Frontiers in neurology
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Circadian rhythms influence sleep and wakefulness. Circadian activity rhythms (CAR) are altered in individuals with dementia or seasonal affective disorder. To date, studies exploring CAR and sleep in postpartum women are rare. ⋯ A higher circadian equation was associated with higher TST (r = 0.83, p < 0.001), less WASO (r = -0.50, p < 0.001), lower self-reported sleep disturbance scores (r = -0.35, p = 0.01), and less morning fatigue (r = -0.26). Findings indicate that mothers with a hospitalized infant have both nocturnal sleep problems and disturbed circadian activity rhythms. Factors responsible for these sleep and rhythm disturbances, the adverse effects on mother's physical and mental well-being, and mother-infant relationship require further study.
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Frontiers in neurology · Jan 2010
Report of a consensus meeting on human brain temperature after severe traumatic brain injury: its measurement and management during pyrexia.
Temperature disturbances are common in patients with severe traumatic brain injury. The possibility of an adaptive, potentially beneficial role for fever in patients with severe brain trauma has been dismissed, but without good justification. Fever might, in some patients, confer benefit. ⋯ At the close of meeting, there was agreement on four key issues relevant to modern temperature measurement and management and for undergirding of an evidence-based practice, culminating in a consensus statement. There is no robust scientific data to support the use of hypothermia in patients whose intracranial pressure is controllable using standard therapy. A randomized clinical trial is justified to establish if body cooling for control of pyrexia (to normothermia) vs moderate pyrexia leads to a better patient outcome for TBI patients.
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Frontiers in neurology · Jan 2010
Anesthesia and Sedation Practices Among Neurointerventionalists during Acute Ischemic Stroke Endovascular Therapy.
Intra-arterial reperfusion therapies are expanding frontiers in acute ischemic stroke (AIS) management but there is considerable variability in clinical practice. The use of general anesthesia (GA) is one example. We aimed to better understand sedation practices in AIS. ⋯ The most frequent type of anesthesia used by Neurointerventionalists for AIS interventions is GA. Prior to making GA standard of care during AIS intervention, more data are needed about effects on clinical outcomes.
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Frontiers in neurology · Jan 2010
Dynamics of sleep-wake cyclicity at night across the human lifespan.
Studies in adult mammals (rats, cats, mice, and humans) have revealed a surprising regularity in the duration of sleep and wake bouts. In particular, wake bout durations exhibit a power-law distribution whereas sleep bout durations exhibit an exponential distribution. Moreover, in rodents, sleep bouts exhibit an exponential distribution at all ages examined, whereas wake bout durations exhibit exponential distributions early in ontogeny with a clear power-law emerging only at the older ages. ⋯ Moreover, sleep bout durations exhibit exponential distributions at all ages tested, except for the youngest (premature infants). Wake bouts exhibit a power-law distribution - but only during a restricted time window during adulthood. We conclude that the developmental trajectory of human sleep-wake cycles does not map well onto those of rodents; however, the method of characterizing sleep-wake cycles, using bout distribution, holds great promise for classifying sleep, its disorders, and tracking its developmental milestones across the lifespan in humans.