Bonica (18 women, 9 men; mean age 50 +/- 12.3 years; median duration of disease 8 weeks, range 2-468 weeks). To measure local sweating rates, two small chambers (5 cm2) were affixed to corresponding areas of hairy skin on the affected and unaffected limbs. Dry nitrogen gas was passed through the chambers (270 ml/min) and evaporation was recorded at both devices with hygrometers. Thermoregulatory sweating (TST) was induced by raising body temperature (intake of 0.5 1 hot tea and infra-red irradiation). Local sweating was also induced through an axon reflex (QSART) by transcutaneous iontophoretic application of carbachol (5 min, 1 mA). In addition, skin temperature was measured on the affected and unaffected side by infra-red thermography. Mean skin temperature was significantly higher on the affected side (P < 0.003). In spite of the temperature differences, there was no difference in basal sweating on the affected and unaffected side. However, both methods of sudomotor stimulation lead to significantly greater sweating responses on the affected compared to the unaffected side (TST: P < 0.05, QSART: P < 0.004). Latency to onset of sweating was significantly shorter on the affected side under both test conditions (P < 0.04 and P < 0.003, respectively). Sweat responses were not correlated to absolute skin temperature but were probably related to the increased blood flow on the affected side. Our findings imply a differential disturbance of vasomotor and sudomotor mechanisms in affected skin. Whereas vasoconstrictor activity is apparently lowered, sudomotor output is either unaltered or may even be enhanced. PMID:9060012

  13. Aerial righting reflexes in flightless animals.

    PubMed

    Jusufi, Ardian; Zeng, Yu; Full, Robert J; Dudley, Robert

    2011-12-01

    Animals that fall upside down typically engage in an aerial righting response so as to reorient dorsoventrally. This behavior can be preparatory to gliding or other controlled aerial behaviors and is ultimately necessary for a successful landing. Aerial righting reflexes have been described historically in various mammals such as cats, guinea pigs, rabbits, rats, and primates. The mechanisms whereby such righting can be accomplished depend on the size of the animal and on anatomical features associated with motion of the limbs and body. Here we apply a comparative approach to the study of aerial righting to explore the diverse strategies used for reorientation in midair. We discuss data for two species of lizards, the gecko Hemidactylus platyurus and the anole Anolis carolinensis, as well as for the first instar of the stick insect Extatosoma tiaratum, to illustrate size-dependence of this phenomenon and its relevance to subsequent aerial performance in parachuting and gliding animals. Geckos can use rotation of their large tails to reorient their bodies via conservation of angular momentum. Lizards with tails well exceeding snout-vent length, and correspondingly large tail inertia to body inertia ratios, are more effective at creating midair reorientation maneuvers. Moreover, experiments with stick insects, weighing an order of magnitude less than the lizards, suggest that aerodynamic torques acting on the limbs and body may play a dominant role in the righting process for small invertebrates. Both inertial and aerodynamic effects, therefore, can play a role in the control of aerial righting. We propose that aerial righting reflexes are widespread among arboreal vertebrates and arthropods and that they represent an important initial adaptation in the evolution of controlled aerial behavior. PMID:21930662

  14. Intra-administration associations and withdrawal symptoms: morphine-elicited morphine withdrawal.

    PubMed

    McDonald, Robert V; Siegel, Shepard

    2004-02-01

    On the basis of a conditioning analysis, some drug "withdrawal symptoms" are conditional responses elicited by stimuli paired with the drug effect. Prior demonstrations of conditional elicitation of withdrawal symptoms evaluated the role of environmental cues; however, pharmacological cues also typically signal a drug effect. Within each administration, early drug onset cues (DOCs) may become associated with the later, larger drug effect (intra-administration associations). This experiment evaluated the contribution of intra-administration associations to withdrawal symptoms. The results indicated that (a). 5 mg/kg morphine elicited behavioral and thermic withdrawal symptoms in rats previously injected on a number of occasions with 50 mg/kg morphine and that (b). DOC-elicited withdrawal symptoms are not a sensitized response to the opiate but rather an associative phenomenon. PMID:14769091

  15. Analysing responses to climate change through the lens of reflexivity.

    PubMed

    Davidson, Debra

    2012-12-01

    Sociologists are increasingly directing attention toward social responses to climate change. As is true of any new field of inquiry, theoretical frameworks guiding the research to date have room for improvement. One advance could be achieved through closer engagement with Reflexivity Theory, particularly the work of Margaret Archer, who asks just how individuals come to give attention to certain problems, and formulate responses to them. Individuals vary significantly in regard to their understanding of and concern for anthropogenic climate change, and these standpoints in turn influence commitment to mitigation and adaptation. The emergent social interactions among all such agents in turn influence the morphogenetic trajectories through which social structures will evolve, but the role of 'meta-reflexives' is particularly crucial. Identifying pathways of individual climate change reflexivity can make a valuable contribution to our understanding of the potential for and nature of collective responses. In this paper, I explore climate change reflexivity, with particular attention to climate change meta-reflexives, through a qualitative analysis of personal interviews with residents of two small communities in Alberta, Canada. Applying Reflexivity Theory to this context articulates dimensions of reflexive processing not elaborated in current theoretical treatments, including future outlook and comfort with uncertainty, among others. PMID:23240835

  16. Characteristics of Glottic Closure Reflex in a Canine Model

    PubMed Central

    Kang, Ju Wan; Kim, Kwang-Moon

    2009-01-01

    Purpose The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex. Materials and Methods Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. Results Ipsilateral reflex closure was consistantly recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia. Conclusions Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients. PMID:19568600

  17. Perceptual rivalry: reflexes reveal the gradual nature of visual awareness.

    PubMed

    Naber, Marnix; Frässle, Stefan; Einhäuser, Wolfgang

    2011-01-01

    Rivalry is a common tool to probe visual awareness: a constant physical stimulus evokes multiple, distinct perceptual interpretations ("percepts") that alternate over time. Percepts are typically described as mutually exclusive, suggesting that a discrete (all-or-none) process underlies changes in visual awareness. Here we follow two strategies to address whether rivalry is an all-or-none process: first, we introduce two reflexes as objective measures of rivalry, pupil dilation and optokinetic nystagmus (OKN); second, we use a continuous input device (analog joystick) to allow observers a gradual subjective report. We find that the "reflexes" reflect the percept rather than the physical stimulus. Both reflexes show a gradual dependence on the time relative to perceptual transitions. Similarly, observers' joystick deflections, which are highly correlated with the reflex measures, indicate gradual transitions. Physically simulating wave-like transitions between percepts suggest piece-meal rivalry (i.e., different regions of space belonging to distinct percepts) as one possible explanation for the gradual transitions. Furthermore, the reflexes show that dominance durations depend on whether or not the percept is actively reported. In addition, reflexes respond to transitions with shorter latencies than the subjective report and show an abundance of short dominance durations. This failure to report fast changes in dominance may result from limited access of introspection to rivalry dynamics. In sum, reflexes reveal that rivalry is a gradual process, rivalry's dynamics is modulated by the required action (response mode), and that rapid transitions in perceptual dominance can slip away from awareness. PMID:21677786

  18. Pediatric Abdominal Pain: An Emergency Medicine Perspective.

    PubMed

    Smith, Jeremiah; Fox, Sean M

    2016-05-01

    Abdominal pain is a common complaint that leads to pediatric patients seeking emergency care. The emergency care provider has the arduous task of determining which child likely has a benign cause and not missing the devastating condition that needs emergent attention. This article reviews common benign causes of abdominal pain as well as some of the cannot-miss emergent causes. PMID:27133248

  19. Hypoxia inhibits abdominal expiratory nerve activity.

    PubMed

    Fregosi, R F; Knuth, S L; Ward, D K; Bartlett, D

    1987-07-01

    Our purpose was to examine the influence of steady-state changes in chemical stimuli, as well as discrete peripheral chemoreceptor stimulation, on abdominal expiratory motor activity. In decerebrate, paralyzed, vagotomized, and ventilated cats that had bilateral pneumothoraces, we recorded efferent activity from a phrenic nerve and from an abdominal nerve (cranial iliohypogastric nerve, L1). All cats showed phasic expiratory abdominal nerve discharge at normocapnia [end-tidal PCO2 38 +/- 2 Torr], but small doses (2-6 mg/kg) of pentobarbital sodium markedly depressed this activity. Hyperoxic hypercapnia consistently enhanced abdominal expiratory activity and shortened the burst duration. Isocapnic hypoxia caused inhibition of abdominal nerve discharge in 11 of 13 cats. Carotid sinus nerve denervation (3 cats) exacerbated the hypoxic depression of abdominal nerve activity and depressed phrenic motor output. Stimulation of peripheral chemoreceptors with NaCN increased abdominal nerve discharge in 7 of 10 cats, although 2 cats exhibited marked inhibition. Four cats with intact neuraxis, but anesthetized with ketamine, yielded qualitatively similar results. We conclude that when cats are subjected to steady-state chemical stimuli in isolation (no interference from proprioceptive inputs), hypercapnia potentiates, but hypoxia attenuates, abdominal expiratory nerve activity. Mechanisms to explain the selective inhibition of expiratory motor activity by hypoxia are proposed, and physiological implications are discussed. PMID:3624126

  20. Drug withdrawal conceptualized as a stressor

    PubMed Central

    Chartoff, Elena H.; Carlezon, William A.

    2015-01-01

    Drug withdrawal is often conceptualized as an aversive state that motivates drug-seeking and drug-taking behaviors in humans. Stress is more difficult to define, but is also frequently associated with aversive states. Here we describe evidence for the simple theory that drug withdrawal is a stress-like state, on the basis of common effects on behavioral, neurochemical, and molecular endpoints. We also describe data suggesting a more complex relationship between drug withdrawal and stress. As one example, we will highlight evidence that, depending on drug class, components of withdrawal can produce effects that have characteristics consistent with mood elevation. In addition, some stressors can act as positive reinforcers, defined as having the ability to increase the probability of a behavior that produces it. As such, accumulating evidence supports the general principles of opponent process theory, whereby processes that have an affective valence are followed in time by an opponent process that has the opposite valence. Throughout, we identify gaps in knowledge and propose future directions for research. A better understanding of the similarities, differences, and overlaps between drug withdrawal and stress will lead to the development of improved treatments for addiction, as well as for a vast array of neuropsychiatric conditions that are triggered or exacerbated by stress. PMID:25083570

  1. Inpatient management of acute alcohol withdrawal syndrome.

    PubMed

    Perry, Elizabeth C

    2014-05-01

    Alcohol withdrawal is a common condition encountered in the hospital setting after abrupt discontinuation of alcohol in an alcohol-dependent individual. Patients may present with mild symptoms of tremulousness and agitation or more severe symptoms including withdrawal seizures and delirium tremens. Management revolves around early identification of at-risk individuals and symptom assessment using a validated tool such as the revised Clinical Institute Withdrawal Assessment for Alcohol score. Benzodiazepines remain the mainstay of treatment and can be administered using a front-loading, fixed-dose, or symptom-triggered approach. Long-acting benzodiazepines such as chlordiazepoxide or diazepam are commonly used and may provide a smoother withdrawal than shorter-acting benzodiazepines, but there are no data to support superiority of one benzodiazepine over another. Elderly patients or those with significant liver disease may have increased accumulation and decreased clearance of the long-acting benzodiazepines, and lorazepam or oxazepam may be preferred in these patients. Patients with symptoms refractory to high doses of benzodiazepines may require addition of a rescue medication such as phenobarbital, propofol or dexmedetomidine. Anticonvulsants (carbamazepine, valproate, gabapentin) may have a role in the management of mild to moderate withdrawal. Other medications such as β-antagonists or neuroleptics may offer additional benefit in select patients but should not be used a monotherapy. PMID:24781751

  2. Autotransfusion utilization in abdominal trauma.

    PubMed

    Smith, L A; Barker, D E; Burns, R P

    1997-01-01

    The purpose of this review is to investigate the utility of autotransfusion in trauma patients in the past 3 years. A retrospective review was conducted of the charts for whom the Haemonetics Cell Saver autotransfusion device (Haemonetics Corp., Natick, MA) was utilized between January 1, 1993, and December 31, 1995. The estimated blood loss and quantity of blood transfused were noted for abdominal trauma patients. Costs of autotransfusion were then compared to estimated blood bank costs for this group. The Haemonetics Cell Saver autotransfusion device was requested for 592 cases from January 1, 1993, to December 31, 1995. Nonorthopedic trauma cases comprised 25 per cent of all autotransfusion cases. One hundred twenty-six patients had isolated abdominal trauma and had a mean estimated blood loss of 4864 +/- 6070 cc. The average volume of intraoperatively salvaged autologous blood transfused (autotransfusion) per patient was 1547 +/- 2359 cc, or a bank blood equivalent of 6.9 units of packed red blood cells. The total cost of autotransfusion in these patients was $63,252.00. Had bank blood been used instead of salvaged autologous blood, the cost would have been $114,523.00; thus, autotransfusion resulted in a savings of $51,271.00. The use of salvaged autologous blood comprised 45 per cent of total blood transfused. On a case-by-case basis, 75 per cent of cases were cost-effective compared to blood bank costs for an equivalent transfusion. Transfusion of intraoperatively salvaged autologous blood (autotransfusion) is a cost-effective, efficient way to provide blood products to operative trauma patients. PMID:8985070

  3. Reversible abnormalities of the Hering Breuer reflex in acrylamide neuropathy.

    PubMed Central

    Satchell, P

    1985-01-01

    The sensitivity of the Hering Breuer reflex was compared in anaesthetised rabbits before, during and after the induction of acrylamide neuropathy, and was measured as the tracheal pressure which produced 30 seconds of apnoea. After four weeks of acrylamide (400 mg/kg total dose) there was ataxia and the conduction velocity of hindlimb motor nerves was significantly reduced. At this time there was a marked and reproducible reduction in the sensitivity of the Hering Breuer reflex. The ataxia resolved within a month of stopping acrylamide administration. Three months after the cessation of acrylamide the sensitivity of the Hering Breuer reflex had increased significantly but had not returned to normal. PMID:2993526

  4. Primitive Reflexes and Attention-Deficit/Hyperactivity Disorder: Developmental Origins of Classroom Dysfunction

    ERIC Educational Resources Information Center

    Taylor, Myra; Houghton, Stephen; Chapman, Elaine

    2004-01-01

    The present research studied the symptomatologic overlap of AD/HD behaviours and retention of four primitive reflexes (Moro, Tonic Labyrinthine Reflex [TLR], Asymmetrical Tonic Neck Reflex [ATNR], Symmetrical Tonic Neck Reflex [STNR]) in 109 boys aged 7-10 years. Of these, 54 were diagnosed with AD/HD, 34 manifested sub-syndromal coordination,…

  5. Baclofen and Gamma-Hydroxybutyrate Withdrawal

    PubMed Central

    LeTourneau, Jennifer L.; Hagg, Daniel S.; Smith, Stephen M.

    2008-01-01

    Introduction Benzodiazepine treatment of life-threatening gamma-hydroxybutyrate (GHB) withdrawal is frequently unsatisfactory. Animal studies suggest strongly that treatment with GABAB agonists, such as baclofen, will be a more effective strategy. Methods A case report from the medical intensive care unit (ICU) of the university tertiary care hospital. Results A 61-year-old woman was admitted to the medical ICU for severe withdrawal symptoms from chronic GHB use. This manifested as delirium, tremor, and seizures despite only small decreases in GHB dose and treatment with benzodiazepines. The addition of baclofen allowed the rapid sequential decreases in the GHB dose without seizure or delirium and resulted in long-term improvement of her tremor. Conclusions Baclofen, a GABAB agonist, may be a useful agent in the treatment of severe GHB withdrawal. PMID:18266111

  6. Complications of alcohol withdrawal: pathophysiological insights.

    PubMed

    Trevisan, L A; Boutros, N; Petrakis, I L; Krystal, J H

    1998-01-01

    Disease processes or events that accompany acute alcohol withdrawal (AW) can cause significant illness and death. Some patients experience seizures, which may increase in severity with subsequent AW episodes. Another potential AW complication is delirium tremens, characterized by hallucinations, mental confusion, and disorientation. Cognitive impairment and delirium may lead to a chronic memory disorder (i.e., Wernicke-Korsakoff syndrome). Psychiatric problems associated with withdrawal include anxiety, depression, and sleep disturbance. In addition, alterations in physiology, mood, and behavior may persist after acute withdrawal has subsided, motivating relapse to heavy drinking. Recent advances in neurobiology may support the development of improved medications to decrease the risk of AW complications and support long-term sobriety. PMID:15706735

  7. Cyclosporine alters opiate withdrawal in rodents.

    PubMed

    Dafny, N; Wagle, V G; Drath, D B

    1985-05-01

    Opiates exert numerous effects on all levels of the central nervous system with tolerance, physical dependence and withdrawal being characteristics of this drug class. The degree of dependence is directly correlated to the intensity of withdrawal. Therefore, success in modifying the withdrawal syndrome may shed light on the dynamics of opiate addiction. The present study demonstrates that cyclosporine, a widely used immunosuppressive drug, considerably modified the behavioral signs of a naloxone-induced abstinence syndrome in morphine-addicted rats. In previous experiments, alpha-interferon has shown similar results. The similarity in actions of these two immunomodulator drugs is discussed and we suggest that opiate addiction may involve the immune system. PMID:4039025

  8. Morphine withdrawal, treatments 1900-30.

    PubMed

    Malcolm, M T

    1999-03-01

    The treatments used between 1900 and 1930 for morphine withdrawal are discussed. The accounts are mainly taken from contemporary textbooks which contain fascinating descriptions of their authors' preferred methods and criticisms of regimes given by other therapists. Delirium, produced by atropine or similar substances, is advocated to cover withdrawal symptoms. The present paper draws parallels with current issues, e.g. withdrawal of opiate under cover of general anaesthesia, follow-up studies and cost-benefit analyses. The particular problems of addicted doctors in 1900-1930 are addressed as are the comparisons then made with non-medically qualified addicts. It is important we keep in mind past mistakes and over-valued ideas so as to reduce any similarly misplaced optimism in our current treatment options. PMID:11623818

  9. Drug withdrawals and the lessons within.

    PubMed

    Smith, Dennis A; Schmid, Esther F

    2006-01-01

    Drug withdrawals over recent decades have triggered changes in the way that drug targets and screening programs are researched and designed. In the cases having the greatest impact, the reason for withdrawal was the reversible interaction of a drug or its metabolite with a single receptor, ion channel or enzyme (primary or secondary pharmacology). Once this interaction is identified, screens can be established and validated. When the mechanism is complex (eg, organ toxicity), however, such screens are difficult to implement and usually examine only the initial step, leading to considerable problems in extrapolation and risk definition. This review classifies drugs withdrawn from the US market over the last 25 years by their reasons for withdrawal, and examines how drug discovery programs have been modified in response to these events. PMID:16445116

  10. Divalproex in the treatment of alcohol withdrawal.

    PubMed

    Myrick, H; Brady, K T; Malcolm, R

    2000-02-01

    The present study represents an open-label clinical trial comparing treatment with a benzodiazepine (lorazepam) to divalproex in 11 inpatients with uncomplicated alcohol withdrawal syndrome. The trial used the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) scale. There were no significant differences in demographics or substance use parameters between the divalproex group (n = 6) or the lorazepam group (n = 5). A significant Group x CIWA-Ar score interaction [F(8,72) = 2.57, p < or = .01] was confirmed and further substantiated by a quadratic trend component for the interaction [F(1,9) = 24.9, p < or = .001]. This preliminary study supports further investigation of divalproex in the treatment of alcohol withdrawal. PMID:10718170

  11. Withdrawal from long-term benzodiazepine treatment.

    PubMed Central

    Petursson, H; Lader, M H

    1981-01-01

    Long-term, normal-dose benzodiazepine treatment was discontinued in 16 patients who were suspected of being dependent on their medication. The withdrawal was gradual, placebo-controlled, and double-blind. All the patients experienced some form of withdrawal reaction, which ranged from anxiety and dysphoria to moderate affective and perceptual changes. Symptom ratings rose as the drugs were discontinued, but usually subsided to prewithdrawal levels over the next two to four weeks. Other features of the withdrawal included disturbance of sleep and appetite and noticeable weight loss. Electroencephalography showed appreciable reduction in fast-wave activity as the drugs were withdrawn, and an improvement in psychological performance was recorded by the Digit Symbol Substitution Test. Because of the risk of dependence on benzodiazepines these agents should probably not be given as regular daily treatment for chronic anxiety. PMID:6114776

  12. Neurotoxic Consequences of Chronic Alcohol Withdrawal: Expression Profiling Reveals Importance of Gender Over Withdrawal Severity

    PubMed Central

    Hashimoto, Joel G; Wiren, Kristine M

    2011-01-01

    While women are more vulnerable than men to many of the medical consequences of alcohol abuse, the role of sex in the response to ethanol is controversial. Neuroadaptive responses that result in the hyperexcitability associated with withdrawal from chronic ethanol likely reflect gene expression changes. We have examined both genders for the effects of withdrawal on brain gene expression using mice with divergent withdrawal severity that have been selectively bred from a genetically heterogeneous population. A total of 295 genes were identified as ethanol regulated from each gender of each selected line by microarray analyses. Hierarchical cluster analysis of the arrays revealed that the transcriptional response correlated with sex rather than with the selected withdrawal phenotype. Consistent with this, gene ontology category over-representation analysis identified cell death and DNA/RNA binding as targeted classes of genes in females, while in males, protein degradation, and calcium ion binding pathways were more altered by alcohol. Examination of ethanol-regulated genes and these distinct signaling pathways suggested enhanced neurotoxicity in females. Histopathological analysis of brain damage following ethanol withdrawal confirmed elevated cell death in female but not male mice. The sexually dimorphic response was observed irrespective of withdrawal phenotype. Combined, these results indicate a fundamentally distinct neuroadaptive response in females compared to males during chronic ethanol withdrawal and are consistent with observations that female alcoholics may be more vulnerable than males to ethanol-induced brain damage associated with alcohol abuse. PMID:17593928

  13. The proprioceptive reflex control of the intercostal muscles during their voluntary activation

    PubMed Central

    Davis, J. Newsom; Sears, T. A.

    1970-01-01

    1. A quantitative study has been made of the reflex effects of sudden changes in mechanical load on contracting human intercostal muscles during willed breathing movements involving the chest wall. Averaging techniques were applied to recordings of electromyogram (EMG) and lung volume, and to other parameters of breathing. 2. Load changes were effected for brief periods (10-150 msec) at any predetermined lung volume by sudden connexion of the airway to a pressure source variable between ± 80 cm H2O so that respiratory movement could be either assisted or opposed. In some experiments airway resistance was suddenly reduced by porting from a high to a low resistance external airway. 3. Contracting inspiratory and expiratory intercostal muscles showed a `silent period' with unloading which is attributed to the sudden withdrawal from intercostal motoneurones of monosynaptic excitation of muscle spindle origin. 4. For both inspiratory and expiratory intercostal muscles the typical immediate effect of an increase in load was an inhibitory response (IR) with a latency of about 22 msec followed by an excitatory response (ER) with a latency of 50-60 msec. 5. It was established using brief duration stimuli (< 40 msec) that the IR depended on mechanical events associated with the onset of stimulation, whereas stimuli greater than 40 msec in duration were required to evoke the ER. 6. For constant expiratory flow rate and a constant load, the ER of expiratory intercostal muscles increased as lung volume decreased within the limits set by maximal activation of the motoneurone pool as residual volume was approached. 7. The ER to a constant load increased directly with the expiratory flow rate at which the load applied, also within limits set by maximal activation of the motoneurone pool. 8. For a given load, the ER during phonation was greater than that occurring at a similar expiratory flow rate without phonation when the resistance of the phonating larynx was mimicked by an

  14. Does Melissa Officinalis Cause Withdrawal or Dependence?

    PubMed Central

    Demirci, Kadir; Akgönül, Mehmet; Demirdaş, Arif; Akpınar, Abdullah

    2015-01-01

    Introduction: Melissa officinalis is a medical and aromatic plant that is used for its hypnotic, sedative, and spasmolytic effects. This report presents a case study of30-year-old patient who was admitted to an emergency department with restlessness, tremor, distractibility, and sweating following a discontinuation of Melissa officinalis consumption. Case report: In this case, withdrawal symptoms may be related to the dependence effect caused by long-term use of Melissa officinalis. Although Melissa officinalis, a plant, is preferred by many patients as an alternative to pharmaceutical drugs, patients should be made aware that it may have a risk of dependency and can lead to withdrawal symptoms. PMID:25870482

  15. [Late-onset alcohol withdrawal syndrome].

    PubMed

    Batel, P; Larivière, P

    2000-10-01

    The alcoholic withdrawal syndrome (AWS) arises variably within hours following the hospitalization of an alcohol dependent patient. Delay usually observed between admission and the first symptoms depends above all on alcohol serum level concentration at arrival and on the degree of severity of physical dependence. The case reported here describes the very late onset severe alcoholic withdrawal syndrome observed in a 57-year-old alcohol dependent patient hospitalized for leg trauma and operated within hours followed admission. The first symptoms of AWS appeared only the 4-th day after hospitalization and the patient quickly developed a clinical state of delirium tremens. Delay in the onset of this AWS is discussed. PMID:11104941

  16. REFLEX MODIFICATION AND THE ASSESSMENT OF SENSORY DYSFUNCTION

    EPA Science Inventory

    In summary, reflex modification of the startle response is a technique that can provide rapid, objective, and quantitative assessments of sensorimotor function. dvantages of this technique involve the ability to test animals rapidly, test without prior training, test without util...

  17. Reconsidering reflexivity: introducing the case for intellectual entrepreneurship.

    PubMed

    Cutcliffe, John R

    2003-01-01

    In this article, the author reconsiders reflexivity and attempts to examine some unresolved issues by drawing particular attention to the relationship between reflexivity and certain related phenomena/processes: the researcher's a priori knowledge, values, beliefs; empathy within qualitative research; the presence and influence of the researcher's tacit knowledge, and May's "magic" in method. Given the limitations of some reflexive activity identified in this article, the author introduces the case for greater intellectual entrepreneurship within the context of qualitative research. He suggests that excessive emphasis on reflexive activity might inhibit intellectual entrepreneurship. Wherein intellectual entrepreneurship implies a conscious and deliberate attempt on the part of academics to explore the world of ideas boldly; to take more risks in theory development and to move away from being timid researchers. PMID:12564268

  18. Spinal Reflexes During Postural Control Under Psychological Pressure.

    PubMed

    Tanaka, Yoshifumi

    2015-07-01

    This study investigated the effect of psychological pressure on spinal reflex excitability. Thirteen participants performed a balancing task by standing on a balance disk with one foot. After six practice trials, they performed one nonpressure and one pressure trial involving a performance-contingent cash reward or punishment. Stress responses were successfully induced; state anxiety, mental effort, and heart rates all increased under pressure. Soleus Hoffmann reflex amplitude in the pressure trial was significantly smaller than in the nonpressure trial. This modification of spinal reflexes may be caused by presynaptic inhibition under the control of higher central nerve excitation under pressure. This change did not prevent 12 of the 13 participants from successfully completing the postural control task under pressure. These results suggest that Hoffmann reflex inhibition would contribute to optimal postural control under stressful situations. PMID:25587695

  19. Nasal reflexes: implications for exercise, breathing, and sex.

    PubMed

    Baraniuk, James N; Merck, Samantha J

    2008-04-01

    Nasal patency, with both congestion and decongestion, is affected in a wide variety of reflexes. Stimuli leading to nasal reflexes include exercise; alterations of body position, pressure, and temperature; neurologic syndromes; and dentistry. As anticipated, the vagal and trigeminal systems are closely integrated through nasobronchial and bronchonasal reflexes. However, perhaps of greater pathophysiologic importance are the naso-hypopharyngeal-laryngeal reflexes that become aggravated during sinusitis. None other than Sigmund Freud saw deeply beyond the facial adornment and recognized the deeper sexual tensions that can regulate nasal functions and psychoanalytical status. Wine, women, and song are linked with airflow through the nose-the nose, which by any other name would still smell as sweetly. PMID:18417057

  20. Reflexive Research Ethics in Fetal Tissue Xenotransplantation Research

    PubMed Central

    Panikkar, Bindu; Smith, Natasha; Brown, Phil

    2013-01-01

    For biomedical research in which the only involvement of the human subject is the provision of tissue or organ samples, a blanket consent, i.e. consent to use the tissue for anything researchers wish to do, is considered by many to be adequate for legal and IRB requirements. Alternatively, a detailed informed consent provides patients or study participants with more thorough information about the research topic. We document here the beliefs and opinions of the research staff on informed consent and the discussion-based reflexive research ethics process that we employed in our fetal tissue xenotransplantion research on the impact of environmental exposures on fetal development. Reflexive research ethics entails the continued adjustment of research practice according to relational and reflexive understandings of what might be beneficent or harmful. Such reflexivity is not solely an individual endeavor, but rather a collective relationship between all actors in the research process. PMID:23074992

  1. Speech Performance, Dysphagia and Oral Reflexes in Cerebral Palsy.

    ERIC Educational Resources Information Center

    Love, Russell J.; And Others

    1980-01-01

    The adequacy of biting, sucking, swallowing, and chewing as well as the presence or absence of nine infantile oral reflexes were assessed in 60 cerebral palsied individuals (ages 3 to 23). (Author/PHR)

  2. Response characteristics of the human torsional vestibuloocular reflex

    NASA Technical Reports Server (NTRS)

    Peterka, Robert J.

    1992-01-01

    The characteristics of the response dynamics of the human torsional vestibuloocular reflex were studied during controlled rotations about an earth-horizontal axis. The results extended the frequency range to 2 Hz and identified the nonlinearity of the amplitude response.

  3. Nasal Reflexes: Implications for Exercise, Breathing, and Sex

    PubMed Central

    Baraniuk, James N.; Merck, Samantha J.

    2014-01-01

    Nasal patency, with both congestion and decongestion, is affected in a wide variety of reflexes. Stimuli that lead to nasal reflexes include exercise, alterations of body position, pressure, and temperature, neurological syndromes, and dentists. As anticipated, the vagal and trigeminal systems are closely integrated through nasobronchial and bronchonasal reflexes. However, perhaps of greater pathophysiological importance are the naso-hypopharyngea-laryngeal reflexes that become aggravated during sinusitis. None other than Sigmund Freud saw deeply beyond the facial adornment and recognized the deeper sexual tensions that can regulate nasal functions and psychoanalytical status. Wine, women and song are linked with airflow through the nose, the nose, that by any other name would still smell as sweetly. PMID:18417057

  4. Human flexor reflex modulation during cycling.

    PubMed

    Brown, D A; Kukulka, C G

    1993-04-01

    1. Human flexor reflex (HFR) responses were elicited during ergometer cycling in neurologically intact humans with the objective of understanding the influence of lower limb muscle activity on phase-dependent reflex modulation during movement. The experimental setup permitted control over background muscle activity and stimulus intensity without significantly interfering with the cycling motion. 2. All experiments involved cycling on an ergometer at a set rate and workload. A 333-Hz, 15-ms pulse train of electrical stimulation was randomly delivered to the skin over the tibial nerve at the ankle at selected lower limb positions. In the first group of experiments, subjects were stimulated at six cycling phases while pedaling with normal, phasic ankle activity (free-form cycling). The second and third group of experiments involved stimulation under static limb positioning conditions and during active pedaling while subjects were asked to maintain a consistent background level of isolated tibialis anterior (TA) or soleus (SOL) electromyographic (EMG) activity. 3. Control criteria were established to assure similar isolated muscle EMG levels and sensory stimulation intensities throughout the experiments. With the aid of the application of a lower extremity brace and visual EMG feedback, SOL and TA activity were confined by the subject to a narrow range during the task of cycling. Stimulus consistency was achieved through maintenance of flexor hallucis brevis M-waves to within an envelope encompassing the mean value +/- 5% of the maximum M-wave amplitude in all experimental conditions. 4. When the subject's limb was statically positioned, the HFR responses in the SOL muscle showed no significant changes in pattern when compared at various limb positions. During cycling with consistent SOL activity, a response waveform pattern of early-latency-long-duration depression was followed by a later-latency facilitation response in all positions except the initial power phase

  5. Withdrawal from Buprenorphine/Naloxone and Maintenance with a Natural Dopaminergic Agonist: A Cautionary Note

    PubMed Central

    Blum, Kenneth; Oscar-Berman, Marlene; Femino, John; Waite, Roger L; Benya, Lisa; Giordano, John; Borsten, Joan; Downs, William B; Braverman, Eric R; Loehmann, Raquel; Dushaj, Kristina; Han, David; Simpatico, Thomas; Hauser, Mary; Barh, Debmalya; McLaughlin, Thomas

    2013-01-01

    Background While numerous studies support the efficacy of methadone and buprenorphine for the stabilization and maintenance of opioid dependence, clinically significant opioid withdrawal symptoms occur upon tapering and cessation of dosage. Methods We present a case study of a 35 year old Caucasian female (Krissie) who was prescribed increasing dosages of prescription opioids after carpel tunnel surgery secondary to chronic pain from reflex sympathetic dystrophy and fibromyalgia. Over the next 5 years, daily dosage requirements increased to over 80 mg of Methadone and 300 ug/hr Fentanyl transdermal patches, along with combinations of 12–14 1600 mcg Actig lollipop and oral 100 mg Morphine and 30 mg oxycodone 1–2 tabs q4-6hr PRN for breakthrough pain. Total monthly prescription costs including supplemental benzodiazepines, hypnotics and stimulants exceeded $50,000. The patient was subsequently transferred to Suboxone® in 2008, and the dosage was gradually tapered until her admission for inpatient detoxification with KB220Z a natural dopaminergic agonist. We carefully documented her withdrawal symptoms when she precipitously stopped taking buprenorphine/naloxone and during follow-up while taking KB220Z daily. We also genotyped the patient using a reward gene panel including (9 genes 18 alleles): DRD 2,3,4; MOA-A; COMT; DAT1; 5HTTLLR; OPRM1; and GABRA3. Findings At 432 days post Suboxone® withdrawal the patient is being maintained on KB220Z, has been urine tested and is opioid free. Genotyping data revealed a moderate genetic risk for addiction showing a hypodopaminergic trait. This preliminary case data suggest that the daily use of KB220Z could provide a cost effective alternative substitution adjunctive modality for Suboxone®. We encourage double-blind randomized –placebo controlled studies to test the proposition that KB220Z may act as a putative natural opioid substitution maintenance adjunct. PMID:24273683

  6. 5 CFR 1650.16 - Required withdrawal date.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.16 Required withdrawal date. (a) A... date described in paragraph (a) of this section, but is not required to do so. (c) In the event that...

  7. 5 CFR 1650.16 - Required withdrawal date.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.16 Required withdrawal date. (a) A... date described in paragraph (a) of this section, but is not required to do so. (c) In the event that...

  8. 5 CFR 1650.16 - Required withdrawal date.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.16 Required withdrawal date. (a) A... date described in paragraph (a) of this section, but is not required to do so. (c) In the event that...

  9. 5 CFR 1650.16 - Required withdrawal date.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... FUNDS FROM THE THRIFT SAVINGS PLAN Post-Employment Withdrawals § 1650.16 Required withdrawal date. (a) A... date described in paragraph (a) of this section, but is not required to do so. (c) In the event that...

  10. 17 CFR 41.47 - Withdrawal of margin.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... after such withdrawal is sufficient to satisfy the required margin for the security futures and related... PRODUCTS Customer Accounts and Margin Requirements § 41.47 Withdrawal of margin. (a) By the...

  11. 29 CFR 102.104 - Withdrawal of petition.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Orders and Advisory Opinions Regarding Board Jurisdiction § 102.104 Withdrawal of petition. The petitioner may withdraw his petition at any time prior to issuance of the Board's advisory opinion....

  12. 48 CFR 14.303 - Modification or withdrawal of bids.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACTING METHODS AND CONTRACT TYPES SEALED BIDDING Submission of Bids 14.303 Modification or withdrawal of... for the bid. (c) Upon withdrawal of an electronically transmitted bid, the data received shall not...

  13. 29 CFR 102.104 - Withdrawal of petition.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Orders and Advisory Opinions Regarding Board Jurisdiction § 102.104 Withdrawal of petition. The petitioner may withdraw his petition at any time prior to issuance of the Board's advisory opinion....

  14. 29 CFR 102.104 - Withdrawal of petition.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Orders and Advisory Opinions Regarding Board Jurisdiction § 102.104 Withdrawal of petition. The petitioner may withdraw his petition at any time prior to issuance of the Board's advisory opinion....

  15. 29 CFR 102.104 - Withdrawal of petition.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Orders and Advisory Opinions Regarding Board Jurisdiction § 102.104 Withdrawal of petition. The petitioner may withdraw his petition at any time prior to issuance of the Board's advisory opinion....

  16. Nasocardiac reflex during aspiration and injection through a nasogastric tube: An infrequent occurrence

    PubMed Central

    Haldar, Rudrashish; Kaur, Jasleen; Bajwa, Sukhminder Jit Singh

    2015-01-01

    Nasocardiac reflex is a relatively less discussed variant of trigeminovagal reflex where the afferent arc of the reflex is represented by any of the branches of the trigeminal nerves, and the efferent arc is via the vagus nerve. Elicitation of this reflex is commonly seen during surgical manipulation and is manifested as bradycardia or even asystole. We report a case where nasocardiac reflex was unusually observed in a patient when aspiration and injection were done through a nasogastric tube. PMID:25878434

  17. An electronic device to record consensual reflex in human pupil.

    PubMed

    Pinheiro, H M; Costa, R M; Camilo, E N R; Gang, Hua

    2015-01-01

    Examination of the pupil offers an objective evaluation of visual function as well as the vegetative pathways to the eye. This work proposes the development of an effective method and a portable device to test the consensual pupillary reflex. The first results demonstrate the success of a new device construction and methodology to record the consensual reflex with different stimulus, in a situation of complete blockage of light. PMID:26262208

  18. [Long loop reflexes--a clinically relevant method].

    PubMed

    Claus, D

    1986-02-01

    Late reflex potentials have been know for a long time. On the upper limb it has been proven that these potentials have a transcortical pathway. The electrical stimulation of nerve trunks is easily applicable in clinical practice and produces clear long-loop responses. The typical results can be reproduced for extrapyramidal, cerebellar and pyramidal lesions by this method. The long-loop reflex is sensitive to lesions in the course of the pyramidal tract. PMID:3007315

  19. Experimental study of displays in contralateral acoustic reflex auditory stimulation.

    PubMed

    Dragan, S P; Bogomolov, A V; Kotlyar-Shapirov, A D; Kondrat'eva, E A

    2016-05-01

    The results of an experimental study of manifestations of the acoustic reflex with contralateral auditory stimulation at a frequency of 1 kHz are presented, and the principal possibility and informativeness of its use for diagnosing the diseases of the organ of hearing are demonstrated. The principal difference of the developed approach is the use of polyharmonic signal for measuring acoustic reflex manifestations during contralateral stimulation, which allows accelerating the examination procedure. PMID:27417727

  20. Mechanical Characteristics of Reflex Durign Upright Posture in Paralyzed Subjects

    NASA Astrophysics Data System (ADS)

    Kim, Yongchul; Youm, Youngil; Lee, Bumsuk; Kim, Youngho; Choi, Hyeonki

    The characteristics of flexor reflexes have been investigated in the previous studies with human subjects who were seated or supine position. However, researchers did not describe how the spinal circuits are used in different hip angles for paralyzed subjects, such as the standing position with walker or cane. In upright posture the compatibility between a flexor reflex of leg and body balance is a special problem for lower limb injured subjects. Therefore, the purpose of this study was to investigate the effects of hip angle change on the flexor reflex evoked in standing paralyzed subjects supported by walker. In this study, six spinal cord injured and four stroke subjects were recruited through the inpatient physical therapy clinics of Korea national rehabilitation hospital. A single axis electronic goniometer was mounted on the lateral side of the hip joint of the impaired limb to record movements in the sagittal plane at this joint. The electronic goniometer was connected to a data acquisition system, through amplifiers to a computer. Since subject' posture influenced characteristics of the flexion reflex response, the subjects were supported in an upright posture by the help of parallelogram walder. Two series of tests were performed on each leg. The first series of the tests investigated the influence of hip angle during stationary standing posture on flexion reflex response. The hip angle was adjusted by the foot plate. The second examined the effect of the voluntary action of subject on swing motion during the gait. The electrically induced flexion reflex simultaneously produced the flexion of the hip, knee and dorsiflexion of the ankle enabling the swing phase of walking. Form the experimental results we observed that the reflex response of hip joint was largerwith the hip in the extended position than in the flexed position during standing posture. Under voluntary movement on flexion reflex during gaint, the peak hip angle induced by stimulation was

  1. [The patient with intra-abdominal hypertension].

    PubMed

    Sakka, Samir G

    2016-01-01

    An intra-abdominal hypertension (IAH) defined as a pathological increase in intra-abdominal pressure (IAP) is commonly found on ICU admission or during the ICU stay. Several studies confirmed that an IAH is an independent predictor for mortality of critically ill patients. The abdominal compartment syndrome (ACS) which is defined as a sustained IAP>20 mmHg (with or without an abdominal perfusion pressure [APP]<60mmHg) that is associated with new organ dysfunction or failure has a mortality of up to 60%. In general, an IAH may be induced by several intra-abdominal as well as extra-abdominal conditions. Reduced abdominal wall compliance, intra-abdominal pathologies (either of the peritoneal space or parenchymateous organs) may lead to an IAH. Most commonly, intra-abdominal infections and/or sepsis and severe trauma or burns are predisposing for an IAH. An early sign may be a decrease in urinary output. The effects of an increased IAP on cardiovascular function are well recognized and include negative effects on preload, afterload and contractility. However, all other compartments of the body may be affected by an IAH. Thus, by an increase of the respective compartment pressure, e.g. intracranial pressure, a poly-compartment syndrome may result. Adequate prevention, a forward-looking strategy, and objective techniques for measurement of IAP are required to avoid or early detect an IAH or ACS. Finally, an immediate and consequent interdisciplinary management using conservative, interventional and operative options are necessary to solve an IAH or ACS. PMID:26863642

  2. 5 CFR 1650.31 - Age-based withdrawals.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Age-based withdrawals. 1650.31 Section 1650.31 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN In-Service Withdrawals § 1650.31 Age-based withdrawals. (a) A participant who has reached age 591/2 and who has...

  3. 5 CFR 1650.31 - Age-based withdrawals.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Age-based withdrawals. 1650.31 Section 1650.31 Administrative Personnel FEDERAL RETIREMENT THRIFT INVESTMENT BOARD METHODS OF WITHDRAWING FUNDS FROM THE THRIFT SAVINGS PLAN In-Service Withdrawals § 1650.31 Age-based withdrawals. (a) A participant who has reached age 591/2 and who has...

  4. Improving Nursing Knowledge of Alcohol Withdrawal: Second Generation Education Strategies.

    PubMed

    Berl, Kimberly; Collins, Michelle L; Melson, Jo; Mooney, Ruth; Muffley, Cheryl; Wright-Glover, Angela

    2015-01-01

    Christiana Care Health System implemented a Care Management Guideline for Alcohol Withdrawal Symptom Management, which provided direction for inpatient screening for alcohol withdrawal risk, assessment, and treatment. Nurses educated on its use expressed confusion with the use of the assessment tools, pharmacokinetics, and pathophysiology of alcohol withdrawal and delirium tremens. Reeducation was provided by nursing professional development specialists. Pre- and postsurveys revealed that nurses were more confident in caring for patients with alcohol withdrawal. PMID:25816126

  5. THE ACTION OF SODIUM 4-HYDROXYBUTYRATE ON SPINAL REFLEXES.

    PubMed

    BASIL, B; BLAIR, A M; HOLMES, S W

    1964-04-01

    The actions of sodium 4-hydroxybutyrate, gamma-aminobutyric acid and meprobamate have been studied in unanaesthetized animals, in local anaesthetic tests, on isolated organ preparations, on convulsions induced by picrotoxin and strychnine, and on monosynaptic (patellar) and polysynaptic (plantar) reflexes of the spinal cord. Sodium 4-hydroxybutyrate induced a sleep-like state with three unusual features: the righting reflex was remarkably persistent, respiration was good throughout and recovery was abrupt. gamma-Aminobutyric acid was inactive and meprobamate caused flaccid paralysis with loss of the righting reflex. None of the agents affected the responses of the rat diaphragm either to direct stimulation of the muscle or to indirect stimulation through the phrenic nerve. Only meprobamate reduced the responses of theguinea-pig isolated ileum preparation, showed local anaesthetic action and had an anticonvulsant action. All three compounds were capable, after intravenous or topical application, of blocking plantar reflexes in doses which did not affect the patellar reflex. The spinal animal responded in the same way, to the same dose of sodium 4-hydroxybutyrate, as the decerebrate preparation. Topical application to the motor cortex had no effect on spinal reflexes. We conclude that sodium 4-hydroxybutyrate acts preferentially on the internuncial neurones in the spinal cord but differs from meprobamate in its other actions. The similarity between the actions of sodium 4-hydroxybutyrate and of gamma-aminobutyric acid provides furtherevidence in support of the hypothesis that sodium 4-hydroxybutyrate is involved in the gamma-aminobutyric acid metabolic pathways. PMID:14190466

  6. Measurement of the lateral thoracic reflex latency in ponies.

    PubMed

    Hahn, C N; Mayhew, I G; Washbourne, J R

    1998-01-01

    Lateral thoracic nerve reflex latencies values were measured in ponies using a simple, non-invasive technique. The reflex was elicited using an external triggering hammer attached to an electrodiagnostic unit. The resulting evoked, compound muscle action potentials were recorded with electrodes, which were placed over the 6th ribs or 11th rib level with the axilla. Two superimposed repeats of 4 signal-averaged sweeps of 50 or 100 milliseconds were recorded and the estimated reflex pathway was measured for each subject in order to calculate the reflex latencies and latency velocities. Mean left and right 6th rib peak latencies were not significantly different from each other (P = .609), but left 6th rib latencies were shorter than those recorded from the 11th rib (P < .0001), substantiating the existence of an indirect (central) pathway to the reflex. The calculated left and right 6th rib latency velocities were not significantly different from each other (P = .58) but left 6th rib latency velocities were different from left 11th rib (P = .009). The calculated latency velocities were within the broad range for corticospinal tract motor conduction velocities and comparable to magnetic motor evoked latency velocities. The use of lateral thoracic reflex latency measurements to objectively identify the site of spinal cord lesions is discussed. PMID:9686392

  7. Auditory Brainstem Circuits That Mediate the Middle Ear Muscle Reflex

    PubMed Central

    Mukerji, Sudeep; Windsor, Alanna Marie; Lee, Daniel J.

    2010-01-01

    The middle ear muscle (MEM) reflex is one of two major descending systems to the auditory periphery. There are two middle ear muscles (MEMs): the stapedius and the tensor tympani. In man, the stapedius contracts in response to intense low frequency acoustic stimuli, exerting forces perpendicular to the stapes superstructure, increasing middle ear impedance and attenuating the intensity of sound energy reaching the inner ear (cochlea). The tensor tympani is believed to contract in response to self-generated noise (chewing, swallowing) and nonauditory stimuli. The MEM reflex pathways begin with sound presented to the ear. Transduction of sound occurs in the cochlea, resulting in an action potential that is transmitted along the auditory nerve to the cochlear nucleus in the brainstem (the first relay station for all ascending sound information originating in the ear). Unknown interneurons in the ventral cochlear nucleus project either directly or indirectly to MEM motoneurons located elsewhere in the brainstem. Motoneurons provide efferent innervation to the MEMs. Although the ascending and descending limbs of these reflex pathways have been well characterized, the identity of the reflex interneurons is not known, as are the source of modulatory inputs to these pathways. The aim of this article is to (a) provide an overview of MEM reflex anatomy and physiology, (b) present new data on MEM reflex anatomy and physiology from our laboratory and others, and (c) describe the clinical implications of our research. PMID:20870664

  8. H-reflex changes following spinal cord injury.

    PubMed

    Little, J W; Halar, E M

    1985-01-01

    Changes in both central synaptic excitability (CSE) and peripheral sensitivity of muscle spindle stretch receptors have been hypothesized to contribute to hyperactive stretch reflexes of spasticity. To assess CSE, the monosynaptic H-reflex to the triceps surae muscles was tested serially over the first six months after traumatic spinal cord injury (SCI). Six clinically complete SCI patients were compared to age-matched control subjects. As a measure of H-reflex excitability, H/M ratios were calculated by dividing maximum H-reflex by maximum M-response amplitude. Analysis of variance over the testing trials showed significant change in H/M ratios for SCI patients (p less than 0.01). T-tests comparing mean H/M ratios at different time periods after SCI revealed a significant increment after three months (p less than 0.01). H-reflex amplitude also increased significantly over this time period (p less than 0.04), but M-response amplitude did not change significantly. These increases in H/M ratio and H-reflex amplitude suggest that an increase in CSE may contribute to the appearance of hyperreflexia after SCI. PMID:3966862

  9. Achilles Tendon Reflex in Accidental Hypothermia and Hypothermic Myxoedema

    PubMed Central

    Maclean, D.; Taig, D. R.; Emslie-Smith, D.

    1973-01-01

    The photomotogram (P.M.G.) of the Achilles tendon reflex was studied in 26 patients with hypothermia (rectal temperature 33·3°C or less), 10 of whom also had myxoedema (serum protein bound iodine 2·8 μg/100 ml or less). No reflex could be elicited in eight (31%) of these patients, including three of those with myxoedema. Hypothermia increases both the contraction and the relaxation times of the reflex, the relaxation phase being particularly prolonged in those with myxoedema. In those patients from whom the reflex was elicited the ratio of the contraction time to the “half-relaxation time” in the P.M.G. was less than unity in six of the seven with myxoedema, and considerably greater than unity in eight of the 11 (73%) who were euthyroid. Thus, analysis of the Achilles tendon reflex P.M.G. correctly predicted the thyroid status in 14 of the 18 hypothermic patients in whom the Achilles tendon reflex was present (78%). The wider use of this rapid test of thyroid function would allow a more rational use of thyroid hormones in hypothermic patients and so lead to a better assessment of their value. PMID:4121692

  10. Abdominal Pain in the Geriatric Patient.

    PubMed

    Leuthauser, Amy; McVane, Benjamin

    2016-05-01

    Abdominal pain in the elderly can be a challenging and difficult condition to diagnose and treat. The geriatric population has significant comorbidities and often takes polypharmacy that can mask symptoms. The presentation of common conditions can be different than that in the younger population, often lacking the traditional indicators of disease, making it of pivotal importance for the clinician to consider a wide differential during their workup. It is also important to consider extra-abdominal abnormality that may manifest as abdominal pain. PMID:27133249

  11. Chylous Ascites after Abdominal Aortic Aneurysm Repair

    PubMed Central

    Ohki, Shinichi; Kurumisawa, Soki

    2015-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  12. Chylous Ascites after Abdominal Aortic Aneurysm Repair.

    PubMed

    Ohki, Shinichi; Kurumisawa, Soki; Misawa, Yoshio

    2016-01-01

    A 73-year-old man was transferred for treatment of abdominal aortic aneurysm. He had no history of abdominal surgeries. Grafting between the infra-renal abdominal aorta and the bilateral common iliac arteries was performed. Proximal and distal cross clamps were applied for grafting. He developed chylous ascites on the 5th post-operative day, 2 days after initiation of oral intake. Fortunately, he responded to treatment with total parenteral hyper-alimentation for 10 days, followed by a low-fat diet. There was no recurrence of ascites. PMID:27087873

  13. [Diagnostic laparocentesis in closed abdominal injury].

    PubMed

    Berkutov, A N; Deriabin, I I; Zakurdaev, V E

    1976-09-01

    To improve the diagnosis of closed abdominal trauma since 1966 the authors have been widely employing laparocentesis. The results of using abdominal punctures an 260 patients are reported. The method proved to be reliable in 97.7%. The use of laparocentesis enabled the authors to reduce the number of errors by 7.3 times, to shorten the terms of establishing the diagnosis by 4 times as compared with the control group of patients (190 subjects in whom the recognition of abdominal injuries is based on common clinical symptoms). PMID:136785

  14. Combined subcutaneous, intrathoracic and abdominal splenosis.

    PubMed

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue. PMID:20804314

  15. Compensatory adrenal growth - A neurally mediated reflex

    NASA Technical Reports Server (NTRS)

    Dallman, M. F.; Engeland, W. C.; Shinsako, J.

    1976-01-01

    The responses of young rats to left adrenalectomy or left adrenal manipulation were compared to surgical sham adrenalectomy in which adrenals were observed but not touched. At 12 h right adrenal wet weight, dry weight, DNA, RNA, and protein content were increased (P less than 0.05) after the first two operations. Left adrenal manipulation resulted in increased right adrenal weight at 12 h but no change in left adrenal weight. Sequential manipulation of the left adrenal at time 0 and the right adrenal at 12 h resulted in an enlarged right adrenal at 12 h (P less than 0.01), and an enlarged left adrenal at 24 h (P less than 0.05), showing that the manipulated gland was capable of response. Bilateral adrenal manipulation of the adrenal glands resulted in bilateral enlargement of 12 h (P less than 0.01). Taken together with previous results, these findings strongly suggest that compensatory adrenal growth is a neurally mediated reflex.

  16. Vestibuloocular reflex of rhesus monkeys after spaceflight

    NASA Technical Reports Server (NTRS)

    Cohen, Bernard; Kozlovskaia, Inessa; Raphan, Theodore; Solomon, David; Helwig, Denice; Cohen, Nathaniel; Sirota, Mikhail; Iakushin, Sergei

    1992-01-01

    The vestibuloocular reflex (VOR) of two rhesus monkeys was recorded before and after 14 days of spaceflight. The gain (eye velocity/head velocity) of the horizontal VOR, tested 15 and 18 h after landing, was approximately equal to preflight values. The dominant time constant of the animal tested 15 h after landing was equivalent to that before flight. During nystagmus induced by off-vertical axis rotation (OVAR), the latency, rising time constant, steady-state eye velocity, and phase of modulation in eye velocity and eye position with respect to head position were similar in both monkeys before and after flight. There were changes in the amplitude of modulation of horizontal eye velocity during steady-state OVAR and in the ability to discharge stored activity rapidly by tilting during postrotatory nystagmus (tilt dumping) after flight: OVAR modulations were larger, and tilt dumping was lost in the one animal tested on the day of landing and for several days thereafter. If the gain and time constant of the horizontal VOR exchange in microgravity, they must revert to normal soon after landing. The changes that were observed suggest that adaptation to microgravity had caused alterations in way that the central nervous system processes otolith input.

  17. ["Reflex--in a strict sense". Ivan Michajlovic Secenov and the founding myths of the 'Russian reflex empire'].

    PubMed

    Wurm, Barbara

    2009-03-01

    This paper aims to reconstruct Ivan Michajlovik Secenov's impact on reflex theory by looking at the different narratives which constitute his specific position in the history of science, where he is considered the Russian founder of a purely materialist framing of consciousness and behaviour, the father figure of objective psychology, and the predecessor of the 'great' Ivan Pavlov. I argue that Secenov himself was very much aware of the symbolic significance of the term "reflex" and that the rhetorical strategies in his opus magnum, The Reflexes of the Brain (1863), deliberately enforce the precarious twofold potential of reflexological conceptions as psycho-physiological structures as well as social programs. Also within the cultural and political settings of the 19th and 20th century, Secenov's comprehensive and multifaceted research work in the field of nerve physiology was gradually reduced to a strong, ideologically interpretable message: "All movements bearing the name of voluntary in physiology are reflex in a strict sense". PMID:19824305

  18. 76 FR 16017 - Withdrawal of Regulatory Guide 8.5

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-22

    ... COMMISSION Withdrawal of Regulatory Guide 8.5 AGENCY: Nuclear Regulatory Commission. ACTION: Withdrawal of Regulatory Guide 8.5, ``Criticality and Other Interior Evacuation Signals.'' FOR FURTHER INFORMATION CONTACT... The U.S. Nuclear Regulatory Commission (NRC) is withdrawing Regulatory Guide 8.5, ``Criticality...

  19. Dynamics of Lip Dyskinesia Associated with Neuroleptic Withdrawal.

    ERIC Educational Resources Information Center

    Newell, Karl M.; Bodfish, James W.; Mahorney, Steven L.; Sprague, Robert L.

    2000-01-01

    The lip movements associated with dyskinesia in six adults with mental retardation were investigated through analysis at medication baseline, at the highest level of withdrawal dyskinesia, and at the lowest level of dyskinesia following medication withdrawal. Lip oscillations following withdrawal were linked to changes in structural complexity of…

  20. 27 CFR 19.729 - Withdrawal of fuel alcohol.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Withdrawal of fuel alcohol..., DEPARTMENT OF THE TREASURY ALCOHOL DISTILLED SPIRITS PLANTS Distilled Spirits for Fuel Use Rules for Use, Withdrawal, and Transfer of Spirits § 19.729 Withdrawal of fuel alcohol. (a) For each shipment or...

  1. 27 CFR 19.729 - Withdrawal of fuel alcohol.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Withdrawal of fuel alcohol..., DEPARTMENT OF THE TREASURY LIQUORS DISTILLED SPIRITS PLANTS Distilled Spirits for Fuel Use Rules for Use, Withdrawal, and Transfer of Spirits § 19.729 Withdrawal of fuel alcohol. (a) For each shipment or...

  2. 27 CFR 19.729 - Withdrawal of fuel alcohol.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Withdrawal of fuel alcohol. 19.729 Section 19.729 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND TRADE BUREAU..., Withdrawal, and Transfer of Spirits § 19.729 Withdrawal of fuel alcohol. (a) For each shipment or...

  3. 20 CFR 408.355 - Can you withdraw your application?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 20 Employees' Benefits 2 2012-04-01 2012-04-01 false Can you withdraw your application? 408.355 Section 408.355 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Withdrawal of Application § 408.355 Can you withdraw your...

  4. 20 CFR 408.355 - Can you withdraw your application?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 20 Employees' Benefits 2 2014-04-01 2014-04-01 false Can you withdraw your application? 408.355 Section 408.355 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Withdrawal of Application § 408.355 Can you withdraw your...

  5. 20 CFR 408.355 - Can you withdraw your application?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 20 Employees' Benefits 2 2011-04-01 2011-04-01 false Can you withdraw your application? 408.355 Section 408.355 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Withdrawal of Application § 408.355 Can you withdraw your...

  6. 20 CFR 408.355 - Can you withdraw your application?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 20 Employees' Benefits 2 2013-04-01 2013-04-01 false Can you withdraw your application? 408.355 Section 408.355 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Withdrawal of Application § 408.355 Can you withdraw your...

  7. 12 CFR 341.5 - Withdrawal from registration.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Withdrawal from registration. 341.5 Section 341... POLICY REGISTRATION OF SECURITIES TRANSFER AGENTS § 341.5 Withdrawal from registration. (a) Notice of withdrawal from registration. Any transfer agent registered under this part that ceases to engage in...

  8. 5 CFR 330.1001 - Withdrawal from competition.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Withdrawal from competition. 330.1001... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Prohibited Practices § 330.1001 Withdrawal from competition... applicant or eligible to withdraw from competition or eligibility, for a position in the competitive...

  9. 5 CFR 330.1001 - Withdrawal from competition.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Withdrawal from competition. 330.1001... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Prohibited Practices § 330.1001 Withdrawal from competition... applicant or eligible to withdraw from competition or eligibility, for a position in the competitive...

  10. 5 CFR 330.1001 - Withdrawal from competition.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Withdrawal from competition. 330.1001... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Prohibited Practices § 330.1001 Withdrawal from competition... applicant or eligible to withdraw from competition or eligibility, for a position in the competitive...

  11. 5 CFR 330.1001 - Withdrawal from competition.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 1 2011-01-01 2011-01-01 false Withdrawal from competition. 330.1001... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Prohibited Practices § 330.1001 Withdrawal from competition... applicant or eligible to withdraw from competition or eligibility, for a position in the competitive...

  12. 5 CFR 330.1001 - Withdrawal from competition.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Withdrawal from competition. 330.1001... RECRUITMENT, SELECTION, AND PLACEMENT (GENERAL) Prohibited Practices § 330.1001 Withdrawal from competition... applicant or eligible to withdraw from competition or eligibility, for a position in the competitive...

  13. Factors Associated with Student Withdrawal from Community College

    ERIC Educational Resources Information Center

    Scoggin, Donna; Styron, Ronald

    2006-01-01

    Research was designed to identify commonalities of personal, enrollment, withdrawal, and evaluative factors as they relate to student withdrawal from community college. The study sought to identify interrelationships between identified reasons for student withdrawal and the variables of gender, race, classification status, degree sought, plans for…

  14. 20 CFR 408.355 - Can you withdraw your application?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Can you withdraw your application? 408.355 Section 408.355 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SPECIAL BENEFITS FOR CERTAIN WORLD WAR II VETERANS Filing Applications Withdrawal of Application § 408.355 Can you withdraw your...

  15. Teachers' Withdrawal Behaviors and Their Relationship with Work Ethic

    ERIC Educational Resources Information Center

    Erdemli, Özge

    2015-01-01

    Problem Situation: People experience ups and downs in their job satisfaction and motivation levels at different points of their work lives for various reasons. One of the outputs of low job satisfaction and motivation is defined as "withdrawal behaviors" in the literature. Withdrawal behaviors are any employee behavior of withdrawal from…

  16. 27 CFR 19.424 - Authorized withdrawals free of tax.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... free of tax. 19.424 Section 19.424 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Withdrawals Spirits Withdrawn Free of Tax § 19.424 Authorized withdrawals free of tax. A proprietor may withdraw spirits from bonded premises free of tax as provided in this chapter: (a) Upon receipt of a...

  17. 27 CFR 19.424 - Authorized withdrawals free of tax.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... free of tax. 19.424 Section 19.424 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Withdrawals Spirits Withdrawn Free of Tax § 19.424 Authorized withdrawals free of tax. A proprietor may withdraw spirits from bonded premises free of tax as provided in this chapter: (a) Upon receipt of a...

  18. 27 CFR 19.424 - Authorized withdrawals free of tax.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... free of tax. 19.424 Section 19.424 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX AND... Withdrawals Spirits Withdrawn Free of Tax § 19.424 Authorized withdrawals free of tax. A proprietor may withdraw spirits from bonded premises free of tax as provided in this chapter: (a) Upon receipt of a...

  19. 47 CFR 1.8 - Withdrawal of papers.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Withdrawal of papers. 1.8 Section 1.8 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE General Rules of Practice and Procedure General § 1.8 Withdrawal of papers. The granting of a request to dismiss or withdraw...

  20. 47 CFR 1.8 - Withdrawal of papers.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Withdrawal of papers. 1.8 Section 1.8 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE General Rules of Practice and Procedure General § 1.8 Withdrawal of papers. The granting of a request to dismiss or withdraw...

  1. 47 CFR 1.8 - Withdrawal of papers.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Withdrawal of papers. 1.8 Section 1.8 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE General Rules of Practice and Procedure General § 1.8 Withdrawal of papers. The granting of a request to dismiss or withdraw...

  2. 47 CFR 1.8 - Withdrawal of papers.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Withdrawal of papers. 1.8 Section 1.8 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE General Rules of Practice and Procedure General § 1.8 Withdrawal of papers. The granting of a request to dismiss or withdraw...

  3. 47 CFR 1.8 - Withdrawal of papers.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Withdrawal of papers. 1.8 Section 1.8 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL PRACTICE AND PROCEDURE General Rules of Practice and Procedure General § 1.8 Withdrawal of papers. The granting of a request to dismiss or withdraw...

  4. 19 CFR 144.36 - Withdrawal for transportation.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Withdrawal for transportation. 144.36 Section 144... § 144.36 Withdrawal for transportation. (a) Time limit. Merchandise may be withdrawn from warehouse for transportation to another port of entry if withdrawal for consumption or exportation can be accomplished at...

  5. 19 CFR 144.36 - Withdrawal for transportation.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 2 2011-04-01 2011-04-01 false Withdrawal for transportation. 144.36 Section 144... § 144.36 Withdrawal for transportation. (a) Time limit. Merchandise may be withdrawn from warehouse for transportation to another port of entry if withdrawal for consumption or exportation can be accomplished at...

  6. 19 CFR 144.36 - Withdrawal for transportation.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 19 Customs Duties 2 2012-04-01 2012-04-01 false Withdrawal for transportation. 144.36 Section 144... § 144.36 Withdrawal for transportation. (a) Time limit. Merchandise may be withdrawn from warehouse for transportation to another port of entry if withdrawal for consumption or exportation can be accomplished at...

  7. 19 CFR 144.36 - Withdrawal for transportation.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 19 Customs Duties 2 2013-04-01 2013-04-01 false Withdrawal for transportation. 144.36 Section 144... § 144.36 Withdrawal for transportation. (a) Time limit. Merchandise may be withdrawn from warehouse for transportation to another port of entry if withdrawal for consumption or exportation can be accomplished at...

  8. Imaging of abdominal aortic aneurysms.

    PubMed

    Sparks, Amy R; Johnson, Philip L; Meyer, Mark C

    2002-04-15

    Given the high rate of morbidity and mortality associated with abdominal aortic aneurysms (AAAs), accurate diagnosis and preoperative evaluation are essential for improved patient outcomes. Ultrasonography is the standard method of screening and monitoring AAAs that have not ruptured. In the past, aortography was commonly used for preoperative planning in the repair of AAAs. More recently, computed tomography (CT) has largely replaced older, more invasive methods. Recent advances in CT imaging technology, such as helical CT and CT angiography, offer significant advantages over traditional CT. These methods allow for more rapid scans and can produce three-dimensional images of the AAA and important adjacent vascular structures. Use of endovascular stent grafts has increased recently and is less invasive for the repair of AAAs in selected cases. Aortography and CT angiography can precisely determine the size and surrounding anatomy of the AAA to identify appropriate candidates for the use of endovascular stent grafts. Helical CT and CT angiography represent an exciting future in the preoperative evaluation of AAAs. However, this technology is not the standard of care because of the lack of widespread availability, the cost associated with obtaining new equipment, and the lack of universal protocols necessary for acquisition and reconstruction of these images. PMID:11989632

  9. Teachers' Withdrawal Behaviors: Integrating Theory and Findings

    ERIC Educational Resources Information Center

    Shapira-Lishchinsky, Orly

    2012-01-01

    Purpose: The article aims to investigate the relationships between different dimensions of organizational ethics and different withdrawal symptoms--lateness, absence, and intent to leave work. Design/methodology/approach: Participants were 1,016 school teachers from 35 high schools in Israel. A joint model of Glimmix procedure of SAS was used for…

  10. Sodium Valproate Withdrawal Correlates with Reduced Aggression

    ERIC Educational Resources Information Center

    Pritchard, Duncan; Hoerger, Marguerite; Dyer, Tim; Graham, Nicola; Penney, Heather; Mace, F. Charles

    2014-01-01

    People with learning disabilities are sometimes prescribed psychotropic medication to help manage their challenging behaviour. This case study describes how a multicomponent behavioural intervention in conjunction with the systematic withdrawal of sodium valproate was strongly correlated with reduced aggression. No symptoms of bipolar disorder or…

  11. 21 CFR 601.43 - Withdrawal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Withdrawal procedures. 601.43 Section 601.43 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS LICENSING Accelerated Approval of Biological Products for Serious or Life-Threatening Illnesses §...

  12. Design of withdrawal-weighted SAW filters.

    PubMed

    Lee, Youngjin; Lee, Seunghee; Roh, Yongrae

    2002-03-01

    This paper presents a new design algorithm for a withdrawal-weighted surface acoustic wave (SAW) transversal filter. The proposed algorithm is based on the effective transmission loss theory and a delta function model of a SAW transversal filter. The design process consists of three steps, which eventually determine eight geometrical design parameters for the filter in order to satisfy given performance specifications. First, the number of fingers in the input and output interdigital transducers (IDTs), plus their geometrical sizes is determined using the insertion loss specification. Second, the number and positions of the polarity reverses in the output IDT are determined using the bandwidth and ripple specifications. Third, the number and position for withdrawing and switching specific fingers in the output IDT and attached electrode area are determined to achieve the desired sidelobe level. The efficiency of the technique is illustrated using a sample design of an IF filter consisting of a uniform input IDT and withdrawal-weighted output IDT. The proposed algorithm is distinct from conventional techniques in that it can optimize the structural geometry of a withdrawal-weighted SAW filter in a direct manner by considering all the performance specifications simultaneously. PMID:12322883

  13. Cohort Survival and Withdrawal Study District Report.

    ERIC Educational Resources Information Center

    Shainline, Michael

    At the completion of the 1986-87 school year, the Albuquerque (New Mexico) Public Schools (APS) conducted a cohort survival and withdrawal study to follow-up 5,976 students who had begun the ninth grade within the district in 1983-84. Current records were matched with those from the 1983-84 school year to determine whether members of the…

  14. 75 FR 22868 - Withdrawal of Regulatory Guide

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-04-30

    ... Safe Shutdown Earthquake Ground Motion.'' FOR FURTHER INFORMATION CONTACT: Rebecca L. Karas... Determination of Safe Shutdown Earthquake Ground Motion,'' dated March 1997. RG 1.165 provides general...-Specific Earthquake Ground Motion.'' The withdrawal of Regulatory Guide 1.165 does not alter the...

  15. Helping Individuals Withdraw from Psychiatric Drugs

    ERIC Educational Resources Information Center

    Cohen, David

    2007-01-01

    Many counselors, psychologists, and social workers assist clients to take psychotropic drugs but recoil from helping clients to rethink drug use or stop taking drugs. They might fear resisting the prevailing ideology, violating "standards of care," or contradicting physicians' advice. This article discusses withdrawal emergent reactions from…

  16. 42 CFR 457.170 - Withdrawal process.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 42 Public Health 4 2012-10-01 2012-10-01 false Withdrawal process. 457.170 Section 457.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs...

  17. 42 CFR 457.170 - Withdrawal process.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 42 Public Health 4 2013-10-01 2013-10-01 false Withdrawal process. 457.170 Section 457.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs...

  18. 42 CFR 457.170 - Withdrawal process.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 42 Public Health 4 2014-10-01 2014-10-01 false Withdrawal process. 457.170 Section 457.170 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs...

  19. 46 CFR 390.9 - Qualified withdrawals.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ..., construction or reconstruction its fair market value. The party must obtain the prior written permission of the... CONSTRUCTION FUND § 390.9 Qualified withdrawals. (a) In general—(1) Defined. In accordance with 46 U.S.C. 53509...: (i) The acquisition, construction or reconstruction of a qualified agreement vessel; (ii)...

  20. 46 CFR 390.9 - Qualified withdrawals.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ..., construction or reconstruction its fair market value. The party must obtain the prior written permission of the... CONSTRUCTION FUND § 390.9 Qualified withdrawals. (a) In general—(1) Defined. In accordance with 46 U.S.C. 53509...: (i) The acquisition, construction or reconstruction of a qualified agreement vessel; (ii)...

  1. 21 CFR 314.530 - Withdrawal procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Withdrawal procedures. 314.530 Section 314.530 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses §...

  2. 21 CFR 314.620 - Withdrawal procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Withdrawal procedures. 314.620 Section 314.620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human Efficacy Studies Are Not Ethical or Feasible...

  3. 21 CFR 314.620 - Withdrawal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Approval of New Drugs When Human... approval. For new drugs approved under this subpart, FDA may withdraw approval, following a hearing...

  4. 21 CFR 314.530 - Withdrawal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS FOR HUMAN USE APPLICATIONS FOR FDA APPROVAL TO MARKET A NEW DRUG Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses § 314.530 Withdrawal procedures. (a) For new drugs approved...

  5. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  6. [Pathophysiology, diagnostics and therapy of chronic cough: neuronal reflexes and antitussiva].

    PubMed

    Dinh, Q T; Heck, S; Le, D D; Bals, R; Welte, T

    2013-06-01

    Cough is the number one symptom for patients to visit a physician worldwide. It is an important neuronal reflex which serves to protect the airways from inhaled exogenous microorganisms, thermal and chemical irritants. Moreover, it prevents the airways from mucus retention.The cough reflex is initiated by activation of different cough receptors. These cough receptors can be divided into three groups according to their electrophysiological properties: into the two Aδ-fiber types "rapid-adapting mechanoreceptor" (RAR) and "slow-adapting mechanoreceptor" (SAR), and the C-fiber receptor.The stimulus is detected by cough receptors which conduct the signal to the cerebral cough centre via vagal-sensory neurons. The cough itself is mediated by efferent motoneurons. Hence the cough reflex consists of 5 functionally sequential parts 1: the cough receptors 2, the primary afferent fibres of the N. vagus 345, N. trigeminus and N. glossopharyngeus 1, the cough centre in the medulla oblongata (N. tractus solitarius) 678, the afferent fibres of the N. phrenicus, spinal nerve and N. laryngeus recurrens, as well as the diaphragm and the abdominal, intercostal and laryngeal muscles. The cough receptors are mainly located in the larynx, trachea and main bronchi 2.The event of coughing can be divided into four subsequent parts: After the first phase of fast inspiration with an opened glottis, there is compression with a closed glottis and increasing tracheal pressure, acceleration and ultimately maximum expiration with an opened glottis 9. According to its characteristics, cough can be split into two distinct types, "aspiration cough", which is loud and involuntary, and "urge-to-cough sensation", which describes an irritant, scratchy, and controlled cough of slowly increasing intensity 10.Acute cough mostly develops because of infection of the respiratory system 111213 and ends spontaneously after 4 weeks. In contrast to this, bacterial infection with pathogens like Adenovirus

  7. Sleep duration, depression, and oxytocinergic genotype influence prepulse inhibition of the startle reflex in postpartum women.

    PubMed

    Comasco, Erika; Gulinello, Maria; Hellgren, Charlotte; Skalkidou, Alkistis; Sylven, Sara; Sundström-Poromaa, Inger

    2016-04-01

    The postpartum period is characterized by a post-withdrawal hormonal status, sleep deprivation, and susceptibility to affective disorders. Postpartum mothering involves automatic and attentional processes to screen out new external as well as internal stimuli. The present study investigated sensorimotor gating in relation to sleep duration, depression, as well as catecholaminergic and oxytocinergic genotypes in postpartum women. Prepulse inhibition (PPI) of the startle reflex and startle reactivity were assessed two months postpartum in 141 healthy and 29 depressed women. The catechol-O-methyltransferase (COMT) Val158Met, and oxytocin receptor (OXTR) rs237885 and rs53576 polymorphisms were genotyped, and data on sleep duration were collected. Short sleep duration (less than four hours in the preceding night) and postpartum depression were independently associated with lower PPI. Also, women with postpartum depression had higher startle reactivity in comparison with controls. The OXTR rs237885 genotype was related to PPI in an allele dose-dependent mode, with T/T healthy postpartum women carriers displaying the lowest PPI. Reduced sensorimotor gating was associated with sleep deprivation and depressive symptoms during the postpartum period. Individual neurophysiological vulnerability might be mediated by oxytocinergic genotype which relates to bonding and stress response. These findings implicate the putative relevance of lower PPI of the startle response as an objective physiological correlate of liability to postpartum depression. PMID:26857197

  8. Peripheral reflex feedbacks in chronic heart failure: Is it time for a direct treatment?

    PubMed Central

    Giannoni, Alberto; Mirizzi, Gianluca; Aimo, Alberto; Emdin, Michele; Passino, Claudio

    2015-01-01

    Despite repeated attempts to develop a unifying hypothesis that explains the clinical syndrome of heart failure (HF), no single conceptual paradigm for HF has withstood the test of time. The last model that has been developed, the neurohormonal model, has the great virtue of highlighting the role of the heart as an endocrine organ, as well as to shed some light on the key role on HF progression of neurohormones and peripheral organs and tissues beyond the heart itself. However, while survival in clinical trials based on neurohormonal antagonist drugs has improved, HF currently remains a lethal condition. At the borders of the neurohormonal model of HF, a partially unexplored path trough the maze of HF pathophysiology is represented by the feedback systems. There are several evidences, from both animal studies and humans reports, that the deregulation of baro-, ergo- and chemo-reflexes in HF patients elicits autonomic imbalance associated with parasympathetic withdrawal and increased adrenergic drive to the heart, thus fundamentally contributing to the evolution of the disease. Hence, on top of guideline-recommended medical therapy, mainly based on neurohormonal antagonisms, all visceral feedbacks have been recently considered in HF patients as additional potential therapeutic targets. PMID:26730288

  9. Genetics Home Reference: abdominal wall defect

    MedlinePlus

    ... size and can usually be diagnosed early in fetal development, typically between the tenth and fourteenth weeks of ... organs at the abdominal wall opening late in fetal development may also contribute to organ injury. Intestinal damage ...

  10. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... this kind of pain when they have a stomach virus, indigestion, gas, or when they become constipated. ...

  11. Familial abdominal chemodectomas with associated cutaneous angiolipomas.

    PubMed

    Lee, S P; Nicholson, G I; Hitchcock, G

    1977-04-01

    The occurrence of cutaneous angiolipomas and intra-abdominal retroperitoneal chemodectomas in two brothers is described. Both died from malignant dissemination of the chemodectomas. It is possible but speculative that two other brothers suffered from the same syndrome. PMID:195258

  12. Correlation between intra-abdominal pressure and pulmonary volumes after superior and inferior abdominal surgery

    PubMed Central

    de Cleva, Roberto; de Assumpção, Marianna Siqueira; Sasaya, Flavia; Chaves, Natalia Zuniaga; Santo, Marco Aurelio; Fló, Claudia; Lunardi, Adriana C.; Filho, Wilson Jacob

    2014-01-01

    OBJECTIVE: Patients undergoing abdominal surgery are at risk for pulmonary complications. The principal cause of postoperative pulmonary complications is a significant reduction in pulmonary volumes (FEV1 and FVC) to approximately 65-70% of the predicted value. Another frequent occurrence after abdominal surgery is increased intra-abdominal pressure. The aim of this study was to correlate changes in pulmonary volumes with the values of intra-abdominal pressure after abdominal surgery, according to the surgical incision in the abdomen (superior or inferior). METHODS: We prospectively evaluated 60 patients who underwent elective open abdominal surgery with a surgical time greater than 240 minutes. Patients were evaluated before surgery and on the 3rd postoperative day. Spirometry was assessed by maximal respiratory maneuvers and flow-volume curves. Intra-abdominal pressure was measured in the postoperative period using the bladder technique. RESULTS: The mean age of the patients was 56±13 years, and 41.6% 25 were female; 50 patients (83.3%) had malignant disease. The patients were divided into two groups according to the surgical incision (superior or inferior). The lung volumes in the preoperative period showed no abnormalities. After surgery, there was a significant reduction in both FEV1 (1.6±0.6 L) and FVC (2.0±0.7 L) with maintenance of FEV1/FVC of 0.8±0.2 in both groups. The maximum intra-abdominal pressure values were similar (p = 0.59) for the two groups. There was no association between pulmonary volumes and intra-abdominal pressure measured in any of the groups analyzed. CONCLUSIONS: Our results show that superior and inferior abdominal surgery determines hypoventilation, unrelated to increased intra-abdominal pressure. Patients at high risk of pulmonary complications should receive respiratory care even if undergoing inferior abdominal surgery. PMID:25029580

  13. A method of reflexive balancing in a pragmatic, interdisciplinary and reflexive bioethics.

    PubMed

    Ives, Jonathan

    2014-07-01

    In recent years there has been a wealth of literature arguing the need for empirical and interdisciplinary approaches to bioethics, based on the premise that an empirically informed ethical analysis is more grounded, contextually sensitive and therefore more relevant to clinical practice than an 'abstract' philosophical analysis. Bioethics has (arguably) always been an interdisciplinary field, and the rise of 'empirical' (bio)ethics need not be seen as an attempt to give a new name to the longstanding practice of interdisciplinary collaboration, but can perhaps best be understood as a substantive attempt to engage with the nature of that interdisciplinarity and to articulate the relationship between the many different disciplines (some of them empirical) that contribute to the field. It can also be described as an endeavour to explain how different disciplinary approaches can be integrated to effectively answer normative questions in bioethics, and fundamental to that endeavour is the need to think about how a robust methodology can be articulated that successfully marries apparently divergent epistemological and metaethical perspectives with method. This paper proposes 'Reflexive Bioethics' (RB) as a methodology for interdisciplinary and empirical bioethics, which utilizes a method of 'Reflexive Balancing' (RBL). RBL has been developed in response to criticisms of various forms of reflective equilibrium, and is built upon a pragmatic characterization of Bioethics and a 'quasi-moral foundationalism', which allows RBL to avoid some of the difficulties associated with RE and yet retain the flexible egalitarianism that makes it intuitively appealing to many. PMID:23444909

  14. The Unknown/The Unanticipated: A Surgical Journey of Correcting HIV-Related Abdominal Lipodystrophy.

    PubMed

    Vella, Michele M

    2016-03-01

    The aim of this study was to explore the pre- and postsurgical journey to correct severe abdominal lipodystrophy of a woman living as AIDS defined for over 23 years. It utilized interpretative phenomenological analysis (IPA) and a single-case-study approach to capture the subjective understanding and sense-making of this surgical process. Verbatim transcripts of seven semi-structured interviews, three participant-created word boards of words or phrases clipped from magazines, field notes, and a reflexive journal were collected as data. Analysis revealed two superordinate themes: the unknown and the unanticipated. These themes simultaneously manifest with shared and nuanced meanings, including the unknown and unanticipated of surviving AIDS and discovering lipodystrophy, the unknown and the unanticipated of the surgical intervention itself, and finally the unknown and the unanticipated of postsurgical complications and experiences within outpatient and inpatient medical settings. PMID:25670663

  15. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  16. Using abdominal massage in bowel management.

    PubMed

    Connor, Michelle; Hunt, Catherine; Lindley, Alison; Adams, John

    2014-07-15

    This article describes the introduction of abdominal massage techniques by a community team as part of a total bowel management programme for people with learning disabilities. A trust-wide audit of prescribed laxative use by this client group raised concerns, and led to a more systematic approach to managing constipation in people with learning disabilities. An education programme for carers proved to be successful. Some reported that adopting abdominal massage provided further opportunity to develop the therapeutic relationship. PMID:25005415

  17. Traumatic pseudoaneurysm of the abdominal aorta.

    PubMed

    Barchiche, R; Bové, T; Demanet, H; Goldstein, J P; Deuvaert, F E

    1999-08-01

    A traumatic pseudoaneurysm of the abdominal aorta is a rare entity, occurring as the result of a missed aortic lesion at the time of the initial injury. Therefore, clinical suspicion and careful abdominal exploration at first laparotomy is mandatory to prevent aortic pseudoaneurysm formation and its risk of delayed rupture. We present a case of successful surgical treatment of a suprarenal aortic false aneurysm, presenting 4 weeks after a life-threatening gunshot wound in a 13-year-old child. PMID:10499389

  18. A focus on intra-abdominal infections

    PubMed Central

    2010-01-01

    Complicated intra-abdominal infections are an important cause of morbidity and are frequently associated with poor prognosis, particularly in higher risk patients. Well defined evidence-based recommendations for intra-abdominal infections treatment are partially lacking because of the limited number of randomized-controlled trials. Factors consistently associated with poor outcomes in patients with intra-abdominal infections include increased illness severity, failed source control, inadequate empiric antimicrobial therapy and healthcare-acquired infection. Early prognostic evaluation of complicated intra-abdominal infections is important to select high-risk patients for more aggressive therapeutic procedures. The cornerstones in the management of complicated intra-abdominal infections are both source control and antibiotic therapy. The timing and the adequacy of source control are the most important issues in the management of intra-abdominal infections, because inadequate and late control of septic source may have a negative effect on the outcomes. Recent advances in interventional and more aggressive techniques could significantly decrease the morbidity and mortality of physiologically severe complicated intra-abdominal infections, even if these are still being debated and are yet not validated by limited prospective trials. Empiric antimicrobial therapy is nevertheless important in the overall management of intra-abdominal infections. Inappropriate antibiotic therapy may result in poor patient outcomes and in the appearance of bacterial resistance. Antimicrobial management is generally standardised and many regimens, either with monotherapy or combination therapy, have proven their efficacy. Routine coverage especially against Enterococci and candida spp is not always recommended, but can be useful in particular clinical conditions. A de escalation approach may be recommended in patients with specific risk factors for multidrug resistant infections such as

  19. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  20. Trigeminocardiac reflex. A clinical phenomenon or a new physiological entity?

    PubMed

    Schaller, B

    2004-06-01

    The trigemino-cardiac reflex (TCR) is defined as the sudden onset of parasympathetic dysrhythmia, sympathetic hypotension, apnea or gastric hypermotility during stimulation of any of the sensory branches of the trigeminal nerve. The sensory nerve endings of the trigeminal nerve send neuronal signals via the Gasserian ganglion to the sensory nucleus of the trigeminal nerve, forming the afferent pathway of the reflex arc. This afferent pathway continues along the short internuncial nerve fibers in the reticular formatio to connect with the efferent pathway in the motor nucleus of the vagus nerve. Clinically, the trigemino-cardiac reflex has been reported to occur during craniofacial surgery, balloon-compression rhizolysis of the trigeminal ganglion, and tumor resection in the cerebellopontine angle. Apart from the few clinical reports, the physiological function of this brainstem-reflex has not yet been fully explored. From experimental findings, it may be suggested that the trigemino-cardiac reflex represents an expression of a central neurogenic reflex leading to rapid cerebrovascular vasodilatation generated from excitation of oxygen-sensitive neurons in the rostral ventrolateral medulla oblongata. By this physiological response, the adjustments of the systemic and cerebral circulations are initiated to divert blood to the brain or to increase blood flow within it. As it is generally accepted that the diving reflex and ischemic tolerance appear to involve at least partially similar physiological mechanisms, the existence of such endogenous neuroprotective strategies may extend the actually known clinical appearance of the TCR and include the prevention of other potentially brain injury states as well. This may be in line with the suggestion that the TCR is a physiological, but not a pathophysiological entity. PMID:15311339

  1. Can Treadmill Perturbations Evoke Stretch Reflexes in the Calf Muscles?

    PubMed Central

    Sloot, Lizeth H.; van den Noort, Josien C.; van der Krogt, Marjolein M.; Bruijn, Sjoerd M.; Harlaar, Jaap

    2015-01-01

    Disinhibition of reflexes is a problem amongst spastic patients, for it limits a smooth and efficient execution of motor functions during gait. Treadmill belt accelerations may potentially be used to measure reflexes during walking, i.e. by dorsal flexing the ankle and stretching the calf muscles, while decelerations show the modulation of reflexes during a reduction of sensory feedback. The aim of the current study was to examine if belt accelerations and decelerations of different intensities applied during the stance phase of treadmill walking can evoke reflexes in the gastrocnemius, soleus and tibialis anterior in healthy subjects. Muscle electromyography and joint kinematics were measured in 10 subjects. To determine whether stretch reflexes occurred, we assessed modelled musculo-tendon length and stretch velocity, the amount of muscle activity, as well as the incidence of bursts or depressions in muscle activity with their time delays, and co-contraction between agonist and antagonist muscle. Although the effect on the ankle angle was small with 2.8±1.0°, the perturbations caused clear changes in muscle length and stretch velocity relative to unperturbed walking. Stretched muscles showed an increasing incidence of bursts in muscle activity, which occurred after a reasonable electrophysiological time delay (163–191 ms). Their amplitude was related to the muscle stretch velocity and not related to co-contraction of the antagonist muscle. These effects increased with perturbation intensity. Shortened muscles showed opposite effects, with a depression in muscle activity of the calf muscles. The perturbations only slightly affected the spatio-temporal parameters, indicating that normal walking was retained. Thus, our findings showed that treadmill perturbations can evoke reflexes in the calf muscles and tibialis anterior. This comprehensive study could form the basis for clinical implementation of treadmill perturbations to functionally measure reflexes during

  2. Genes and Abdominal Aortic Aneurysm

    PubMed Central

    Hinterseher, Irene; Tromp, Gerard; Kuivaniemi, Helena

    2010-01-01

    Abdominal aortic aneurysm (AAA) is a multifactorial disease with a strong genetic component. Since first candidate gene studies were published 20 years ago, nearly 100 genetic association studies using single nucleotide polymorphisms (SNPs) in biologically relevant genes have been reported on AAA. The studies investigated SNPs in genes of the extracellular matrix, the cardiovascular system, the immune system, and signaling pathways. Very few studies were large enough to draw firm conclusions and very few results could be replicated in another sample set. The more recent unbiased approaches are family-based DNA linkage studies and genome-wide genetic association studies, which have the potential of identifying the genetic basis for AAA, if appropriately powered and well-characterized large AAA cohorts are used. SNPs associated with AAA have already been identified in these large multicenter studies. One significant association was of a variant in a gene called CNTN3 which is located on chromosome 3p12.3. Two follow-up studies, however, could not replicate the association. Two other SNPs, which are located on chromosome 9p21 and 9q33 were replicated in other samples. The two genes with the strongest supporting evidence of contribution to the genetic risk for AAA are the CDKN2BAS gene, also known as ANRIL, which encodes an antisense RNA that regulates expression of the cyclin-dependent kinase inhibitors CDKN2A and CDKN2B, and DAB2IP, which encodes an inhibitor of cell growth and survival. Functional studies are now needed to establish the mechanisms by which these genes contribute to AAA pathogenesis. PMID:21146954

  3. Aging attenuates the vestibulosympathetic reflex in humans

    NASA Technical Reports Server (NTRS)

    Ray, Chester A.; Monahan, Kevin D.

    2002-01-01

    BACKGROUND: The vestibular system contributes to sympathetic activation by engagement of the otolith organs. However, there is a significant loss of vestibular function with aging. Therefore, the purpose of the present study was to determine if young and older individuals differ in their cardiovascular and sympathetic responses to otolithic stimulation (ie, head-down rotation, HDR). We hypothesized that responses to otolithic stimulation would be attenuated in older adults because of morphological and physiological alterations that occur in the vestibular system with aging. METHODS AND RESULTS: Arterial blood pressure, heart rate, muscle sympathetic nerve activity (MSNA), and head rotation were measured during HDR in 11 young (26 +/- 1 years) and 11 older (64 +/- 1 years) subjects in the prone posture. Five older subjects performed head rotation (chin to chest) in the lateral decubitus position, which simulates HDR but does not alter afferent inputs from the vestibular system. MSNA responses to HDR were significantly attenuated in older as compared with young subjects (P<0.01). MSNA increased in the older subjects by only 12 +/- 5% as compared with 85 +/- 16% in the young. Furthermore, HDR elicited significant reductions in mean arterial blood pressure in older (Delta-6 +/- 1 mm Hg; P<0.01) but not young subjects (Delta1 +/- 1 mm Hg). In contrast to HDR, head rotation performed in the lateral decubitus position did not elicit hypotension. MSNA responses to baroreceptor unloading and the cold pressor test were not different between the age groups. CONCLUSIONS: These data indicate that aging attenuates the vestibulosympathetic reflex in humans and may contribute to the increased prevalence of orthostatic hypotension with age.

  4. Gravity and Development of Cardiopulmonary Reflex

    NASA Astrophysics Data System (ADS)

    Nagaoka, Shunji; Eno, Yuko; Ohira, Yoshinobu

    Cardio-pulmonary reflex, which our cardiac activity is synchronized to the respiration by autonomic nervous system regulation, is called as "respiratory sinus arrhythmia" and commonly found in adult. The physiological function of the espiratory sinus arrhythmia is considered to maximize the gas exchange during respiration cycle. This respiration induced heart rate variability (RHRV) is only found in mammals and avian showing a remarkable postnatal development, whereas no RHRV in aquatic species such as fish or amphibian. To elucidate our hypothesis that gravity exposure may plays a key role in the postnatal development of RHRV as well as its evolutional origin in these ground animals, we have studied effects of hypergravity (2G) on the postnatal development of RHRV using rat. Pregnant Wister rats were kept in centrifugal cages system for 38 days from 6th days of pregnant mother to have neonates until 23 days old. Electrocardiograph was recorded from the neonates in 2 to 23 days old in 2G group with simultaneous control (1G) group. The RHRV analysis was performed by calculating a component of Fourier power spectral coincide with the respiration frequency. In both groups, averaged resting heart rate gradually increase from 2 to 23 days old. When comparing the heart rate between the two groups, the 2G group indicated significantly lower (240± 8 bpm) than 1G control (326±21 bpm, p¡0.001) in 2 days old, where as no significance in 23 days old. The RHRV of 2 days old neonates in both groups indicated very small magnitude but significantly lower in 2G group than 1G control (p¡0.01). The RHRV gradually increase during the first 2 weeks and then rapid increased to reached 45 fold of magnitude in 1G control, whereas 69 fold in 2G group. The results strongly suggested that the postnatal innervation from respiration to cardiovascular centers was gravity dependent.

  5. Driving a car using reflexive fuzzy behaviors

    SciTech Connect

    Pin, F.G.; Watanabe, Y.

    1992-10-01

    Vehicle control in a-priori unknown, unpredictable, and dynamic environments requires many calculational and reasoning schemes to operate on the basis of very imprecise, incomplete, or unreliable data. For such systems, in which all the uncertainties can not be engineered away, approximate reasoning may provide an alternative to the complexity and computational requirements of conventional uncertainty analysis and propagation techniques. Two types of computer boards including custom-designed VLSI chips have been developed to add a fuzzy inferencing capability to real-time control systems. All inferencing rules on a chip are processed in parallel, allowing execution of the entire rule base in about 30 {mu}sec, and therefore, making control of ``reflex-type`` of motions envisionable. The use of these boards and the approach using superposition of elemental sensor-based behaviors for the development of qualitative reasoning schemes emulating human-like navigation in a-prioii unknown environments are discussed. We describe how the human-like navigation scheme implemented on one of the qualitative inferencing boards was installed on a test-bed platform to investigate two control modes for driving a car in a-priori unknown environments on the basis of sparse and imprecise sensor data. In the first mode, the car navigates autonomously, while in the second mode, the system acts as a driver`s aid providing the driver with linguistic (fuzzy) commands to turn left or right and speed up or slow down depending on the obstacles perceived by the sensors. Experiments with both modes of control are described in which the system uses only three acoustic range (sonar) sensor charmers to perceive the environment. Simulation results as well as indoor and outdoor experiments are discussed to illustrate the feasibility and robustness of autonomous navigation and/or safety enhancing driver`s aid using the new fuzzy inferencing hardware system and some human-like reasoning schemes.

  6. Driving a car using reflexive fuzzy behaviors

    SciTech Connect

    Pin, F.G.; Watanabe, Y.

    1992-01-01

    Vehicle control in a-priori unknown, unpredictable, and dynamic environments requires many calculational and reasoning schemes to operate on the basis of very imprecise, incomplete, or unreliable data. For such systems, in which all the uncertainties can not be engineered away, approximate reasoning may provide an alternative to the complexity and computational requirements of conventional uncertainty analysis and propagation techniques. Two types of computer boards including custom-designed VLSI chips have been developed to add a fuzzy inferencing capability to real-time control systems. All inferencing rules on a chip are processed in parallel, allowing execution of the entire rule base in about 30 [mu]sec, and therefore, making control of reflex-type'' of motions envisionable. The use of these boards and the approach using superposition of elemental sensor-based behaviors for the development of qualitative reasoning schemes emulating human-like navigation in a-prioii unknown environments are discussed. We describe how the human-like navigation scheme implemented on one of the qualitative inferencing boards was installed on a test-bed platform to investigate two control modes for driving a car in a-priori unknown environments on the basis of sparse and imprecise sensor data. In the first mode, the car navigates autonomously, while in the second mode, the system acts as a driver's aid providing the driver with linguistic (fuzzy) commands to turn left or right and speed up or slow down depending on the obstacles perceived by the sensors. Experiments with both modes of control are described in which the system uses only three acoustic range (sonar) sensor charmers to perceive the environment. Simulation results as well as indoor and outdoor experiments are discussed to illustrate the feasibility and robustness of autonomous navigation and/or safety enhancing driver's aid using the new fuzzy inferencing hardware system and some human-like reasoning schemes.

  7. GABAA- and glycine-mediated inhibitory modulation of the cough reflex in the caudal nucleus tractus solitarii of the rabbit.

    PubMed

    Cinelli, Elenia; Iovino, Ludovica; Bongianni, Fulvia; Pantaleo, Tito; Mutolo, Donatella

    2016-09-01

    Cough-related sensory inputs from rapidly adapting receptors (RARs) and C fibers are processed by second-order neurons mainly located in the caudal nucleus tractus solitarii (NTS). Both GABAA and glycine receptors have been proven to be involved in the inhibitory control of second-order cells receiving RAR projections. We investigated the role of these receptors within the caudal NTS in the modulation of the cough reflex induced by either mechanical or chemical stimulation of the tracheobronchial tree in pentobarbital sodium-anesthetized, spontaneously breathing rabbits. Bilateral microinjections (30-50 nl) of the receptor antagonists bicuculline and strychnine as well as of the receptor agonists muscimol and glycine were performed. Bicuculline (0.1 mM) and strychnine (1 mM) caused decreases in peak abdominal activity and marked increases in respiratory frequency due to decreases in both inspiratory time (Ti) and expiratory time (Te), without concomitant changes in arterial blood pressure. Noticeably, these microinjections induced potentiation of the cough reflex consisting of increases in the cough number associated with decreases either in cough-related Ti after bicuculline or in both cough-related Ti and Te after strychnine. The effects caused by muscimol (0.1 mM) and glycine (10 mM) were in the opposite direction to those produced by the corresponding antagonists. The results show that both GABAA and glycine receptors within the caudal NTS mediate a potent inhibitory modulation of the pattern of breathing and cough reflex responses. They strongly suggest that disinhibition is one important mechanism underlying cough regulation and possibly provide new hints for novel effective antitussive strategies. PMID:27402692

  8. Death caused by cardioinhibitory reflex: what experts believe.

    PubMed

    Schrag, Bettina; Mangin, Patrice; Vaucher, Paul; Bollmann, Marc D

    2012-03-01

    The danger of neck compression without restriction of the arterial flow remains unresolved in forensic medicine. There is an ongoing debate concerning life endangerment due to the cardioinhibitory reflex. The aim of this study was to determine what forensic medical experts believe and how they deal with this reflex. An anonymous electronic questionnaire was sent to 1429 forensic medical experts all over the world. We asked them about their opinion on the cardioinhibitory reflex, its role in causing death, and what their diagnostic criteria were.A total of 182 questionnaires were returned. The experts who answered were from 32 different countries. Our survey showed that 80.2% of experts believe that the cardioinhibitory reflex can theoretically cause death. In the practical application opinions diverge though. Apparently, the practical application mainly depends on the habit of the individual expert. We observed no consensus on the diagnostic criteria to be used. Given the potentially frequent use of the concept of the cardioinhibitory reflex in forensic practice and its judicial impact it would be important to reach a consensus. PMID:22442830

  9. Persistence of the nasotrigeminal reflex after pontomedullary transection.

    PubMed

    Panneton, W Michael; Gan, Qi; Sun, D Wei

    2012-03-15

    Most behaviors have numerous components based on reflexes, but the neural circuits driving most reflexes rarely are documented. The nasotrigeminal reflex induced by stimulating the nasal mucosa causes an apnea, a bradycardia, and variable changes in mean arterial blood pressure (MABP). In this study we tested the nasotrigeminal reflex after transecting the brainstem at the pontomedullary junction. The nasal mucosae of anesthetized rats were stimulated with ammonia vapors and their brainstems then were transected. Complete transections alone induced an increase in resting heart rate (HR; p<0.001) and MABP (p<0.001), but no significant change in ventilation. However, the responses to nasal stimulation after transection were similar to those seen prior to transection. HR still dropped significantly (p<0.001), duration of apnea remained the same, as did changes in MABP. Results from rats whose transection were incomplete are discussed. These data implicate that the neuronal circuitry driving the nasotrigeminal reflex, and indirectly the diving response, is intrinsic to the medulla and spinal cord. PMID:22154693

  10. Plasticity of the human otolith-ocular reflex

    NASA Technical Reports Server (NTRS)

    Wall, C. 3rd; Smith, T. R.; Furman, J. M.

    1992-01-01

    The eye movement response to earth vertical axis rotation in the dark, a semicircular canal stimulus, can be altered by prior exposure to combined visual-vestibular stimuli. Such plasticity of the vestibulo-ocular reflex has not been described for earth horizontal axis rotation, a dynamic otolith stimulus. Twenty normal human subjects underwent one of two types of adaptation paradigms designed either to attenuate or enhance the gain of the semicircular canal-ocular reflex prior to undergoing otolith-ocular reflex testing with horizontal axis rotation. The adaptation paradigm paired a 0.2 Hz sinusoidal rotation about a vertical axis with a 0.2 Hz optokinetic stripe pattern that was deliberately mismatched in peak velocity. Pre- and post-adaptation horizontal axis rotations were at 60 degrees/s in the dark and produced a modulation in the slow component velocity of nystagmus having a frequency of 0.17 Hz due to putative stimulation of the otolith organs. Results showed that the magnitude of this modulation component response was altered in a manner similar to the alteration in semicircular canal-ocular responses. These results suggest that physiologic alteration of the vestibulo-ocular reflex using deliberately mismatched visual and semicircular canal stimuli induces changes in both canal-ocular and otolith-ocular responses. We postulate, therefore, that central nervous system pathways responsible for controlling the gains of canal-ocular and otolith-ocular reflexes are shared.

  11. Effect of cervicolabyrinthine impulsation on the spinal reflex apparatus

    NASA Technical Reports Server (NTRS)

    Yarotskiy, A. I.

    1980-01-01

    In view of the fact that the convergence effect of vestibular impulsation may both stimulate and inhibit intra and intersystemic coordination of physiological processes, an attempt was made to define the physiological effect on the spinal reflex apparatus of the convergence of cervicolabyrinthine impulsation on a model of the unconditioned motor reflex as a mechanism of the common final pathway conditioning the formation and realization of a focused beneficial result of human motor activities. More than 100 persons subjected to rolling effect and angular acceleration during complexly coordinated muscular loading were divided according to typical variants of the functional structure of the patella reflex in an experiment requiring 30 rapid counterclockwise head revolutions at 2/sec with synchronous recording of a 20 item series of patella reflex acts. A knee jerk coefficient was used in calculations. In 85 percent of the cases 2 patellar reflexograms show typical braking and release of knee reflex and 1 shows an extreme local variant. The diagnostic and prognostic value of these tests is suggested for determining adaptive possibilities of functional systems in respect to acceleration and proprioceptive stimuli.

  12. Postherpetic pseudohernia: delayed onset of paresis of abdominal muscles due to herpes zoster causing an ipsilateral abdominal bulge.

    PubMed

    Ohno, Shunsuke; Togawa, Yasuhiro; Chiku, Tsuyoshi; Sano, Wataru

    2016-01-01

    Postherpetic pseudohernia causes an abdominal bulge as well as an abdominal wall herniation. This disease is one of the neurological complications of herpes zoster and essentially consists of paresis of ipsilateral abdominal muscles. Postherpetic pseudohernia may be mistaken for abdominal wall herniation because it is not well known. We describe two cases presenting an abdominal bulge. The ipsilateral abdominal bulge appeared after recovery from abdominal zoster. Abdominal CT showed no evidence of a herniation or mass. We diagnosed a postherpetic pseudohernia. One of the patients recovered spontaneously 4 months after the onset, and the other partially recovered after 2 months. This disease can be expected to disappear spontaneously, unlike abdominal herniation requiring surgery. It has been reported that 79.3% of patients eventually recovered spontaneously. For surgeons and general practitioners, it is beneficial to keep this disease in mind when examining a patient presenting an abdominal bulge. PMID:27229900

  13. Opiate withdrawal behavior after focal brain stimulation.

    PubMed

    Williams, D A; Thorn, B E

    1984-11-01

    Electrical stimulation of the brainstem abolishes pain, while continued stimulation induces tolerance to the analgesic effect. Analgesic drugs producing tolerance also induce physical dependence, suggesting that the phenomenon of tolerance is associated with addiction. There is evidence that the neural mechanism for stimulation-produced analgesia is related to the release of opiate substances within the brain. We therefore propose that repeated or protracted brain stimulation elicits dependence upon the endorphins released by electrical stimulation of the neurons themselves. To investigate this possibility, rats were given repetitive bursts of analgesic electrical brain stimulation for two hours. Immediately thereafter, they were injected with the opiate antagonist, naloxone. Behaviors associated with low grade opiate withdrawal were observed. These data suggest that prolonged analgesic stimulation can result in naloxone-precipitated behaviors similar to the behaviors exhibited during opiate withdrawal. PMID:6542676

  14. Identification and management of alcohol withdrawal syndrome.

    PubMed

    Mirijello, Antonio; D'Angelo, Cristina; Ferrulli, Anna; Vassallo, Gabriele; Antonelli, Mariangela; Caputo, Fabio; Leggio, Lorenzo; Gasbarrini, Antonio; Addolorato, Giovanni

    2015-03-01

    Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol. Other drugs, such as α2-agonists (clonidine and dexmetedomidine) and β-blockers can be used as adjunctive treatments to control neuroautonomic hyperactivity. Furthermore, neuroleptic agents can help control hallucinations. Finally, other medications for the treatment for AWS have been investigated with promising results. These include carbamazepine, valproate, sodium oxybate, baclofen, gabapentin and topiramate. The usefulness of these agents are discussed. PMID:25666543

  15. Dexmedetomidine for Sedation during Withdrawal of Support

    PubMed Central

    O’Hara, Chris; Tamburro, Robert F; Ceneviva, Gary D

    2015-01-01

    Agents used to control end-of-life suffering are associated with troublesome side effects. The use of dexmedetomidine for sedation during withdrawal of support in pediatrics is not yet described. An adolescent female with progressive and irreversible pulmonary deterioration was admitted. Despite weeks of therapy, she did not tolerate weaning of supplemental oxygen or continuous bilevel positive airway pressure. Given her condition and the perception that she was suffering, the family requested withdrawal of support. Despite opioids and benzodiazepines, she appeared to be uncomfortable after support was withdrawn. Ketamine was initiated. Relief from ketamine was brief, and its use was associated with a “wide-eyed” look that was distressing to the family. Ketamine was discontinued and a dexmedetomidine infusion was initiated. The patient’s level of comfort improved greatly. The child died peacefully 24 hours after initiating dexmedetomidine from her underlying disease rather than the effects of the sedative. PMID:26339188

  16. General Considerations of Ruptured Abdominal Aortic Aneurysm: Ruptured Abdominal Aortic Aneurysm

    PubMed Central

    Lee, Chung Won; Bae, Miju; Chung, Sung Woon

    2015-01-01

    Although development of surgical technique and critical care, ruptured abdominal aortic aneurysm still carries a high mortality. In order to obtain good results, various efforts have been attempted. This paper reviews initial management of ruptured abdominal aortic aneurysm and discuss the key point open surgical repair and endovascular aneurysm repair. PMID:25705591

  17. [Insomnia therapy and withdrawal of hypnotics].

    PubMed

    Garma, L; Widlöcher, D; Scherrer, J

    1982-11-18

    The aim of this study is to evaluate the efficiency of a treatment prescribed, in the course of an hospital consultation for sleep pathology, to patients suffering from chronic insomnia not improved by longstanding and sustained medication with hypnotic drugs. The basis of the treatment is a progressive but total withdrawal of hypnotics in so far taken regularly. The withdrawal of hypnotics was prescribed to 79 patients: 33 aged 17 to 39 years (group 1, mean age 30) and 46 aged 40 to 70 years (group 2, mean age 51). 41 showed primary psychophysiological insomnia and 28 showed insomnia associated with psychiatric disorders. In patients of group 1, the average durations were 8 years for insomnia and 3 years for sustained hypnotic use; these durations were 15 and 5 years respectively in patients of group 2. Hypnotic drug withdrawal was achieved without placebos in 3 months in group 1 patients and 5 months in group 2 patients. 65 patients completely stopped the continual use of hypnotics. Subjective improvement of insomnia was reported by 51 of these patients (as well as by 6 patients who were given simultaneous antidepressant therapy). 16 of the 51 improved patients have resorted to hypnotics occasionally (at intervals of 10 days or more). After complete withdrawal, patients went on consulting for various lengths of time: 5 months average for group 1, 14 months average for group 2. This study of a fairly large group of insomniacs shows the frequent ineffectiveness of a sustained use of currently available hypnotics. It also shows that two times out of three the complete stop of sustained hypnotic medication proved beneficial to the patient. PMID:6297032

  18. Cardiovascular collapse with attempted pericardial drain withdrawal

    PubMed Central

    Kraus, Molly B; Spitznagel, Rachel A; Kugler, Jane A

    2016-01-01

    Cardiac tamponade is a rare but serious emergency condition in the pediatric population. As treatment, a pericardial drain is often placed to evacuate the fluid. We present a case of a 4-year-old girl with cardiac tamponade secondary to renal failure. After the tamponade resolved, she suffered cardiovascular collapse upon attempted drain withdrawal. This case highlights an unusual cause for cardiovascular collapse, which occurred on blind removal of a pericardial drain. PMID:27625522

  19. Ground-Water-Withdrawal Component of the Michigan Water-Withdrawal Screening Tool

    USGS Publications Warehouse

    Reeves, Howard W.; Hamilton, David A.; Seelbach, Paul W.; Asher, A. Jeremiah

    2009-01-01

    A water-withdrawal assessment process and Internet-based screening tool have been developed to evaluate proposed new or increased high-capacity water withdrawals in Michigan. Michigan legislation defines high capacity withdrawals as those capable of removing an average of 100,000 gallons per day for a consecutive 30-day period. This report describes the ground-water component of the screening tool, provides background information used to develop the screening tool, and documents how this component of the screening tool is implemented. The screening tool is based on application of an analytical model to estimate streamflow depletion by a proposed pumping well. The screening tool is designed to evaluate intermittent pumping, to account for the dynamics of stream-aquifer interaction, and to apportion streamflow depletion among neighboring streams. The tool is to be used for an initial screening of a proposed new or increased high-capacity withdrawal in order to identify withdrawals that may cause adverse resource impacts. The screening tool is not intended to be a site-specific design tool. Results of an example application of the screening tool in Kalamazoo County, Mich., are compared to streamflow depletion estimated by use of a regional ground-water-flow model to demonstrate its performance.

  20. Single Canonical Model of Reflexive Memory and Spatial Attention

    PubMed Central

    Patel, Saumil S.; Red, Stuart; Lin, Eric; Sereno, Anne B.

    2015-01-01

    Many neurons in the dorsal and ventral visual stream have the property that after a brief visual stimulus presentation in their receptive field, the spiking activity in these neurons persists above their baseline levels for several seconds. This maintained activity is not always correlated with the monkey’s task and its origin is unknown. We have previously proposed a simple neural network model, based on shape selective neurons in monkey lateral intraparietal cortex, which predicts the valence and time course of reflexive (bottom-up) spatial attention. In the same simple model, we demonstrate here that passive maintained activity or short-term memory of specific visual events can result without need for an external or top-down modulatory signal. Mutual inhibition and neuronal adaptation play distinct roles in reflexive attention and memory. This modest 4-cell model provides the first simple and unified physiologically plausible mechanism of reflexive spatial attention and passive short-term memory processes. PMID:26493949

  1. ESO Reflex: A Graphical Workflow Engine for Astronomical Data Reduction

    NASA Astrophysics Data System (ADS)

    Hook, Richard; Romaniello, Martino; Ullgrén, Marko; Maisala, Sami; Solin, Otto; Oittinen, Tero; Savolainen, Villa; Järveläinen, Pekka; Tyynelä, Jani; Péron, Michèle; Izzo, Carlo; Ballester, Pascal; Gabasch, Armin

    2008-03-01

    ESO Reflex is a software tool that provides a novel approach to astronomical data reduction. The reduction sequence is rendered and controlled as a graphical workflow. Users can follow and interact with the processing in an intuitive manner, without the need for complex scripting. The graphical interface also allows the modification of existing workflows and the creation of new ones. ESO Reflex can invoke standard ESO data reduction recipes in a flexible way. Python scripts, IDL procedures and shell commands can also be easily brought into workflows and a variety of visualisation and display options, including custom product inspection and validation steps, are available. ESO Reflex was developed in the context of the Sampo project, a three-year effort led by ESO and conducted by a software development team from Finland as an in-kind contribution to joining ESO. It is planned that the software will be released to the community in late 2008.

  2. A reflexive toy-model for financial market

    NASA Astrophysics Data System (ADS)

    Palatella, Luigi

    2010-01-01

    We propose a reflexive toy model for market dynamics, based on the idea that existing reflexive loops are generated by the conviction, shared by many market operators, that a certain price follows a certain model. Their trading behaviour will therefore increase the probability that the model predictions are in fact fulfilled. We analytically write the equations generating a reflexive loop stemming from a simple linear regression model, and we show that the resulting toy model yields a peculiar intermittent behavior. The presence of two unstable fixed points is apparent from our numerical calculation and the residence-time distribution density in these points asymptotically follows an inverse-power-law tail. The exponent of this tail, as well as the scaling properties of the model output, are close to those stemming from real-price time series.

  3. Monopolar recording of H reflexes at various sites.

    PubMed

    Little, J W; Hayward, L F; Halar, E

    1989-01-01

    Various monopolar recording electrode sites have been used to record H reflexes and M responses. This investigation revealed a decrease in maximum M response amplitude accompanied by an increase in the H/M amplitude ratio as the active recording electrode was positioned more distally, below the gastrocnemii muscle bellies. H and M latencies were also significantly longer at the most distal recording site, but the latency difference is relatively independent of recording site. Serial variation was least at the most proximal recording site for an immobilized ankle. For an unrestrained ankle, serial variation was greater, but was least at the most distal site. The standard recording site, midway between knee and ankle, was not the best site for minimizing serial variation, and it was the least sensitive to vibration-induced reflex excitability changes. For serial testing of H reflex excitability, an immobilized ankle and measured proximal and distal recording sites are recommended. PMID:2752953

  4. Consequences of multiple withdrawals from alcohol.

    PubMed

    Duka, Theodora; Gentry, John; Malcolm, Robert; Ripley, Tamzin L; Borlikova, Gilyanna; Stephens, Dai N; Veatch, Lynn M; Becker, Howard C; Crews, Fulton T

    2004-02-01

    This article represents the proceedings of a symposium at the 2003 annual meeting of the Research Society on Alcoholism in Fort Lauderdale, FL, organized by Theodora Duka and chaired by Dai Stephens. The purpose of the symposium was to examine the effects of multiple experiences of withdrawal from alcohol in animals made dependent on alcohol and in humans who are alcohol dependent. Parallels were drawn to the effects of repeated short-lived high-content alcohol exposures in animals and in humans who are social drinkers but indulge in binge drinking. The presentations were (1) Multiple detoxifications and risk of relapse in abstinent alcoholics, by John Gentry and Robert Malcolm; (2) Emotional and cognitive impairments after long-term use of alcohol: relationship to multiple detoxifications and binge drinking, by Theodora Duka; (3) The effect of repeated withdrawal from ethanol on conditioning to appetitive stimuli, by Tamzin Ripley, Gilyanna Borlikova, and Dai Stephens; (4) Alcohol withdrawal kindling: electrographic measures in a murine model of behavioral seizure sensitization, by Lynn Veatch and Howard Becker; and (5) Binge drinking induced changes in CNS, by Fulton Crews. PMID:15112931

  5. Clinical management of alcohol withdrawal: A systematic review.

    PubMed

    Kattimani, Shivanand; Bharadwaj, Balaji

    2013-07-01

    Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed. PMID:25013309

  6. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  7. Intracranial causes of ophthalmoplegia: the visual reflex pathways.

    PubMed

    Stalcup, Seth T; Tuan, August S; Hesselink, John R

    2013-01-01

    The gathering of visual information is a complex process that relies on concerted movements of the eyes, and cranial nerves II-VIII are at least partially involved in the visual system. The cranial nerves do not function in isolation, however, and there are multiple higher-order cortical centers that have input into the cranial nerves to coordinate eye movement. Among the functions of the cortical reflex pathways are (a) controlling vertical and horizontal gaze in response to vestibular input to keep the eyes focused on an object as the head moves through space, and (b) controlling rapid, coordinated eye movement to a new visual target (saccades). There are also reflex pathways connecting the cranial nerves involved in vision that produce consensual blinking of the eyes in response to corneal stimulation of one eye and consensual pupillary constriction in response to light input on one pupil. A variety of intracranial pathologic conditions, including benign and malignant neoplasms, infection, trauma, autoimmune diseases, vascular anomalies, degenerative diseases, and inherited-congenital disorders, can disrupt the cranial nerves and visual reflex pathways. This disruption can manifest in myriad ways-for example, as extraocular muscle paresis, afferent pupillary defect, oculosympathetic paresis (Horner syndrome), internuclear ophthalmoplegia, dorsal midbrain (Parinaud) syndrome, or loss of the corneal reflex. Knowledge of the function and anatomy of the cranial nerves and visual reflex pathways, coupled with selection of the proper magnetic resonance pulse sequence, will allow the radiologist to order appropriate imaging of the involved cranial nerve or visual reflex pathway based on the patient's symptoms and thereby play an essential role in establishing the diagnosis and planning appropriate therapy. PMID:24025940

  8. Assessment of pupillary light reflex using a smartphone application

    PubMed Central

    Shin, Young Duck; Bae, Jin Ho; Kwon, Eun Jung; Kim, Hyeon Tae; Lee, Tae-Soo; Choi, Young Jin

    2016-01-01

    In unconscious patients, pupillary light reflex is an indicator of brain damage. In the current study, a smartphone application was developed for the purpose of measuring pupillary light reflex with an aim to determine the agreement between pupillary light reflex measurements using a smartphone application (APP) and a penlight (PEN). The APP acquires five sequential photographs using the camera flash in order to stimulate the pupil. The initial image is captured prior to the flash, and the subsequent image is obtained while the flash is on. The remaining three images are captured whilst the flash is off. Pupillary right reflex was assessed in 30 healthy subjects using a PEN. After 10 min, the examiners inspected the images of light reflex acquired from the same subjects using the APP, and completed the corresponding questionnaire containing details of pupil size and degree of response. Agreement between the two assessment methods was determined by calculating bias, limits of agreement, and the intraclass correlation (ICC) coefficient. A statistically significant difference was not observed between the two methods regarding pupil size and degree of response. Bias was 0.1 mm and limits of agreement were ±1.5 mm, as compared with PEN. ICC was 0.93 (95% confidence interval, 0.89–0.96). Therefore, it may be concluded that the results of pupillary light reflex assessed by PEN and APP display no significant difference. Furthermore, the APP provides advantages such as portability, objectivity and the possibility of being used as objective medical evidence. PMID:27446266

  9. Vestibulocollic reflexes in the absence of head postural control

    PubMed Central

    Forbes, Patrick A.; Siegmund, Gunter P.; Happee, Riender; Schouten, Alfred C.

    2014-01-01

    Percutaneous electrical vestibular stimulation evokes reflexive responses in appendicular muscles that are suppressed during tasks in which the muscles are not contributing to balance control. In neck muscles, which stabilize the head on the torso and in space, it is unclear whether similar postural task dependence shapes vestibular reflexes. We investigated whether vestibulocollic reflexes are modulated during tasks in which vestibular information is not directly relevant to maintaining the head balanced on the torso. We hypothesized that vestibulocollic reflexes would be 1) evoked when neck muscles are not involved in balancing the head on the torso and 2) invariant across synergistic neck muscle contraction tasks. Muscle activity was recorded bilaterally in sternocleidomastoid and splenius capitis muscles during head-free and head-fixed conditions while subjects were exposed to stochastic electrical vestibular stimulation (±5 mA, 0–75 Hz). Significant vestibular reflex responses (P < 0.05) were observed during head-free and head-fixed trials. Response magnitude and timing were similar between head-free and head-fixed trials for sternocleidomastoid, but splenius capitis magnitudes decreased with the head fixed by ∼25% (P < 0.05). Nevertheless, this indicates that vestibulocollic responses are evoked independent of the requirement to maintain postural control of the head on the torso. Response magnitude and timing were similar across focal muscle contractions (i.e., axial rotation/flexion/extension) provided the muscle was active. In contrast, when subjects cocontracted neck muscles, vestibular-evoked responses decreased in sternocleidomastoid by ∼30–45% (P < 0.05) compared with focal muscle contractions but remained unchanged in splenius capitis. These results indicate robust vestibulocollic reflex coupling, which we suggest functions through its closed-loop influence on head posture to ensure cervical spine stabilization. PMID:25008409

  10. Automated data reduction workflows for astronomy. The ESO Reflex environment

    NASA Astrophysics Data System (ADS)

    Freudling, W.; Romaniello, M.; Bramich, D. M.; Ballester, P.; Forchi, V.; García-Dabló, C. E.; Moehler, S.; Neeser, M. J.

    2013-11-01

    Context. Data from complex modern astronomical instruments often consist of a large number of different science and calibration files, and their reduction requires a variety of software tools. The execution chain of the tools represents a complex workflow that needs to be tuned and supervised, often by individual researchers that are not necessarily experts for any specific instrument. Aims: The efficiency of data reduction can be improved by using automatic workflows to organise data and execute a sequence of data reduction steps. To realize such efficiency gains, we designed a system that allows intuitive representation, execution and modification of the data reduction workflow, and has facilities for inspection and interaction with the data. Methods: The European Southern Observatory (ESO) has developed Reflex, an environment to automate data reduction workflows. Reflex is implemented as a package of customized components for the Kepler workflow engine. Kepler provides the graphical user interface to create an executable flowchart-like representation of the data reduction process. Key features of Reflex are a rule-based data organiser, infrastructure to re-use results, thorough book-keeping, data progeny tracking, interactive user interfaces, and a novel concept to exploit information created during data organisation for the workflow execution. Results: Automated workflows can greatly increase the efficiency of astronomical data reduction. In Reflex, workflows can be run non-interactively as a first step. Subsequent optimization can then be carried out while transparently re-using all unchanged intermediate products. We found that such workflows enable the reduction of complex data by non-expert users and minimizes mistakes due to book-keeping errors. Conclusions: Reflex includes novel concepts to increase the efficiency of astronomical data processing. While Reflex is a specific implementation of astronomical scientific workflows within the Kepler workflow

  11. Startle and blink reflex in high functioning autism.

    PubMed

    Erturk, Ozdem; Korkmaz, Baris; Alev, Gulce; Demirbilek, Veysi; Kiziltan, Meral

    2016-06-01

    An important clinical feature of autism is the presence of atypical responses to sensory stimuli. In this study, we investigated if high functioning autistic patients had abnormalities in the blink reflex and the startle reaction to auditory or somatosensory stimuli. Fourteen patients aged between 7 and 16 years were included in the study. We found a longer latency of the blink reflex, an increased duration and amplitude of the auditory startle reaction and a lower presence rate of the somatosensorial startle reaction in autistic patients. To better define the sensorial characteristics of the disease could improve the therapeutic management of children with autism spectrum disorder. PMID:26997128

  12. Acupuncture - An effective tool in the management of gag reflex

    PubMed Central

    Anand, M. Vijay; Rai, Rathika; Bettie, Nirmal F.; Ramachandiran, Hari; Solomon; Praveena, Subramaniyam

    2015-01-01

    Gagging is of great concern to the dentist as it is a serious impediment during the execution of various dental procedures. The etiology of gagging is multifactorial, and several suggestions have been offered to arrest this reflex, some of which are nonsustainable and does not show the immediate result. Acupuncture has been successfully employed as an adjunct to local anesthesia in dental extractions, pain management and also in the symptomatic management of temporomandibular joint disorders. The author highlights the application of acupuncture in the management of patients with gag reflex during dental procedures and its benefits are reported. PMID:26538942

  13. Implementation of reflex loops in a biomechanical finite element model.

    PubMed

    Salin, Dorian; Arnoux, Pierre-Jean; Kayvantash, Kambiz; Behr, Michel

    2016-11-01

    In the field of biomechanics, the offer of models which are more and more realistic requires to integrate a physiological response, in particular, the controlled muscle bracing and the reflexes. The following work aims to suggest a unique methodology which couples together a sensory and motor loop with a finite element model. Our method is applied to the study of the oscillation of the elbow in the case of a biceps brachial stretch reflex. The results obtained are promising in the purpose of the development of reactive human body models. PMID:27108871

  14. Operating characteristics of a magnetically insulated reflex ion diode

    SciTech Connect

    Strobel, G.L.

    1982-08-01

    Steady-state space charge limited-flow calculations have been carried out for an applied B/sub theta/ magnetically insulated reflexing ion diode. Reflex ion energy spectra characteristic of a thin foil cathode and of a transparent mesh have been used. A one-dimensional calculation shows higher ion current densities with a mesh cathode, and that the emission electron current density increases with the applied B/sub theta/ magnetic field. The ion current density is calculated to increase slightly with radius.

  15. Thoracic and abdominal blastomycosis in a horse.

    PubMed

    Toribio, R E; Kohn, C W; Lawrence, A E; Hardy, J; Hutt, J A

    1999-05-01

    A 5-year-old Quarter Horse mare was examined because of lethargy, fever, and weight loss of 1 month's duration. Thoracic auscultation revealed decreased lung sounds cranioventrally. Thoracic ultrasonography revealed bilateral anechoic areas with hyperechoic strands, consistent with pleural effusion and fibrin tags. A large amount of free fluid was evident during abdominal ultrasonography. Abnormalities included anemia, hyperproteinemia, hyperglobulinemia, hyperfibrinogenemia, and hypoalbuminemia. Thoracic radiography revealed alveolar infiltrates in the cranial and caudoventral lung fields. A cavitary mass, consistent with an abscess, could be seen caudodorsal to the crura of the diaphragm. Ultrasonographic evaluation of this area revealed a hypoechoic mass with septations. Bilateral thoracocentesis was performed. Bacterial culture of the pleural fluid did not yield growth, but Blastomyces dermatitidis was isolated from pleural fluid, abdominal fluid, and an aspirate of the abscess. The mare was euthanatized, and a diagnosis of thoracic and abdominal blastomycosis was confirmed at necropsy. PMID:10319179

  16. [Differential diagnosis of abdominal cysts in children].

    PubMed

    Józsa, Gergő; Mohay, Gabriella; Pintér, András; Vástyán, Attila

    2015-09-13

    19 children were diagnosed with abdominal cysts of different origin in the Surgical Unit of the Department of Pediatrics, Medical University of Pécs, Hungary between 2010 and 2013. The authors discuss the details of representative cases of a parovarial cyst, an intestinal duplication, and an omental cyst with emphasis on the clinical symptoms, diagnostic tools, and surgical interventions. The authors conclude that abdominal cysts often cause mild symptoms only, and they are discovered accidentally by ultrasound imaging performed for other reasons. In some cases, the cyst can cause severe complaints or even acute abdomen requiring emergency surgery. Laporoscopy may be a valuable method both in diagnosis and surgical therapy. Abdominal CT or MRI are not required in the majority of the patients. PMID:26552027

  17. [Abdominal splenosis: an often underdiagnosed entity].

    PubMed

    Vercher-Conejero, J L; Bello-Arqués, P; Pelegrí-Martínez, L; Hervás-Benito, I; Loaiza-Góngora, J L; Falgas-Lacueva, M; Ruiz-Llorca, C; Pérez-Velasco, R; Mateo-Navarro, A

    2011-01-01

    Splenosis is defined as the heterotopic autotransplantation of splenic tissue because of a ruptured spleen due to trauma or surgery. It is a benign and incidental finding, although imaging tests may sometimes orient toward malignancy simulating renal tumors, abdominal lymphomas, endometriosis, among other. We report the case of a 42-year old male in whom a MRI was performed after a study due to abdominal pain. Multiple enlarged lymph nodes were observed in the abdomen, suggestive of lymphoproliferative disease. As an important background, splenectomy was carried out due to abdominal trauma at age 9. After several studies, it was decided to perform a (99m)Tc-labeled heat-damaged red blood cell scintigraphy that showed multiple pathological deposits distributed throughout the abdomen, and even the pelvis, being consistent with splenosis. PMID:20570413

  18. [Abdominal aortic aneurysm and renovascular disease].

    PubMed

    Riambau, Vicente; Guerrero, Francisco; Montañá, Xavier; Gilabert, Rosa

    2007-06-01

    Recent technological advances in the diagnosis and therapy of abdominal aortic aneurysm and renovascular disease are continuing to bring about changes in the way patients suffering from these conditions are treated. The prevalence of both these conditions is increasing. This is due to greater life-expectancy in patients with arteriosclerosis, a pathogenetic factor underlying both conditions. The application of diagnostic imaging techniques to non-vascular conditions has led to the early diagnosis of abdominal aortic aneurysm. Clinical suspicion of reno-vascular disease can be confirmed easily using high-resolution diagnostic imaging modalities such as CT angiography and magnetic resonance angiography. Endovascular intervention is successfully replacing conventional surgical repair techniques, with the result that it may be possible to improve outcome in both conditions using effective and minimally invasive approaches. Future technological developments will enable these endovascular techniques to be applied in the large majority of patients with abdominal aortic aneurysm or renovascular disease. PMID:17580053

  19. Bioprosthetic Mesh in Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Mesh materials have undergone a considerable evolution over the last several decades. There has been enhancement of biomechanical properties, improvement in manufacturing processes, and development of antiadhesive laminate synthetic meshes. The evolution of bioprosthetic mesh materials has markedly changed our indications and methods for complex abdominal wall reconstruction. The authors review the optimal properties of bioprosthetic mesh materials, their evolution over time, and their indications for use. The techniques to optimize outcomes are described using bioprosthetic mesh for complex abdominal wall reconstruction. Bioprosthetic mesh materials clearly have certain advantages over other implantable mesh materials in select indications. Appropriate patient selection and surgical technique are critical to the successful use of bioprosthetic materials for abdominal wall repair. PMID:23372454

  20. Flap Coverage of Anterior Abdominal Wall Defects

    PubMed Central

    Sacks, Justin M.; Broyles, Justin M.; Baumann, Donald P.

    2012-01-01

    Reconstruction of complex defects of the anterior abdomen is both challenging and technically demanding for reconstructive surgeons. Advancements in the use of pedicle and free tissue transfer along with the use of bioprosthetic and synthetic meshes have provided for novel approaches to these complex defects. Accordingly, detailed knowledge of abdominal wall and lower extremity anatomy in combination with insight into the design, implementation, and limitations of various flaps is essential to solve these complex clinical problems. Although these defects can be attributed to a myriad of etiologic factors, the objectives in abdominal wall reconstruction are consistent and include the restoration of abdominal wall integrity, protection of intraabdominal viscera, and the prevention of herniation. In this article, the authors review pertinent anatomy and the various local, regional, and distant flaps that can be utilized in the reconstruction of these complex clinical cases of the anterior abdomen. PMID:23372457

  1. Abdominal aortic aneurysm--the forgotten diagnosis?

    PubMed Central

    Contini, S.; McMaster, P.

    1980-01-01

    A review of all cases of abdominal aortic aneurysm presenting to Addenbrooke's Hospital, Cambridge, in a 4-year period revealed that there were 118 such patients and confirmed the relatively low operative mortality for elective aneurysmal surgery (6.6%) compared with the high mortality (66.6%) for ruptured or leaking abdominal aneurysm. In only 50% of the cases was the correct diagnosis made during the lifetime of the patient; nor was the correct diagnosis always made after admission to hospital. The need for an early and accurate diagnosis of abdominal aneurysms is stressed and an increased awareness of this condition, based on well established clinical features, would undoubtedly reduce the overall mortality. Images Fig. 1 PMID:7393787

  2. [Pediatric Abdominal Pain – Harmless or Harmful?].

    PubMed

    Furlano, Raoul Ivano

    2016-04-27

    Abdominal pain is a very common pediatric complaint. In the majority of cases there is no life-threatening pathology behind this symptom, but a functional disease. However, all-day activities of children and adolescents are often limited, frequent absences from school, and general physician/ pediatrician office visits with often unnecessary diagnostic and therapies are registered. Once an organic etiology of the abdominal pain is excluded by a thoroughly medical history taking and physical examination, the first steps for a successful alleviation of the pain is the reassurance of the patients and their family that there is no life-threatening pathology. There is evidence that cognitive-behavioral therapy may be useful in improving pain and disability outcome in the short term. There is no evidence for pharmacological, dietetic, or complementary intervention in the treatment of chronic functional abdominal pain. PMID:27120211

  3. Reliable Diameter Control of Carbon Nanotube Nanobundles Using Withdrawal Velocity.

    PubMed

    Shin, Jung Hwal; Kim, Kanghyun; An, Taechang; Choi, WooSeok; Lim, Geunbae

    2016-12-01

    Carbon nanotube (CNT) nanobundles are widely used in nanoscale imaging, fabrication, and electrochemical and biological sensing. The diameter of CNT nanobundles should be controlled precisely, because it is an important factor in determining electrode performance. Here, we fabricated CNT nanobundles on tungsten tips using dielectrophoresis (DEP) force and controlled their diameters by varying the withdrawal velocity of the tungsten tips. Withdrawal velocity pulling away from the liquid-air interface could be an important, reliable parameter to control the diameter of CNT nanobundles. The withdrawal velocity was controlled automatically and precisely with a one-dimensional motorized stage. The effect of the withdrawal velocity on the diameter of CNT nanobundles was analyzed theoretically and compared with the experimental results. Based on the attachment efficiency, the withdrawal velocity is inversely proportional to the diameter of the CNT nanobundles; this has been demonstrated experimentally. Control of the withdrawal velocity will play an important role in fabricating CNT nanobundles using DEP phenomena. PMID:27581602

  4. Chronic rupture of abdominal aortic aneurysm.

    PubMed

    Kotsis, Thomas; Thomas, Kotsis; Tympa, Aliki; Aliki, Tympa; Kalinis, Aris; Aris, Kalinis; Vasilopoulos, Ioannis; Ioannis, Vasilopoulos; Theodoraki, Kassiani; Kassiani, Theodoraki

    2011-10-01

    Although the mortality rate after abdominal aortic aneurysm rupture approximates 90% despite the urgent management, a few cases of chronic rupture and delayed repair have been reported in the world literature; anatomic and hemodynamic reasons occasionally allow for the fortunate course of these patients. We report in this article the case of 76-year-old man with a ruptured abdominal aortic aneurysm who was transferred to our facility 4 weeks after his initial hospitalization in a district institution and who finally had a successful open repair. PMID:21620664

  5. An unusual cause of abdominal pain.

    PubMed

    Terneu, S; Verhelst, D; Thys, F; Ketelslegers, E; Hantson, P; Wittebole, X

    2003-01-01

    A 36-year-old woman presented to the Emergency Room because of abdominal pain associated with hematuria and red blood blending to stool. On admission, the physical examination revealed abdominal tenderness and diffuse cutaneous hematoma. The laboratory findings showed abnormal clotting tests with high International Normalised Ratio (INR) and prolonged activated partial thromboplastin time. Hemoperitoneum and ureteral hematoma were noted on the abdomen computed tomography. The patient confessed she had ingested difenacoum for several weeks. All the symptoms resolved with fresh frozen plasma perfusion and vitamin K. PMID:14635532

  6. [Abdominal migraine as a cause of chronic recurrent abdominal pain in a 9-years-old girl--case report].

    PubMed

    Kwiecień, Jarosław; Piasecki, Leszek; Kasner, Jacek; Karczewska, Krystyna

    2005-08-01

    Abdominal migraine is a rarely recognized functional intestinal disorder, manifesting as recurrent paroxysmal abdominal pain of neurogenic origin. The authors describe the 9-years old girl referred to the hospital because of chronic paroxysmal abdominal pain. She did not improve after medication used commonly in functional abdominal disorders (drotaverine, mebeverine, trimebutine). On the ground of various investigations organic causes of abdominal pain were excluded. Carefully completed anamnesis, as well as precise description of the clinical picture of abdominal pain attacks, has lead to the diagnosis of abdominal migraine. According to advice of neurologist the treatment with amitriptyline was introduced. Thereafter a significant improvement was observed. Abdominal migraine has to be taken in to account when diagnosing chronic abdominal pain in children. PMID:16245431

  7. Affective Modulation of the Startle Eyeblink and Postauricular Reflexes in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Dichter, Gabriel S.; Benning, Stephen D.; Holtzclaw, Tia N.; Bodfish, James W.

    2010-01-01

    Eyeblink and postauricular reflexes to standardized affective images were examined in individuals without (n = 37) and with (n = 20) autism spectrum disorders (ASDs). Affective reflex modulation in control participants replicated previous findings. The ASD group, however, showed anomalous reflex modulation patterns, despite similar self-report…

  8. Reflex Modification by Acoustic Signals in Newborn Infants and in Adults.

    ERIC Educational Resources Information Center

    Hoffman, Howard S.; And Others

    1985-01-01

    Five experiments using identical reflex modification procedures on neonates and adults suggest developmental differences in processing auditory stimuli. Neonates failed to exhibit reflex inhibition by either prior acoustic or tactile stimuli. Adults exhibited robust reflex inhibition to these same stimuli. Developmental processes implied by these…

  9. Blink reflexes and magnetic resonance imaging in focal unilateral central trigeminal pathway demyelination.

    PubMed Central

    Kiers, L; Carroll, W M

    1990-01-01

    The electrically elicited blink reflex allows quantitative analysis of the corneal reflex which traverses the trigeminal and facial nerves and the brainstem. Two patients presenting with symptomatic unilateral trigeminal lesions are described, in whom the blink reflexes showed conduction block and slowing at predictable sites in the central pathways, and magnetic resonance imaging confirmed precisely the clinical and electrophysiological localisation. Images PMID:2380735

  10. Dipeptides delay the onset of morphine withdrawal in the mouse.

    PubMed

    Kovács, G L; Szontágh, L; Baláspiri, L; Telegdy, G

    1984-01-01

    The effect of dipeptides was studied on naloxone-precipitated morphine withdrawal in the mouse. In accordance with previous data, s.c. treatment with Z-prolyl-D-leucine delayed the onset of withdrawal jumpings . Replacement of L-proline by L-glutamate or L-pyroglutamate resulted in dipeptides which were more potent in morphine withdrawal than was Z-prolyl-D-leucine. PMID:6540034

  11. The interpersonal process model of demand/withdraw behavior.

    PubMed

    Baucom, Brian R; Dickenson, Janna A; Atkins, David C; Baucom, Donald H; Fischer, Melanie S; Weusthoff, Sarah; Hahlweg, Kurt; Zimmermann, Tanja

    2015-02-01

    The demand/withdraw interaction pattern is a destructive cycle of relationship communication behavior that is associated with negative individual and relationship outcomes. Demand/withdraw behavior is thought to be strongly linked to partners' emotional reactions, but current theories are inconsistent with empirical findings. The current study proposes the interpersonal process model of demand/withdraw behavior, which includes linkages between each partners' emotional reactions and the interpersonal behavior of demanding and withdrawing. Data come from problem solving discussions of 55 German couples with observationally coded demand/withdraw behavior and fundamental frequency (f₀) to measure vocally encoded emotional arousal. Actor-partner interdependence models (Kenny, Kashy, & Cook, 2006) were used to examine associations among demand/withdraw behavior and f₀ in the overall discussion and 5-min segments. Significant cross-partner associations emerged for demanding and withdrawing behavior across the whole conversation as well as within 5-min segments, and these associations are partially accounted for by each individual's f₀. When behaviorally coded demanders expressed more vocal arousal, they demanded more and withdrew less while their partners withdrew more. In contrast, when behaviorally coded withdrawers expressed more vocal arousal, their partners demanded less and withdrew more. Findings demonstrate that demand/withdraw behavior varies between couples (i.e., some couples engage in a stronger demand/withdraw cycle than others) and between segments (i.e., when 1 partner increases demanding, the other increases withdrawing). Findings support key elements of the interpersonal process model, showing intra- and interpersonal pathways linking demand/withdraw behavior and emotion and demonstrate the importance of partners' behavioral roles in these linkages. PMID:25495639

  12. Ethanol withdrawal in mice precipitated and exacerbated by hyperbaric exposure

    SciTech Connect

    Alkana, R.L.; Finn, D.A.; Galleisky, G.G.; Syapin, P.J.; Malcolm, R.D.

    1985-01-01

    Mice were fed an ethanol-containing liquid diet for 9 days. On removal of the diet, exposure to 12 atmospheres absolute of a mixture of helium and oxygen precipitated earlier withdrawal, increased withdrawal scores for the first 6 hours, and increased the peak withdrawal intensity compared to dependent animals exposed to control conditions. The enhanced withdrawal did not appear to reflect alterations in ethanol elimination, oxygen or helium partial pressures, body temperature, or general excitability. These results extend to chronically treated animals the evidence that hyperbaric exposure antagonizes the membrane actions of ethanol.

  13. Withdrawal symptoms in internet gaming disorder: A systematic review.

    PubMed

    Kaptsis, Dean; King, Daniel L; Delfabbro, Paul H; Gradisar, Michael

    2016-02-01

    Internet gaming disorder (IGD) is currently positioned in the appendix of the DSM-5 as a condition requiring further study. The aim of this review was to examine the state of current knowledge of gaming withdrawal symptomatology, given the importance of withdrawal in positioning the disorder as a behavioral addiction. A total of 34 studies, including 10 qualitative studies, 17 research reports on psychometric instruments, and 7 treatment studies, were evaluated. The results indicated that the available evidence on Internet gaming withdrawal is very underdeveloped. Internet gaming withdrawal is most consistently referred to as 'irritability' and 'restlessness' following cessation of the activity. There exists a concerning paucity of qualitative studies that provide detailed clinical descriptions of symptoms arising from cessation of internet gaming. This has arguably compromised efforts to quantify withdrawal symptoms in empirical studies of gaming populations. Treatment studies have not reported on the natural course of withdrawal and/or withdrawal symptom trajectory following intervention. It is concluded that many more qualitative clinical studies are needed, and should be prioritised, to develop our understanding of gaming withdrawal. This should improve clinical descriptions of problematic internet gaming and in turn improve the quantification of IGD withdrawal and thus treatments for harmful internet gaming. PMID:26704173

  14. Authentic role of ATP signaling in micturition reflex

    PubMed Central

    Takezawa, Kentaro; Kondo, Makoto; Kiuchi, Hiroshi; Ueda, Norichika; Soda, Tetsuji; Fukuhara, Shinichiro; Takao, Tetsuya; Miyagawa, Yasushi; Tsujimura, Akira; Matsumoto-Miyai, Kazumasa; Ishida, Yusuke; Negoro, Hiromitsu; Ogawa, Osamu; Nonomura, Norio; Shimada, Shoichi

    2016-01-01

    Adenosine triphosphate (ATP) is a signaling molecule that regulates cellular processes. Based on previous studies of bladder function over the past decade, bladder ATP signaling was thought to have an essential role in the normal micturition reflex. In this study, we performed detailed analyses of bladder function in purinergic receptor-deficient mice using the automated voided stain on paper method and video-urodynamics. Unexpectedly, a lack of P2X2 or P2X3 receptors did not affect bladder function under normal physiological conditions, indicating that bladder ATP signaling is not essential for normal micturition reflex. In contrast, we found that lipopolysaccharide (LPS) induced markedly high levels of ATP release from the urothelium. In addition, LPS-induced rapid bladder hyperactivity was attenuated in P2X2−/− and P2X3−/− mice. Contrary to the previous interpretation, our present findings indicate that bladder ATP signaling has a fundamental role in the micturition reflex, especially in bladder dysfunction, under pathological conditions. Therefore, the bladder ATP signaling pathway might be a highly promising therapeutic target for functional bladder disorders. This study newly defines an authentic role for bladder ATP signaling in the micturition reflex. PMID:26795755

  15. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered...

  16. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered...

  17. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered...

  18. 21 CFR 890.1450 - Powered reflex hammer.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Powered reflex hammer. 890.1450 Section 890.1450 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES PHYSICAL MEDICINE DEVICES Physical Medicine Diagnostic Devices § 890.1450 Powered...

  19. Reconceptualizing reflexivity and dissonance in professional and personal domains.

    PubMed

    Brooks, Ann

    2008-09-01

    Debates around 'reflexivity' and the construction of the gendered self within late modernity have occupied the attention of both 'reflexive modernization' theorists (Beck, Giddens and Lash 1994; Beck and Beck-Gernsheim 1996; Giddens 1991, 1992) as well as gender and feminist theorists. While theorists such as Beck and Giddens have been preoccupied with establishing the connection between reflexivity and the construction of the 'non-gendered' self, gender and feminist theorists have sought to amplify the debate by exploring the intersecting nexus of contemporary theorizing, more fully within this context. This paper explores the theoretical underpinnings of these debates and their application to specific professional and personal domains. I consider three case studies to assess these issues as outlined in my own work, Brooks 2006, and in the work of Wajcman and Martin 2002, and McDowell 1997, which draw on empirical research and explore changes to gender identity within professional and personal domains. I conclude that there is little evidence in the research presented here of any systematic reconfiguring of gender identities leading to a detraditionalization of gender as suggested by the 'reflexive modernization' theorists. PMID:18782154

  20. Normal values of patellar and ankle tendon reflex latencies.

    PubMed

    Frijns, C J; Laman, D M; van Duijn, M A; van Duijn, H

    1997-02-01

    The clinical value of latency measurement of tendon reflexes in neurological patients has been reported by several authors. However, normal values are not readily comparable. In the present study, latencies and amplitudes of patellar (PTR) and ankle tendon reflexes (ATR) were measured at rest and after facilitation in 102 normal controls. A manually operated reflex hammer, tipped with electrically conductive rubber, ensured an immediate start of the sweep of the oscilloscope. Latencies showed a significant correlation with height (r = 0.70 for PTR and r = 0.72 for ATR, P < 0.0001) and to a lesser degree with age (r = 0.16 and r = 0.30, P < 0.0001). While amplitudes were highly variable, rendering them less useful for diagnostic purposes, latencies showed minimal intra-individual variability (CV 1.5 and 0.8%, respectively). Correlation of ATR-latency with the H-reflex latency of the soleus muscle was very high (r = 0.97, P < 0.0001). Comparison with three other hammer types yielded corresponding results with a hammer supplied with a piezo-electric element; however, significantly shorter latencies were found with a hammer with a microswitch, and with another hammer with a spring-contact, due to a delay from the tap on the tendon until the start of the sweep of the monitor. PMID:9107465