Evansmurray5246
Ambulance drivers in the Netherlands are trained to drive as fluent as possible when transporting a head injured patient to the hospital. Acceleration and deceleration have the potential to create pressure changes in the head that may worsen outcome. Although the idea of fluid shift during braking causing intra cranial pressure (ICP) to rise is widely accepted, it lacks any scientific evidence. In this study we evaluated the effects of driving and deceleration during ambulance transportation on the intra cranial pressure in supine position and 30
upright position.
Participants were placed on the ambulance gurney in supine position. During driving and braking the optical nerve sheath diameter (ONSD) was measured with ultrasound. Because cerebro spinal fluid percolates in the optical nerve sheath when ICP rises, the diameter of this sheath will distend if ICP rises during braking of the ambulance. The same measurements were taken with the headrest in 30
upright position.
Mean ONSD in 20 subjects in supine position increased from 4.80 (IQR 4.80-5.00) mm during normal transportation to 6.00 (IQR 5.75-6.40) mm (p< 0.001) during braking. ONSD's increased in all subjects in supine position. After raising the headrest of the gurney 30
mean ONSD increased from 4.80 (IQR 4.67-5.02) mm during normal transportation to 4.90 (IQR 4.80-5.02) mm (p= 0.022) during braking. In 15 subjects (75%) there was no change in ONSD at all.
ONSD and thereby ICP increases during deceleration of a transporting vehicle in participants in supine position. Raising the headrest of the gurney to 30 degrees reduces the effect of breaking on ICP.
ONSD and thereby ICP increases during deceleration of a transporting vehicle in participants in supine position. Raising the headrest of the gurney to 30 degrees reduces the effect of breaking on ICP.The perifornical area of the hypothalamus has been known as the center for the defense response, or fight-or-flight response, which is characterized by a concomitant rise in arterial blood pressure, heart rate, and respiratory frequency. It is well established that orexin neurons, which are located in this region, play a critical role in this response. In this study, we further examined this role by recording orexin neuronal activity and heart rate in freely moving mice using an original dual-channel fiber photometry system in vivo. Analysis of orexin neuron activity in relation to autonomic responses to aversive stimuli revealed a rapid increase in neuronal activity just prior to changes in heart rate. In addition, we examined whether orexin neurons would be activated by a conditioned neutral sound that was previously associated with aversive stimulus. We show that the memory of the aversive stimulus activated orexin neurons and increased heart rate. Our data suggest that orexin neurons are a key component linking aversive emotions to autonomic defense response. Our data also suggest that targeting orexin neurons may enable treatment of psychiatric disorders associated with chronic stress and traumatic memories.
Although the Chinese government has introduced a series of regulations to promote tobacco-related health education in workplaces, their implementation has been far from satisfactory. The aim of the present study was to explore the association of company-level tobacco-related health education and employee smoking behaviour.
Data from the 2018 Asia Best Workplace Mainland China programme were used to address these aims. This was a cross-sectional study that included 14,195 employees from 79 companies in mainland China. Spearman correlation tests were used to examine unadjusted correlations between the study variables, and binary logistic regression was used for multivariable analysis. The dependent variables included smoking-related variables or health information-seeking behaviour. The explanatory variable was the company-level tobacco-related health education.
Tobacco-related health education was associated with better smoking harm awareness (OR = 2.23; 95% CI = 1.94-2.56), lower second-hand smoke exposure (OR = 0.73; 95% CI = 0.66-0.81), better perception of the workplace environment (OR = 2.04; 95% CI = 1.84-2.26) and positive health information-seeking behaviour (OR = 2.07; 95% CI = 1.86-2.30). Job position interacted with health education, suggesting that the positive association of health education was lower for general employees than employees who held an administrative position.
Tobacco-related health education is not only associated with lower SHS exposure but also related to more positive environmental perceptions and health attitudes, and these effects are significant for higher-ranking employees. Policy makers should recognize and reduce these potential health disparities.
Tobacco-related health education is not only associated with lower SHS exposure but also related to more positive environmental perceptions and health attitudes, and these effects are significant for higher-ranking employees. Policy makers should recognize and reduce these potential health disparities.
It is estimated that5% to 10% of patients with myocardial infarction (MI) present with no obstructive coronary arterylesions. Until now, most studies have focused on acute coronary syndrome, including different clinical entities with a similar presentation encompassed under the term MINOCA (MI with non-obstructive coronary arteries). The aim of this study is to assess the prognosis of patients diagnosed with true infarction, confirmed by cardiovascular magnetic resonance (CMR), in the absence of significant coronary lesions.
Prospective multicenter registry study, including 120 consecutive patients with a CMR-confirmed MI without obstructive coronaryartery lesions. DZD9008 ic50 The primary clinical outcome was major adverse cardiovascular events (MACE death, non-fatal infarction, stroke, or cardiac readmission), assessed over three years.
Seventy-six patients (63.3%) were admitted with a diagnosis of acute coronary syndrome, and 44 (36.6%) for other causes (mainly heart failure); the definitive diagnosis was established by CMR.
