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PubMed1985

Pyridoxylated polyhemoglobin as a red cell substitute for resuscitation of lethal hemorrhagic shock in conscious rats.

In our previous work, pyridoxylated polyhemoglobin (PP-PolyHB) was shown to have a P50 = 16-18 torr, and a half-life (T 1/2) of 20 hrs in the circulation of rats given a 75% isovolemic exchange transfusion. For the present study, a rapid and lethal hemorrhagic shock model has been specifically designed to assess the ability of PP-PolyHB to function as an emergency resuscitation fluid. Using 48 fully conscious rats with special chronic arterial and venous cannulations, shock was induced by bleeding 67% of total blood volume in less than 40 min; producing 100% mortality in nonresuscitated controls. Resuscitation was carried out using one of the following infusion fluids equivalent in volume to the bled volume: Ringer's solution, albumin solution, stroma-free Hb (SFHb), pyridoxylated SFHb (PP-SFHb), PP-PolyHb, and whole blood. Long-term (greater than 8 day) survival rate of rats (n = 12) resuscitated with PP-PolyHb was 75% compared to 83% for autologous whole blood. Survival following resuscitation with the other fluids was substantially lower. These results indicate that PP-PolyHb could effectively resuscitate lethal hemorrhagic shock in conscious rats, and provide long-term survival afterwards, even in the absence of any additional fluid maintenance.

Animals↗
PubMed1983

Statistical studies on evaluation of mild disturbance of consciousness. Study of a simpler scale for clinical use.

In an effort to express the grades of mild disturbance of consciousness (MDOC), or clouding of consciousness, 25 items were selected for application in clinical examination. Factor analysis of the 25 items revealed that MDOC has a two-factor structure; namely, the performance factor (F1) and the verbal factor (F2). This structure was maintained in the sequential examinations. Guttman's scale analysis showed that the scale using the 25 items may be considered to approximate a unidimensional scale. By item selection according to communality, the 25 items could be reduced to 12 items without losing the two-factor structure or the usefulness and reliability of the examination. The principal component analysis (PCA) score, the F1 score, and the F2 score, calculated from the 12 items, were found to be good scales to describe an overall picture and characteristics of the F1 and the F2 of MDOC, respectively. Furthermore, by means of the characteristic curve (ogive) method, it was revealed that MDOC consisted of four clusters of items, the F2 factor (mild), F1 factor (mild), F2 factor (moderate), and F1 factor (moderate), according to the MDOC severity, so that a simpler scale composed of a representative item from each cluster could be constructed which exhibited a high correlation coefficient with the original PCA score.

Brain Diseases↗
PubMed1988

Relationship of depth of brain lesions to consciousness and outcome after closed head injury.

Magnetic resonance (MR) imaging was performed in 94 patients who sustained closed head injury of varying severity. Results of MR studies obtained after the intensive care phase of treatment disclosed that intracranial lesions were present in about 88% of the patients. Consistent with the centripetal model of progressive brain injury proposed in 1974 by Ommaya and Gennarelli, the depth of brain lesion was positively related to the degree and duration of impaired consciousness. Further analysis indicated that the relationship between depth of brain lesion and impaired consciousness could not be attributed to secondary effects of raised intracranial pressure or to the size of intracranial lesion(s).

Adolescent↗
PubMed2004

[Health as expanding consciousness: based on the experiences of victims of sexual violence].

PURPOSE: This study was to explore health experiences of victims of sexual violence reflected in Newman's health as expanding consciousness theory. METHOD: Nurse as researcher use Newman's praxis methodology because it is good for showing the process of interaction between researcher and sexual abuse victims. RESULTS: The significant characteristics of early health experiences during negative situations were a lot of suffering. However, after a turning point in health experience, the health experiences of most of the participants evolved as expanding consciousness. CONCLUSION: The study has provided support for Newman's theory of health. Most of the participants recognised meanings in their patterns and trustful caring relationships with the nurse as researcher. Pattern recognition as a nursing practice was a meaningful transforming process in the participant-nurse partnership.

Adolescent↗
PubMed1991

[Effect of lateral position and chest percussion on pulmonary gas exchange in patients with decreased level of consciousness].

The purpose of this study is to verify the effect of lateral position and chest percussion on gas exchange in the decreased level of conscious patients. The Subjects for this study were 21 patients 'admitted in ICU of CNUH from Dec 18th, 1989 to Aug 4th, 1990. The Data was analyzed by paired t-test. The results of this study as follows: 1) In comparison of supine position, good-lung dependent position and good-lung dependent with chest percussion, the difference of PaO. was statistically significant (P less than 0.05). 2) In comparison of supine position, good-lung dependent position and good-lung dependent with chest percussion, the difference of A-a Do. was statistically significant (p less than 0.05). In conclusion, the use of good-lung dependent position and chest percussion was effective nursing intervention on decreased level of conscious patients in ICU.

Consciousness↗
PubMed2005

Clinical diagnosis of prolonged states of impaired consciousness in adults.

A prolonged state of impaired consciousness is a devastating consequence of severe structural brain injury but fortunately is uncommon. Patients may be diagnosed as being in a persistent vegetative state, having akinetic mutism, or being in a minimally conscious state. These conditions can be distinguished from each other by a comprehensive clinical neurologic examination. Recovery is determined by age, cause, and time in such state. For patients diagnosed as being in a permanent (irreversible) vegetative state, hope for a clinically meaningful recovery is unrealistic after 1 year. Prolonged survival is possible only with meticulous care and aggressive medical intervention to prevent and treat systemic complications.

Adult↗
PubMedDate not supplied

Exploring spirituality and consciousness with an expanded science: beyond the ego with empiricism, phenomenology, and contemplation.

Spirituality has been recognized as pivotal in health education and health promotion. Although spirituality is often discussed as a dimension of health, there is little evidence of integrating it into educational settings and health promotion programs. The difficulty in addressing the concept of spirituality is related to both its association with denominational religion and our cultural emphasis on the material realm. However, some scholars are now associating spirituality with the development of human consciousness beyond the ego level. It has been suggested that the scientific investigation of this development beyond the ego may be possible with empirical and phenomenological, as well as with traditional contemplative methods. Thus, investigation in the realms of consciousness beyond the ego can be addressed within theories of knowledge that are grounded in experience. An examination of the spirituality/consciousness relationship may be crucial for any profession that purports to address the health issues of the whole person. It may then be possible to more easily integrate spirituality into educational settings and health enhancement programs. If spirituality is part of human experience, then willingness to make forays into this dimension is fundamental to health.

Consciousness↗
PubMed1987

[Conscious levels of processing a preceding stimulus and priming effect].

This study was conducted to investigate how two different conditions of processing a prime would affect the lexical decision time of a target. One condition was called the conscious condition, where a prime was presented for 250 ms and a subject was instructed to expect any target from that prime. Another condition was the unconscious condition, where a prime was briefly exposed and followed by a pattern mask so that a subject could not identify it. The effect of an associative strength of prime-target relatedness was also investigated. The associative strength of prime-target relatedness in the related condition was relatively weak in Exp. I, and strong in Exp. II. In the conscious condition, facilitation and inhibition were found both in Exp. I and in Exp. II. On the other hand, in the unconscious condition, only inhibition was found in Exp. I, but only facilitation in Exp. II. These results suggest that automatic activation and attention system were both needed to account for priming effect.

Adult↗
PubMed2001

Conscious control of movements: increase of temporal precision in voluntarily delayed actions.

The variability of simple actions with response to auditory stimuli was studied under different delay conditions. Subjects reacted as fast as possible or with a defined time delay (from 250 to 750 ms) to a tone switching off by pressing a response-key with the left index finger (controlled by the right hemisphere) or with the right one (left hemisphere). For short delays (requested response times below 350 ms) variability of responses was much larger then for longer delays (above 350 ms), especially for the right hand. Thus, precise temporal control on consciously mediated actions sets only in after a rather long delay (in some cases after half a second). Neuronal mechanisms underlying conscious temporal control of actions appear to be different for the two hemispheres.

Adult↗
PubMed1999

A technique for evaluating analgesia in conscious perching birds.

OBJECTIVE: To develop a technique for objective assessment of modulation of nociperception in conscious perching birds. ANIMALS: 31 adult African grey parrots. PROCEDURE: Birds were randomly assigned to receive saline (0.9% NaCl) solution (n = 10), butorphanol tartrate (11), or buprenorphine hydrochloride (10), i.m. Birds were fitted with a surface electrode on the medial metatarsus of 1 leg. An electrical stimulus was delivered to the bird's foot through an aluminum surface on half of the perch. The alternate side of the perch delivered a noxious thermal stimulus. A withdrawal response to either stimulus was recorded when the bird lifted its foot or vigorously flinched its wings. RESULTS: Responses to thermal stimuli were extremely variable during baseline testing and after administration of drugs. Thus, significant differences were not detected after drug injection. In contrast, responses to an electrical stimulus were predictable with much less variation. CONCLUSIONS AND CLINICAL RELEVANCE: This method and device allowed for the reliable determination of withdrawal threshold in perching birds. Use of this technique for objective assessment of modulation of nociperception in conscious perching birds will enable assessment of analgesic drugs.

Analgesia↗
PubMed2000

[Response to immunoadsorption and steroid therapies in a patient with carcinomatous Lambert-Eaton myasthenia syndrome accompanied by disturbed consciousness].

A 75 year-old man developed gait disturbance and somnolence over a period of three months. Electroencephalography indicated theta slowing and cerebrospinal fluid (CSF) examination showed an increased cell count of 23/microliter and IgG of 7.2 mg/dl. He showed fatigue-inducing muscle weakness and the Harvey-Masland test demonstrated a low M-wave amplitude of 0.6 mV which increased to 3 mV with 50 Hz high-frequency stimulations. The serum titer of P/Q type anti-voltage-gated calcium channel (VGCC) antibody was quite high at 11,901 pmol/L (< 20 pmol/L). The patient was diagnosed as Lambert-Eaton myasthenia syndrome (LEMS) although at first no carcinoma was detected. Immunoadsorption therapy with a phenilalanine absorber column resulted in a reduction in the titer of anti-VGCC antibody to half of the initial concentration, but it increased again within several days. Six repeats of immunoadsorption and concomitant administration of prednisolone at a dose of 40 mg daily succeeded in reducing the anti-VGCC antibody titer of to below 390 pmol/L. The patient's consciousness disturbance and muscle weakness improved simultaneously over the next month and the lumbar puncture and electroencephalography showed normal results. Prednisolone administration was maintained at a dose of 30 mg daily and one year after occurrence of the first symptoms, a small cell lung carcinoma was detected. There was no evidence of limbic encephalitis such as an elevation of anti-Hu antibody in his CSF and serum or abnormal signal intensities in the hippocampal formations on MR imaging. The etiology of his disturbed consciousness remained unclear, but, in the case of LEMS, it could be a manifestation of a paraneoplastic syndrome associated with small-cell lung carcinoma. It is noteworthy that the anti-VGCC antibody titer rose to 1,262 pmol/L 2 months before his tumor was detected and decreased to 286 pmol/L after chemotherapy. P/Q type anti-VGCC antibody could therefore be a useful tumor marker reflecting activity of small-cell carcinoma.

Aged↗
PubMed2000

Self-consciousness and animal suffering.

Animals with relatively highly developed brains are likely to experience some degree of self-awareness and the ability to think. As well as being interesting in its own right, self-consciousness matters from an ethical point of view, since it can give rise to forms of suffering above and beyond the immediate physical sensations of pain or distress. This article surveys the evidence for animal self-consciousness and its implications for animal welfare.

Animal Population Groups↗
PubMed2000

[Complications in home treatment of patients with severe disturbances of consciousness].

We have been providing home treatment for patients with severe disturbance of consciousness requiring various medical treatments for about 10 years. In the 65 cases we have encountered, we studied complications during the course of the home treatment. The proportions of infections, decubiti and convulsions were found to be very high. With infections in particular, conditions worsened rapidly in many cases, so we made it a principle to have the patients hospitalized early. We also investigated changes in serum albumin levels, peripheral blood lymphocyte count and prognostic nutritional index (PNI). Patients who develop infections repeatedly and succumb to early death often show low values for PNI and lymphocyte count. The low values are considered useful as one indicator of the general conditions of patients under home treatment. For the management of patients with severe disturbances of consciousness, it is important to keep a close liaison with other departments or hospitals and strengthen home nursing sections.

Adult↗
PubMed2001

[Multiple sclerosis with consciousness disturbance: a case report].

We report here a nine-year-old girl with multiple sclerosis having consciousness disturbance at admission. Neurological examination revealed drowsiness, unstable emotion, decreased visual acuity, disturbance of convergence, and clumsy coordination movements. Her cerebrospinal fluid IgG and myelin basic protein were increased. Electroencephalogram showed intermittent, high voltage slow waves predominant in the frontal lobes. Magnetic resonance imaging (MRI) found multiple demyelinating plaques in the brainstem, thalamus, periventricular white matter. The brainstem reticular formation was involved. Since she had had bilateral acute optic neuritis and papillitis two years before the admission, the diagnosis of multiple sclerosis was made. Methylprednisolone pulse therapy improved her neurological symptoms and MRI findings. Multiple sclerosis in children, unlike that in adults, may present with symptoms mimicking an encephalopathy. Our case suggested that consciousness disturbance in childhood multiple sclerosis results from lesions in the brainstem activating reticular formation including the thalamus.

Child↗
PubMedDate not supplied

[Determination of melatonin concentrations in patients with consciousness disturbances after craniocerebral trauma. Preliminary communication].

The study was performed in cooperation of the Department of Neurotraumatology and the Department of Clinical Biochemistry Jagiellonian University in Cracow. In patients with central nervous system injury, diagnosed upon computerized tomography scan, melatonin levels were measured. The most frequent reason of damage was severe craniocerebral trauma. Consciousness, assessed according to Glasgow Coma Scale, was between 3 to 13 points. Melatonin levels were measured at 8 a.m. The investigation could not demonstrate any correlations between consciousness disturbances after head injury and serum melatonin levels in the morning. To draw a final conclusion further experiments are necessary. They will help to explain the role of endogenous melatonin in patients after craniocerebral injury.

Adolescent↗
PubMed2001

Information measures for conscious experience.

This paper argues that consciousness is integrated information, and introduces measures to assess it. These measures lead to the prediction that a physical system such as the brain gives rise to consciousness when some of its elements constitute a complex having high minimum information midpartition (MID) complexity.

Action Potentials↗
PubMed2002

Noninvasive monitoring of human consciousness by near-infrared spectroscopy (NIRS) during high +Gz stress.

Noninvasive monitoring of the relative change in oxygen saturation (rSO2) in cerebral tissue by near-infrared multi-wavelength spectroscopy (NIRS) was investigated in humans under high acceleration (+Gz) stress. These profiles included sustained 15-second +Gz plateaus and repeated short duration +Gz pulses of varying duration. The end points in this study were loss of consciousness due to high +Gz exposure (GLOC). In many cases subjects demonstrated cognitive and physical symptoms related to reduced cerebral blood flow without frank unconscious, which has been called Almost Loss of Consciousness (ALOC). Both the rSO2 levels during and after the +Gz exposures and the total time subjects were incapacitated after GLOC were recorded. It was found that while the drop in rSO2 at the onset of GLOC was lower during pulse exposures as compared to sustained exposures, the total time to recovery from GLOC was longer during the sustained runs. By applying a better understanding of the nature and timing of +Gz-induced changes in cerebral tissue oxygenation, more efficient control systems for personal protective gear for pilots of high performance aircraft can be implemented.

Acceleration↗
PubMed1975

Transformations of consciousness. A cartography. I. The perception-hallucination continuum.

Self-awareness emerges from the evolutionary transformation of material structures into magical, mythical and mental structures of consciousness. Western varieties of conscious states may be mapped on a perception-hallucination continuum of increasing ergotropic or hyper-arousal. These levels of subcortical arousal are cortically or cognitively interpreted as normal, creative, hyperhrenic, cataleptic and ecstatic states. During increasing hyper-arousal (characterized by EEG desynchronization): (1) the variability of the EEG amplitude decreases in introverts whereas in extroverts, it increases; (2) exteroception is transformed into an experience of interoception, while willed motor activity becomes increasingly impaired and ultimately inhibited, and (3) information processing during these hallucinatory states is preferentially shifted from the speech dominant and motor-coordinating or "major" toward the nonverbal, gestalt-perceiving, the non-dominant or "minor" cortical hemisphere.

Amnesia↗