Medical science monitor : international medical journal of experimental and clinical research
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A review of the current literature was attempted in order to determine to what degree new technological features, such as the use of proteomics, genomics, and gene microarrays, have contributed to the elucidation of the specific pathways to the formation of endometriosis as well as to the discovery of potential biomarkers and new treatment strategies. Endometriosis is well described as a condition in which multiple genetic components and still foggy environmental risk factors are important determinants of the disease's origin, maintenance, persistence, and clinical outcome. ⋯ The evolving genomic and proteomic technologies remain poised to revolutionize the diagnosis and treatment of endometriosis but have not yet lead to a single new therapy or tested biomarker. The reasons have mainly to do with the complex and multifactorial character of the disease itself.
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General anesthesia is characterized by unconsciousness, analgesia, muscle relaxation, and depression of reflexes, generally in response to the administration of chemical agents that induce reversible unconsciousness. Study of the cognitive neuroscientific basis of general anesthesia involves evaluation of the effect of anesthetic agents on consciousness and the brain mechanisms underlying cognitive function. Central nervous system dysfunction after anesthesia and/or surgery can occur at any age but is a particular issue for elderly patients. Studies of delirium and postoperative cognitive dysfunction have been published in many countries since the end of the last century. We present a discussion of delirium disorders and a review of the literature. ⋯ The brain is the main target organ for anesthetic and adjuvant drugs, and age-associated changes in the brain have important implications with respect to general anesthesia. Anesthetists and surgeons have suspected for many years that some patients suffer a postoperative decline in cognitive function. The condition generally has a good outcome because oxidative nerve cell derangements and neurotransmitter imbalances are transient.
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Ultrasound measurement of the optic nerve sheath diameter (ONSD) has been shown to correlate with intracranial pressure (ICP). This study looked at intra-observer and inter-observer reliability among three emergency physicians (EPs) using three different imaging protocols. ⋯ These data suggest comparable precision and inter-observer reliability can be achieved. However, larger values when using the 10-5 MHz probe suggest different cut-off thresholds for normal upper limits. The coronal imaging technique demonstrated less inter-rater variance and may be a better technique when such small measurement differences are important.