A study presenting findings of focal hippocampal x-irradiation in early infancy and late behavior at two ages was carried out using Long-Evans hooded rats (Rattus norvegicus). Animals from eleven litters received 150-R irradiation treatments for 5 or 15 consecutive days and were then tested in an open field situation and in a two-way active avoidance apparatus. The results indicated that the behavioral deficits paralleled those seen in animals with classical hippocampal lesions. The results were offered in support of a response suppression model for hippocampal functioning.

Age Factors↗

PubMedDate not supplied

Acetylcholinesterase inhibition in dementia with Lewy bodies: results of a prospective pilot trial.

OBJECTIVE: Dementia with Lewy bodies (DLB) is the second commonest form of dementia. The response to acetylcholinesterase inhibition (AChEI) could be greater in DLB than in Alzheimer's disease (AD) because cholineacetyl-transferase levels are more reduced in the former. This preliminary trial seeks to compare performances in cognitive tasks before and after tacrine administration in DLB and AD subjects. METHODS: Six DLB and 6 AD patients were enrolled in an open, nonrandomized, intervention trial using 80 mg/day tacrine. Patients met ADRDA or DLB consortium criteria for probable diseases. Subjects were matched for Mini Mental State Examination (MMSE) score, age and sex. Mattis Dementia Rating Scale (DRS), Controlled Oral Word Association Test (FAS) and Boston Naming tests were administered at baseline and at 6 months into treatment. RESULTS: AD and DLB groups did not differ in initial mean total DRS scores. In the primary analysis, both groups declined during the course of treatment (-7.3 +/- 4.2 and -16.8 +/- 39.2 DRS points, respectively). Due to the large variability in DLB posttreatment scores, this group was divided post hoc into responders (DLBr) and nonresponders (DLBnr). The DLBr group outperformed the DLBnr group at baseline (p < 0.05) and, notably, in follow-up DRS test scores (p < 0.001). Two-way MANOVA comparing both DLB subgroups with either the entire AD cohort or similarly stratified AD subgroups showed a significant interaction (F = 7.6; p < 0.015), attributed mostly to declines in DLBnr group scores (p < 0.01). Surprisingly, on DRS memory subscale and FAS tests, there were significant improvements in DLBr scores (p < 0.02). A baseline MMSE (or DRS memory) score >/=15 predicted a positive response to tacrine in DLB. Acceleration of parkinsonism occurred in all DLB subjects. CONCLUSION: Results from a primary analysis of the therapeutic effect of 80 mg/day tacrine in DLB and AD were negative. However, post hoc analysis showed that mild to moderate DLB responds favorably to AChEI relative to AD through stabilization of global cognitive decline and improvements in specific cognitive areas. These results could be useful in the planning of a more definitive study.

Aged↗

PubMedDate not supplied

Temperature monitoring need not be done routinely during general anesthesia.

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Anesthesia, General↗

PubMedDate not supplied

Pulse oximetry monitoring of sedated pediatric dental patients.

Hypoxemia is recognized as a major complication of sedating pediatric dental patients. Traditional methods of patient monitoring show changes only with moderate to severe hypoxemia. This study compared pulse oximetry, a new monitoring technology, to traditional techniques in their ability to detect hypoxemia in sedated children. The results demonstrated that pulse oximetry is a more sensitive monitor of mild to moderate hypoxemia than measurements of heart rate, blood pressure, respiratory rate, or visual observation for cyanosis in sedated pediatric dental patients.

Anesthesia, Dental↗

PubMedDate not supplied

Dysrhythmias controlled with stellate ganglion block in a child with diabetes and a variant of long QT syndrome.

BACKGROUND AND OBJECTIVES: A 9-year-old boy with a history of poorly controlled insulin-dependent diabetes mellitus was found at home unresponsive. QT prolongation was diagnosed on inspection of Holter monitoring performed immediately before episodes of ventricular fibrillation. METHODS: In spite of medical management with propranolol, esmolol, phenytoin, and diazepam, the patient continued to have episodes of QT prolongation followed by ventricular dysrhythmias that reverted to sinus rhythm only after cardiopulmonary resuscitation and cardioversion. RESULTS: A series of left stellate ganglion blocks with bupivacaine eradicated the dysrhythmias. The child was then referred to another institution for insertion of an automatic internal cardioverter defibrillator. CONCLUSIONS: This case report emphasizes the effectiveness of left stellate ganglion block with bupivacaine in a child with a variant of long QT syndrome.

Autonomic Nerve Block↗