Articles: cations.
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Successful critical care management of patients with aneurysmal subarachnoid hemorrhage (SAH) requires a thorough understanding of the disease and its complications and a familiarity with modern multimodality neuromonitoring technology. This article reviews the natural history of aneurysmal SAH and strategies for disease management in the acute setting, including available tools for monitoring brain function. Intensive care management of patients with SAH focuses on prevention of further neurologic injury. ⋯ There is increasing awareness of extracerebral complications, including electrolyte disturbances (eg, cerebral salt wasting) and cardiac dysfunction. Prompt recognition and treatment of these disorders maximizes the odds of a good functional outcome. Technologic advances hold the promise of improved detection and treatment of secondary neurologic insults.
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Neurosciences continues to be the leading journal for Neurosciences in Saudi Arabia and the Middle East. In January 2007, Neurosciences was indexed by Thomson ISI in Science Citation Index Expanded online at ISI Web of KnowledgeSM and Neurosciences Citation Index. Since then a significantly increased volume of scientific articles continues to be submitted to the journal by enthusiastic authors, a fact that enriches the scientific contents of the journal. ⋯ A small number of articles were rejected last year due to extensive plagiarism and duplicate publication. We hope all our readers benefitted from the introduction of the Arabic abstracts, and enjoyed the new look and the feel of the journal. We extend our sincerest thanks to our authors, readers, reviewers, and board members, and wish all a successful year.
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The sensitivity of selected ion flow tube mass spectrometry, SIFT-MS, has been increased such that it is now possible to detect metabolites present at a part-per-billion, ppb, level in single breath exhalations. However, to utilize this improved sensitivity, the overlaps (coincidences) of those ions resulting from interfering reactions of impurity precursor ions with some breath metabolites present at higher concentrations with the analytical product ions characteristic of particular metabolites must be accounted for. ⋯ It is shown that when using H(3)O(+) to quantify formaldehyde and acetaldehyde the reactions of impurity O(2)(+) ions with methanol and ethanol (always present in breath) must be accounted for and that the quantification of acetaldehyde must avoid the interference of the CO(2) present in exhaled breath. Finally, it is indicated that the analysis of 2-propanol can be achieved using both H(3)O(+) and NO(+) precursor ions.
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Brain-gut axis represents a complex reflex circuit that integrates the communication between cortex and the digestive system. Disturbances of the neuromodulatory processes in the brain-gut axis generate functional digestive disorders mainly centered on the pain symptoms and motility disorders. ⋯ The efficacy of the methods using electrostimulation is dependent on the parameters of the physical system used: amplitude, frequency, burst time of the electrical current and also the positioning of the electrodes. While pharmacological interventions are largely used at the moment, neuromodulatory interventions involving electrical stimulation showed clinical efficacy in research trials and have promise.
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Delirium is a complex neuropsychiatric syndrome presenting primarily with disturbances of cognition, perception and sensorium, alertness, sleep/wake cycle, and psychomotor behavior in the context of a medical etiology. The presentation can be quite variable among patients and even within a given patient because of its waxing and waning course. This variability and overlap with other psychiatric syndromes has led to substantial underrecognition and undertreatment in clinical settings. ⋯ Similarly, research is warranted that focuses on preventing delirium, potentially by identifying susceptible patients and intervening early. It is particularly challenging to devise cost-effective interventions for preventing and identifying delirium early in its course, given the rapid pace and resource limitations in inpatient and intensive care settings, and current data do not clearly indicate that such systems have proven benefit. Still, the indisputable health and financial costs of delirium indicate that prevention and identification should be a high priority.