Search NEL Online

Case Reports 2004; 25(Suppl 1): 133-136 PubMed PMID: 15735596 Citation  Keywords:  Adult, Cost of Illness, Humans, Infant Care, Infant, Newborn, Infant, Premature, Intensive Care, Neonatal, Mothers:psychology, Narration, Time Factors,.   

: In this Letter, the author walks through 'Memory Lane'. She reflects upon the birth, growth and developmental trajectory of her third child who was born too soon, in a major Hospital in London. Her aim is to share her knowledge and experiences with other parents and professionals. The author acknowledges the feelings which is so common amongst mothers of preterm babies i.e. that the baby does not belong to them. Moreover, she reflects upon her participation in caring for her daughter, how overwhelming it all was and her joy when her child left hospital and is a healthy teenager....

Read abstract

Journal Article 2004; 25(Suppl 1): 103-109 PubMed PMID: 15735592 Citation  Keywords:  Caregivers:psychology, Counseling, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Parents:psychology, Physician's Role, Psychological Techniques,.   

: Counselling psychology appears to be neglecting the importance and merits of working with the client population associated with the preterm neonate within the Neonatal Intensive Care Unit (NICU). Throughout, the benefits of such a move are highlighted with particular emphasis on how counselling psychologists are uniquely qualified for this role. Specialist knowledge required to provide clients with the greatest therapeutic gains illustrates the pertinent issues, with proposals for clinical practice put forward. NHS Trusts nationwide are encouraged to recruit this ready-made professional into the Department for the psychological health of parents and caregivers engaged in caring for the preterm neonate....

Read abstract

Journal Article 2004; 25(Suppl 1): 67-77 PubMed PMID: 15735588 Citation  Keywords:  Blood Gas Monitoring, Transcutaneous, Child Development, Conditioning (Psychology), Extremities:physiology, Female, Gastrointestinal Contents:chemistry, Handling (Psychology), Heart:physiology, Humans, Hydrogen-Ion Concentration, Infant Behavior, Infant C.   

: This article provides a synopsis of a series of studies exploring the effects of TAC-TIC (Touching And Caressing-Tender In Caring) therapy with premature infants. Study 1 looked at the short and long-term effects and found enhanced mental development in the stroked infants at 15 months. In study 2 the physiological effects of an abbreviated version of TAC-TIC with high-risk ventilated infants were examined and it was concluded that TAC-TIC exerted no harm to these vulnerable infants. The behavioural reactions of a sample of premature and low birthweight infants to TAC-TIC and parental responses to administering it were explored in study 3. The infants were found to respond predominantly with arm and leg movements to TAC-TIC while fathers and mothers reported enjoying performing TAC-TIC and elicited a similar pattern and frequency of behavioural reactions. In study 4 the question of whether TAC-TIC benefits preterm infant learning and/or sucking behaviour was investigated. The conclusion reached was that TAC-TIC may potentially benefit cognitive performance within the neonatal period and that this may be an early indicator of long-term cognitive gains reported by previous studies. Using a matched subjects design, study 5 explored the impact of TAC-TIC upon the digestive system by analysing gastric aspirates before and after TAC-TIC and a control period of time. It was concluded that TAC-TIC appeared to induce a more suitable stomach environment for digestion....

Read abstract

Journal Article 2004; 25(Suppl 1): 49-55 PubMed PMID: 15735586 Citation  Keywords:  Empathy, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Neonatology:methods, Pain:diagnosis, Pain Management, Palliative Care:methods, Terminal Care,.   

: Research has shown that even extremely premature babies are sufficiently developed, anatomically and physiologically, to be capable of experiencing and responding to pain. All newborn infants and especially those who require intensive care in the first days of life are exposed to some painful procedures. Part of the neonatologist's role is the detection and management of pain in these infants. Difficult challenges come with this role. All medications carry known or potential adverse effects and limited research has been done in this vulnerable population. The benefits and risks of all available pain-relieving measures should be balanced when planning management. Compassion is no excuse for a high incidence of undesirable or dangerous side effects. We must proceed with great care....

Read abstract

Journal Article 2004; 25(6): 407-410 PubMed PMID: 15665800 Citation  Keywords:  Action Potentials, Animals, Entropy, Intralaminar Thalamic Nuclei:physiology, Male, Models, Neurological, Neuralgia:physiopathology, Nonlinear Dynamics, Rats, Rats, Wistar, Rhizotomy,.   

OBJECTIVES: A novel evaluative approach was used to determine single unit activities of non-bursting intralaminar thalamic nuclei under neuropathic pain state following dorsal rhizotomy.

SETTINGS AND DESIGN: Extensive dorsal rhizotomy at cervicothoracic level in rats was used as a model of central pain. After rhizotomy, rats were divided into two groups: rats without any signs of self-mutilation, and those presenting self-mutilation. Spontaneous single unit activities of neurons of intralaminar thalamic nuclei were recorded and interspike intervals (ISIs) of non-bursting cells were counted for both groups and compared with that of non-rhizotomized control rats. Chaodynamic methods were applied for the evaluation of the ISIs.

RESULTS: In control rats Lyapunov exponents, Shannon entropy and mutual information average values were significantly higher than those of rhizotomized rats without any signs of self-mutilation. Paradoxically, in animals presenting self-mutilation following rhizotomy the evaluated parameters were similar to those of controls. Further, Lyapunov exponents were positive values in all animals indicating chaotic pattern of the neuronal firing.

MAIN FINDINGS: 1. Neurons behave in chaotic way in all animals, 2. The most regular firing was found in non-mutilating rhizotomized animals, 3. Patterns of the firing in selfmutilating rats were similar to those in controls.

CONCLUSIONS: It is concluded that pain feeling is not executed neither by changes of chaotic dynamics of non-bursting intralaminar thalamic neurons. On the other hand, the paradoxical firing of the neurons under pathological brain matrix might participate in modification pain feeling....

Read abstract  Full text PDF

Clinical Trial 2004; 25(4): 287-291 PubMed PMID: 15361819 Citation  Keywords:  Adolescent, Adult, Aged, Carotid Artery Diseases:diagnostic imaging, Carotid Artery, Internal:diagnostic imaging, Catheterization:methods, Cerebral Angiography, Embolization, Therapeutic:methods, Female, Humans, Intracranial Aneurysm:diagnostic imaging, M.   

OBJECTIVES: The incidence of giant aneurysms in the paraclinoid section of the internal carotid artery (ICA) is low. They manifest their occurrence by subarachnoid haemorrhage and neurological and hormonal symptoms, resulting from compression on either the nervous structures or on the pituitary. The treatment of these aneurysms is a challenge for the surgeon, due to a difficult access, high operational risk and when the size of operated malformations is large.

MATERIAL AND METHODS: Between the years 1994 and 2001, twenty (20) patients with giant paraclinoid aneurysms of the carotid artery were submitted to: endovascular treatment - 7 patients and to microsurgery - 13 patients. The treatment, following the access to the aneurysm and consisting in short-time (temporary) endovascular occlusion of ICA, was applied in some cases, while trapping was the method of choice in other cases.

RESULTS: Good results of the endovascular treatment were obtained in 6 patients and, in one (1) case, satisfactory result was observed. Regarding the whole study group, hormonal symptoms (amenorrhoea) occurred in one case only. Four aneurysms were totally embolized, 1 - almost totally and 2 - partially. Recanalisation was observed in one case after 2 years. In the surgical method, good and very good results were obtained in 10 patients and satisfactory results - in 3 patients.

CONCLUSION: Application of either the endovascular method or of the microsurgical method - or of both these methods - used individually in case of a given aneurysm, increases the chances for an effective occlusion with a lower operative risk....

Read abstract  Full text PDF

Editorial 2004; 25(3): 159-163 PubMed PMID: 15349077 Citation  Keywords:  Decision Making, Freedom, Humans, Interpersonal Relations, Play and Playthings,.   

...

Read abstract  Full text PDF

Clinical Trial 2004; 25(1-2): 141-147 PubMed PMID: 15159698 Citation  Keywords:  Brain Ischemia:cerebrospinal fluid, Humans, Interleukin-1:cerebrospinal fluid, Interleukin-6:cerebrospinal fluid, Intracranial Aneurysm:cerebrospinal fluid, Rupture, Spontaneous, Subarachnoid Hemorrhage:cerebrospinal fluid, Time Factors, Vasospasm, Intrac.   

: Cytokines play a key role in mutual influence of the immunological, endocrine and CNS systems. It has been proven that proinflammatory ILs may intensify the cascade of biochemical changes in ischemic brain damage. Vasospasm, which may accompany SAH and often coexists with symptoms of DINDs, is the cause of ischemic changes in the brain. It is thought that immunological mechanisms may be one of the causes of degenerative-productive changes in vessel walls, in delayed vasospasm following SAH, which lead to substantial vasospasm and in consequence too cerebral ischemia. In the randomly selected group of patients, who underwent surgical treatment after aneurysmal SAH, we determined the concentration of IL-1 beta and IL-6 in CSF in the periods between Days 0 to 3; 4 to 7; and 8 to 15 after the occurrence of SAH. The presence and dynamics of development of vasospasm were assessed on the basis of increasing DINDs as well as CT and cerebral angiography. We examined the concentrations of ILs in CSF using radioimmunological methods, applying commercially available tests for their assessment. We found that in the period between 8 and 15 days after SAH, in increasing delayed vasospasm and DINDs, here is a statistically significant increase concentration of IL-1 beta in CSF (105.4 +/- 46.9 pg x ml-1; p<0.005), and no significant changes in patients without vasospasm and neurological deficits. On the other hand, we noted a statistically significant increase concentration of IL-6 in CSF (4802 +/- 1170 ng x ml-1; p<0.05) only in the acute phase after SAH (Days 0-3) in patients in poor clinical condition, in whom delayed vasospasm and cerebral ischemia developed later. This increase of ILs level in CSF is probably related to the intensity of the SAH, and secondarily aggravates the vasospasm and ischemic changes in the brain....

Read abstract