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Contains fulltext : 175794.pdf (publisher's version ) (Closed access)

Contains fulltext : 185904.pdf (publisher's version ) (Open Access), Background: One of the most commonly used auricular acupuncture points selected for different pain treatment regimens is Shenmen. This point on the ear has been recognized as having a wide number of applications, as found by scientific investigation. Methods: Within this crossover study, the ear acupoint Shenmen was stimulated with two different kinds of laser (green, 532 nm and yellow, 589 nm) in 22 healthy volunteers (13 female, 9 male; mean age ± SD = 25.3 ± 4.1 years; range 21-36 years). Both green and yellow lasers were used for 15 min in the same volunteers in two different sessions. Results: The most prominent finding was that systolic blood pressure decreased significantly (p = 0.048) after yellow laser stimulation. Heart rate also decreased significantly (p < 0.001), whereas heart rate variability ratio low frequency (LF)/high frequency (HF) (p < 0.001) increased. The effects were significantly more pronounced in females than in males. In addition, the temperature was measured, and temperature increases were demonstrated at different locations on the ear using imaging methods. Conclusions: This study shows evidence of the effect of auricular laser acupuncture. However, a comparison with other publications was impossible because this is the first study using green and yellow laser stimulation on the ear.

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STUDY AIM: To provide a consensus of European leading authorities about the optimal use of clinical neurophysiological (CN) tests (electroencephalogram [EEG]; evoked potentials [EP]; electroneuromyography [ENMG]) in the intensive care unit (ICU) and, particularly, about the way to make these tests clinically useful for the management of individual patients. METHODS: This study gathered together several European clinical neurophysiologists and neurointensivists whose leading contributions in the adult or paediatric ICU and in continuous neuromonitoring had been peer-acknowledged. It was based on both a literature review and each participant's own experience. Given the methodological impossibility to gather studies fulfilling criteria of evidence-based medicine, this article essentially relies on expert opinions that were gained after several rounds, in which each expert was invited to communicate his own contribution to all other experts. A complete consensus has been reached when submitting the manuscript. RESULTS: What the group considered as the best classification systems for EEG and EP abnormalities in the ICU is first presented. CN tests are useful for diagnosis (epilepsy, brain death, and neuromuscular disorders), prognosis (anoxic ischemic encephalopathy, head trauma, and neurologic disturbances of metabolic and toxic origin), and follow-up, in the adult, paediatric, and neonatal ICU. Regarding prognosis, a clear distinction is made between these tests whose abnormalities are indicative of an ominous prognosis and those whose relative normalcy is indicative of a good prognosis. The prognostic significance of any test may vary as a function of coma etiology. CONCLUSION: CN provides quantitative functional assessment of the nervous system. It can be used in sedated or curarized patients. Therefore, it should play a major role in the individual assessment of ICU patients.

Continuous microcirculation monitoring of the right foot was carried out for the first time in a 62-year-old patient with cryoglobulinaemia prior to, during and after manual needle insertion at Jic Xi(St.41) acupuncture point using a new method of laser Doppler perfusion imaging (PIMII, Lisca AB, Linkoping, Sweden). In addition to visual inspection, changes in mean perfusion were also used as evaluation parameters. Our results suggest that the new biomedical technique of laser Doppler imaging is a useful method for monitoring the effects of acupuncture on the peripheral microcirculation.

Several pathophysiological processes cause reversible functional abnormalities before the appearance of any structural, irreversible damage, in which case the observation of these abnormalities can constitute an invaluable warning signal to prevent the occurrence of irreversible neurological sequelae. Several processes occurring in the operating room (OR) and intensive care unit (lCU) belong to this last category and justify the usefulness of clinical neurophysiology as a neuromonitoring tool during surgery and in coma. Recent technological advances offer new concepts in monitoring of brain signals. In ICU and OR, modern computer technology has recently provided a large number of sophisticated neuromonitoring systems. The dimensions of the helmet vary because it is adjustable. Therefore, the helmet takes into consideration the individual head size and shape. Electrodes for electroencephalography (EEG), stimulus-induced brain oscillations, early somatosensory EPs (SEPs), and brainstem auditory EPs (BAEPs) are generally placed according to the International 10–20 System. Improvement in EEG assessment may be obtained with optimal electrode montages and objective spectral parameters. The montages currently in use are symmetrical and favor central and occipital electrodes. Monitoring of carotid endarterectomy (CEA) is necessary when selective shunting is performed. Monitoring techniques differ in many respects, such as the physiological mechanism studied, the invasiveness of the technique, and subjective versus objective assessment.