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1. Nitrous oxide-induced myeloneuropathy.

Author

Swart G., Blair C., Lu Z., Yogendran S., Offord J., Sutherland E., Barnes S., Palavra N., Cremer P., Bolitho S., Michael Halmagyi G., Swart G., Blair C., Lu Z., Yogendran S., Offord J., Sutherland E., Barnes S., Palavra N., Cremer P., Bolitho S., and Michael Halmagyi G.

Abstract

Background and purpose: Nitrous oxide misuse is a recognized issue worldwide. Prolonged misuse inactivates vitamin B12, causing a myeloneuropathy. Method(s): Twenty patients presenting between 2016 and 2020 to tertiary hospitals in Sydney with myeloneuropathy due to nitrous oxide misuse were reviewed. Result(s): The average age was 24 years, and mean canister consumption was 148 per day for 9 months. At presentation, paresthesias and gait unsteadiness were common, and seven patients were bedbound. Mean serum B12 was normal (258 pmol/L, normal range [NR] = 140-750) as was active B12 (87 pmol/L, normal > 35). In contrast, mean serum homocysteine was high (51 mumol/L, NR = 5-15). Spinal magnetic resonance imaging (MRI) showed characteristic dorsal column T2 hyperintensities in all 20 patients. Nerve conduction studies showed a predominantly axonal sensorimotor neuropathy (n = 5). Patients were treated with intramuscular vitamin B12, with variable functional recovery. Three of the seven patients who were bedbound at presentation were able to walk again with an aid at discharge. Of eight patients with follow-up data, most had persistent paresthesias and/or sensory ataxia. Mobility scores at admission and discharge were not significantly correlated with the serum total and active B12 levels or cumulative nitrous oxide use. There were no significant trends between serum active B12 level and cumulative nitrous oxide use (Spearman rho = -0.331, p = 0.195). Conclusion(s): Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients.Copyright © 2021 European Academy of Neurology.

Published
2021

5. Abstracts

Author

Michèle, Saiah, Alain, Borgeat, Oliver, Wilder-Smith, Hung, Orlando R., Hope, Charles E., Laney, Geoffrey, Whynot, Sara C., Coonan, Thomas J., Malloy, David S., Patterson, S., Gelb, A., Manninen, P., Strum, D., Glosten, B., Spellman, M. J., Eger, E. I., Craen, R. A., Gelb, A. W., Murkin, J. M., Chong, K. Y., Penning, D. H., El-Behairy, H., Brien, J. F., Coh, J. W., Arellano, R., Correa, J., Fedorko, L., Arellano, R., Liu, Z., Boylan, J. F., Sandler, A. N., Nierenberg, H., Sheiner, P. A., Greig, P. D., O’Leary, G. M., Teasdale, S. J., Glynn, M. F. X., Orser, B. A., Wang, L. -Y., MacDonald, J. F., Loomis, C. W., Arunachalam, K. D., Vyas, D., Milne, B., Gagnon, Daniel, Lavoie, Josée, Dupuis, Jean-Yves, Miller, D. R., Martineau, R. J., Greenway, D., Olivaris, L., Hull, K., Tierney, R. N. M., Wynands, J. E., Martineau, R., St-Jean, B., Kitts, J., Miller, D., Lindsay, P., Curran, M., Allen, G. C., Crossan, M. L., Wise, Richard, Donati, François, Bevan, David R., Hardy, J. F., Desroches, J., Perrault, J., Carrier, M., Robitaille, D., Ansley, D. M., O’Connor, J. P., Dolman, J., Townsend, G. E., Ricci, D., Liepert, D. J., Browne, P. M., Hertz, T., Rooney, M., Yip, R. W., Code, W., Phillips, A. A., McLean, R. F., Devitt, J. H., Harrington, E. M., Byrick, R. J., Wong, P. Y., Wigglesworth, D., Kay, J. C., Sinclair, L. A., Koch, J. P., Deemar, K. A., Christakis, G. K., Belo, S., Angle, P., Cheng, D., Boylan, J., Sandler, A., Feindel, C., Carmichael, F., Boylen, P., Boylen, P., DeLima, L. G. R., Nathan, H. J., Hynes, M. S., Bourke, M. E., Russell, G. N., Seyone C., Chung F., Chartrand, Daniel, Roux, Lucie, Dain, S. L., Smith, B. D., Webster, A. C., Wigglesworth, D. F., Rose, D. K., Caskennette, G., Mechetuk, C., Doyle, D. John, DeMajo, Wilfred, van den Bosch, Frank, Lee, Mark, McClenaghan, K. M., Mazer, C. D., Preston, R., Crosby, E. T., Kotarba, D., Dudas, H., Elliott, R. D., Enns, J., Manninen, P. H., Farrar, J. K., Huzyka, David L., Lin, L. Philip, Fossey, Susan, Finucane, Brendan T., Stockwell, M., Lozanoff, S., Lang, S., Hyssen, J., Campbell, D. C., Douglas, M. J., Pavy, T. J. G., Flanagan, M. L., McMorland, G. H., Bands, Colin, Ffaracs, Ch. B., Lipsett, Catherine, Drover, David, Stafford-Smith, Mark, Stevens, Sarah, Shields, Kate, MacSween, Michael J., McAllister, J. D., Morley-Forster, P. K., White, A. K., Taylor, M. D., Vandenberghe, H. M., Knoppert, D., Reimer, H., Duke, P. C., Kehler, C. H., Kepron, M. W., Taraska, V. A., Carstoniu, J., Norman, P., Katz, J., Hannallah, Medhat, Cooney, C. M., Lyons, J. B., Hennigan, A., Blunnie, W. P., Moriarty, D. C., Dobkowski, W. B., Prato, F. S., Shannon, N. A., Drost, D. J., Arya, B., Wills, J. M., Bond, D., Morley-Forester, P., JB, Mullen, Spahr-Schopfer, I., Lerman, J., Cutz, E., Dolovich, M., Kowalski, S., Ong, B., Bell, D., Ostryzniuk, T., Serrette, C., Wasylak, T., Coke, S., Tsuda, Takako, Nakagawa, Takashi, Mabuchi, Norifumi, Ando, Hiroshi, Nishida, Osamu, Azami, Takafumi, Katsuya, Hirotada, Goto, Yukio, Searle, N., Roy, M., R. R. T., Smith, Charles E., Pinchak, Alfred C., Hagen, Joan F., Hancock, Donald, Krassioukov, Andrei V., Weaver, Lynne C., Sutton, I. R., Mutch, W. A. C., Teskey, J. M., Thomson, I. R., Rosenbloom, M., Thiessen, D., Teasdale S., Corbin H., Graham, M. R., Lang, S. A., Chang, P., Gerard, M., Tetzlaff, J. E., Walsh, M., Yoon, H., Warriner, Brian, Fancourt-Smith, Peter, McEwen, Jim, Crane, Judy, Badner, N. H., Bhandari, R., Komar, W. E., Ganapathy, S., Warriner, C. B., McCormack, J. P., Levine, M., Glick, N., Chan, V. W. S., McQuestion, M., Gomez, M., Cruise, C., Evana, D., Shumka, D., Smyth, R. J., Graham, M., Halpenny, David, Goresky, Gerald V., Zaretski, J. Eldon, Kavanagh, B., Roger, S., Davies, A., Friedlander, M., Cohen M. M., Duncan P. G., Pope W. D. B., Biehl D., Merchant R., Tweed, W. A., Tessler, Michael J., Angle, Mark, Kleiman, Simcha, Kavanagh, B. P., Doak, G. J., Li, G., Hall, R. I., Sulliyan, J. A., Yee, I., Halpern, S., Pittini, R., Huh, C., Bryson, G. L., Gverzdys, R., Perreault, C., Ferland, L., Gobeil, F., Girard, D., Smyth, R., Asokumar, B., Glynn, M., Silveira, Sandra, Clark, Jeff, Milgram, Paul, Splinter, W. M., MacNeill, H. B., Ménard, E. A., Rhine, E. J., Roberts, D. J., Gould, G. M., Johnson, G. G., Quance, Daniel, Wiesel, Saul, Easdown, Jane, Truong, N. Tien, Miller, Normand, Sheiner, Nathan, Welborn, L., Norden, J., Hannallah, R., Broadman, L., Seiden, N., Iwai, M., Iwai, R., Horigome, H., Yamashita, M., Wood, Catherine E., Klassen, Kim, Kleinman, S., Yentis, S., Sikich, N., Yemen, T. A., Mascik, B., Nelson, W., Ghantous, H., Gandolfi, J., Wood, Gordon, Ali, Mohamed, Inman, Kevin, Karski, J. M., Carroll, J., Brooks, D., Oakley, P. A., Webster, P. M., Karski, J., Yao, T., Ivanov, J., Young, P., Carson, S., Weisel, R. D., Cooper, Richard M., Wong, David T., Wagner, Douglas P., Knaus, William A., Munshi, Charul A., Kampine, John P., Soutter, I. D., Mathieu, A., Gafni, A., Dauphin, A., Torsher, L., Tierney, M., Hopkins, H. S., Baylon, G. J., Peter, Elizabeth A., Bellhouse, C. P., Dore, Caroline, Rachwal, T. W., Lanigan, D. T., Yip, Raymond, Derdemezi, J. B., Britt, B. A., Withington, D. E., Reynolds, F., Patrick, A., Man, W., Searle, N. R., Ste-Marie, H., Kostash, Mark A., Johnston, Richard, Bailey, R. J., Sharpe, M. D., Woda, R. P., Haug, M., Slugg, P., Lockrem, J., Barnett, G., Finegan, B. A., Robertson, M., Taylor, D., Frost, G., Koshal, A., Rodney, Grant E., Reichert, Clayton C., O’Regan, Desmond N., Blackstock, Derek, Steward, David J., Wenstone, Richard, Harrington, Ellen, Wong, A., Braude, B., Fear, D., Bissonnette, B., Reid, Craig W., Hull, Kathryn A., Yogendran, S., McGuire, G., Chan, V., Hartley, E., Van Kessel, K., Weisel, R., Takla, N., Tremblay, N. A., Ralley, F. E., Ramsay, J. G., Robbins, G. R., Salevsky, F. C., Gandhi, S., Nimphius, N., Dionne, Bernard, Jodoin, Christian, Lorange, Michel, Lapointe, Alain, Hawboldt, Geoffrey, Volgyesi, G. A., Tousignant, Guy, Barnett, R., and Gallant, B.

Published
1992
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9. Erratum

Author

Michèle, Saiah, Alain, Borgeat, Oliver, Wilder-Smith, Hung, Orlando R., Hope, Charles E., Laney, Geoffrey, Whynot, Sara C., Coonan, Thomas J., Malloy, David S., Patterson, S., Gelb, A., Manninen, P., Strum, D., Glosten, B., Spellman, M. J., Eger, E. I., Craen, R. A., Gelb, A. W., Murkin, J. M., Chong, K. Y., Penning, D. H., El-Behairy, H., Brien, J. F., Coh, J. W., Arellano, R., Correa, J., Fedorko, L., Arellano, R., Liu, Z., Boylan, J. F., Sandler, A. N., Nierenberg, H., Sheiner, P. A., Greig, P. D., O’Leary, G. M., Teasdale, S. J., Glynn, M. F. X., Orser, B. A., Wang, L. -Y., MacDonald, J. F., Loomis, C. W., Arunachalam, K. D., Vyas, D., Milne, B., Gagnon, Daniel, Lavoie, Josée, Dupuis, Jean-Yves, Miller, D. R., Martineau, R. J., Greenway, D., Olivaris, L., Hull, K., Tierney, R. N. M., Wynands, J. E., Martineau, R., St-Jean, B., Kitts, J., Miller, D., Lindsay, P., Curran, M., Allen, G. C., Crossan, M. L., Wise, Richard, Donati, François, Bevan, David R., Hardy, J. F., Desroches, J., Perrault, J., Carrier, M., Robitaille, D., Ansley, D. M., O’Connor, J. P., Dolman, J., Townsend, G. E., Ricci, D., Liepert, D. J., Browne, P. M., Hertz, T., Rooney, M., Yip, R. W., Code, W., Phillips, A. A., McLean, R. F., Devitt, J. H., Harrington, E. M., Byrick, R. J., Wong, P. Y., Wigglesworth, D., Kay, J. C., Sinclair, L. A., Koch, J. P., Deemar, K. A., Christakis, G. K., Belo, S., Angle, P., Cheng, D., Boylan, J., Sandler, A., Feindel, C., Carmichael, F., Boylen, P., Boylen, P., DeLima, L. G. R., Nathan, H. J., Hynes, M. S., Bourke, M. E., Russell, G. N., Seyone C., Chung F., Chartrand, Daniel, Roux, Lucie, Dain, S. L., Smith, B. D., Webster, A. C., Wigglesworth, D. F., Rose, D. K., Caskennette, G., Mechetuk, C., Doyle, D. John, DeMajo, Wilfred, van den Bosch, Frank, Lee, Mark, McClenaghan, K. M., Mazer, C. D., Preston, R., Crosby, E. T., Kotarba, D., Dudas, H., Elliott, R. D., Enns, J., Manninen, P. H., Farrar, J. K., Huzyka, David L., Lin, L. Philip, Fossey, Susan, Finucane, Brendan T., Stockwell, M., Lozanoff, S., Lang, S., Hyssen, J., Campbell, D. C., Douglas, M. J., Pavy, T. J. G., Flanagan, M. L., McMorland, G. H., Bands, Colin, Ffaracs, Ch. B., Lipsett, Catherine, Drover, David, Stafford-Smith, Mark, Stevens, Sarah, Shields, Kate, MacSween, Michael J., McAllister, J. D., Morley-Forster, P. K., White, A. K., Taylor, M. D., Vandenberghe, H. M., Knoppert, D., Reimer, H., Duke, P. C., Kehler, C. H., Kepron, M. W., Taraska, V. A., Carstoniu, J., Norman, P., Katz, J., Hannallah, Medhat, Cooney, C. M., Lyons, J. B., Hennigan, A., Blunnie, W. P., Moriarty, D. C., Dobkowski, W. B., Prato, F. S., Shannon, N. A., Drost, D. J., Arya, B., Wills, J. M., Bond, D., Morley-Forester, P., JB, Mullen, Spahr-Schopfer, I., Lerman, J., Cutz, E., Dolovich, M., Kowalski, S., Ong, B., Bell, D., Ostryzniuk, T., Serrette, C., Wasylak, T., Coke, S., Tsuda, Takako, Nakagawa, Takashi, Mabuchi, Norifumi, Ando, Hiroshi, Nishida, Osamu, Azami, Takafumi, Katsuya, Hirotada, Goto, Yukio, Searle, N., Roy, M., R. R. T., Smith, Charles E., Pinchak, Alfred C., Hagen, Joan F., Hancock, Donald, Krassioukov, Andrei V., Weaver, Lynne C., Sutton, I. R., Mutch, W. A. C., Teskey, J. M., Thomson, I. R., Rosenbloom, M., Thiessen, D., Teasdale S., Corbin H., Graham, M. R., Lang, S. A., Chang, P., Gerard, M., Tetzlaff, J. E., Walsh, M., Yoon, H., Warriner, Brian, Fancourt-Smith, Peter, McEwen, Jim, Crane, Judy, Badner, N. H., Bhandari, R., Komar, W. E., Ganapathy, S., Warriner, C. B., McCormack, J. P., Levine, M., Glick, N., Chan, V. W. S., McQuestion, M., Gomez, M., Cruise, C., Evana, D., Shumka, D., Smyth, R. J., Graham, M., Halpenny, David, Goresky, Gerald V., Zaretski, J. Eldon, Kavanagh, B., Roger, S., Davies, A., Friedlander, M., Cohen M. M., Duncan P. G., Pope W. D. B., Biehl D., Merchant R., Tweed, W. A., Tessler, Michael J., Angle, Mark, Kleiman, Simcha, Kavanagh, B. P., Doak, G. J., Li, G., Hall, R. I., Sulliyan, J. A., Yee, I., Halpern, S., Pittini, R., Huh, C., Bryson, G. L., Gverzdys, R., Perreault, C., Ferland, L., Gobeil, F., Girard, D., Smyth, R., Asokumar, B., Glynn, M., Silveira, Sandra, Clark, Jeff, Milgram, Paul, Splinter, W. M., MacNeill, H. B., Ménard, E. A., Rhine, E. J., Roberts, D. J., Gould, G. M., Johnson, G. G., Quance, Daniel, Wiesel, Saul, Easdown, Jane, Truong, N. Tien, Miller, Normand, Sheiner, Nathan, Welborn, L., Norden, J., Hannallah, R., Broadman, L., Seiden, N., Iwai, M., Iwai, R., Horigome, H., Yamashita, M., Wood, Catherine E., Klassen, Kim, Kleinman, S., Yentis, S., Sikich, N., Yemen, T. A., Mascik, B., Nelson, W., Ghantous, H., Gandolfi, J., Wood, Gordon, Ali, Mohamed, Inman, Kevin, Karski, J. M., Carroll, J., Brooks, D., Oakley, P. A., Webster, P. M., Karski, J., Yao, T., Ivanov, J., Young, P., Carson, S., Weisel, R. D., Cooper, Richard M., Wong, David T., Wagner, Douglas P., Knaus, William A., Munshi, Charul A., Kampine, John P., Soutter, I. D., Mathieu, A., Gafni, A., Dauphin, A., Torsher, L., Tierney, M., Hopkins, H. S., Baylon, G. J., Peter, Elizabeth A., Bellhouse, C. P., Dore, Caroline, Rachwal, T. W., Lanigan, D. T., Yip, Raymond, Derdemezi, J. B., Britt, B. A., Withington, D. E., Reynolds, F., Patrick, A., Man, W., Searle, N. R., Ste-Marie, H., Kostash, Mark A., Johnston, Richard, Bailey, R. J., Sharpe, M. D., Woda, R. P., Haug, M., Slugg, P., Lockrem, J., Barnett, G., Finegan, B. A., Robertson, M., Taylor, D., Frost, G., Koshal, A., Rodney, Grant E., Reichert, Clayton C., O’Regan, Desmond N., Blackstock, Derek, Steward, David J., Wenstone, Richard, Harrington, Ellen, Wong, A., Braude, B., Fear, D., Bissonnette, B., Reid, Craig W., Hull, Kathryn A., Yogendran, S., McGuire, G., Chan, V., Hartley, E., Van Kessel, K., Weisel, R., Takla, N., Tremblay, N. A., Ralley, F. E., Ramsay, J. G., Robbins, G. R., Salevsky, F. C., Gandhi, S., Nimphius, N., Dionne, Bernard, Jodoin, Christian, Lorange, Michel, Lapointe, Alain, Hawboldt, Geoffrey, Volgyesi, G. A., Tousignant, Guy, Barnett, R., and Gallant, B.

Published
1992
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10. dcc orchestrates the development of the prefrontal cortex during adolescence and is altered in psychiatric patients

Author

Manitt, C., Eng, C., Pokinko, M., Ryan, R. T., Torres-Berrio, A., Lopez, J. P., Yogendran, S. V., Daubaras, M. J. J., Grant, A., Schmidt, E. R. E., Tronche, F., Krimpenfort, P., Cooper, H. M., Pasterkamp, R. J., Kolb, Bryan, Turecki, G., Wong, T. P., Nestler, E. J., Giros, B., Flores, C., Manitt, C., Eng, C., Pokinko, M., Ryan, R. T., Torres-Berrio, A., Lopez, J. P., Yogendran, S. V., Daubaras, M. J. J., Grant, A., Schmidt, E. R. E., Tronche, F., Krimpenfort, P., Cooper, H. M., Pasterkamp, R. J., Kolb, Bryan, Turecki, G., Wong, T. P., Nestler, E. J., Giros, B., and Flores, C.

Abstract

Adolescence is a period of heightened susceptibility to psychiatric disorders of medial prefrontal cortex (mPFC) dysfunction and cognitive impairment. mPFC dopamine (DA) projections reach maturity only in early adulthood, when their control over cognition becomes fully functional. The mechanisms governing this protracted and unique development are unknown. Here we identify dcc as the first DA neuron gene to regulate mPFC connectivity during adolescence and dissect the mechanisms involved. Reduction or loss of dcc from DA neurons by Cre-lox recombination increased mPFC DA innervation. Underlying this was the presence of ectopic DA fibers that normally innervate non-cortical targets. Altered DA input changed the anatomy and electrophysiology of mPFC circuits, leading to enhanced cognitive flexibility. All phenotypes only emerged in adulthood. Using viral Cre, we demonstrated that dcc organizes mPFC wiring specifically during adolescence. Variations in DCC may determine differential predisposition to mPFC disorders in humans. Indeed, DCC expression is elevated in brains of antidepressant-free subjects who committed suicide.

Published
2013

11. dcc orchestrates the development of the prefrontal cortex during adolescence and is altered in psychiatric patients

Author

Manitt, C, primary, Eng, C, additional, Pokinko, M, additional, Ryan, R T, additional, Torres-Berrío, A, additional, Lopez, J P, additional, Yogendran, S V, additional, Daubaras, M J J, additional, Grant, A, additional, Schmidt, E R E, additional, Tronche, F, additional, Krimpenfort, P, additional, Cooper, H M, additional, Pasterkamp, R J, additional, Kolb, B, additional, Turecki, G, additional, Wong, T P, additional, Nestler, E J, additional, Giros, B, additional, and Flores, C, additional

Published
2013
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15. Nitrous oxide-induced myeloneuropathy.

Author

Swart G, Blair C, Lu Z, Yogendran S, Offord J, Sutherland E, Barnes S, Palavra N, Cremer P, Bolitho S, and Michael Halmagyi G

Subjects
Adult, Humans, Magnetic Resonance Imaging, Nitrous Oxide adverse effects, Vitamin B 12 adverse effects, Young Adult, Peripheral Nervous System Diseases, Vitamin B 12 Deficiency chemically induced, Vitamin B 12 Deficiency complications
Abstract

Background and Purpose: Nitrous oxide misuse is a recognized issue worldwide. Prolonged misuse inactivates vitamin B12, causing a myeloneuropathy., Methods: Twenty patients presenting between 2016 and 2020 to tertiary hospitals in Sydney with myeloneuropathy due to nitrous oxide misuse were reviewed., Results: The average age was 24 years, and mean canister consumption was 148 per day for 9 months. At presentation, paresthesias and gait unsteadiness were common, and seven patients were bedbound. Mean serum B12 was normal (258 pmol/L, normal range [NR] = 140-750) as was active B12 (87 pmol/L, normal > 35). In contrast, mean serum homocysteine was high (51 μmol/L, NR = 5-15). Spinal magnetic resonance imaging (MRI) showed characteristic dorsal column T2 hyperintensities in all 20 patients. Nerve conduction studies showed a predominantly axonal sensorimotor neuropathy (n = 5). Patients were treated with intramuscular vitamin B12, with variable functional recovery. Three of the seven patients who were bedbound at presentation were able to walk again with an aid at discharge. Of eight patients with follow-up data, most had persistent paresthesias and/or sensory ataxia. Mobility scores at admission and discharge were not significantly correlated with the serum total and active B12 levels or cumulative nitrous oxide use. There were no significant trends between serum active B12 level and cumulative nitrous oxide use (Spearman rho = -0.331, p = 0.195)., Conclusions: Nitrous oxide misuse can cause a severe but potentially reversible subacute myeloneuropathy. Serum and active B12 can be normal, while elevated homocysteine and dorsal column high T2 signal on MRI strongly suggest the diagnosis. Neurological deficits can improve with abstinence and B12 supplementation, even in the most severely affected patients., (© 2021 European Academy of Neurology.)

Published
2021
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16. Prenatal Maternal Stress From a Natural Disaster and Hippocampal Volumes: Gene-by-Environment Interactions in Young Adolescents From Project Ice Storm.

Author

Cao-Lei L, Yogendran S, Dufoix R, Elgbeili G, Laplante DP, and King S

Abstract

Gene-by-environment interactions influence brain development from conception to adulthood. In particular, the prenatal period is a window of vulnerability for the interplay between environmental and genetic factors to influence brain development. Rodent and human research demonstrates that prenatal maternal stress (PNMS) alters hippocampal volumes. Although PNMS affects hippocampal size on average, similar degrees of PNMS lead to different effects in different individuals. This differential susceptibility to the effects of PNMS may be due to genetic variants. Hence, we investigated the role of genetic variants of two SNPs that are candidates to moderate the effects of PNMS on hippocampal volume: COMT (rs4680) and BDNF (rs6265). To investigate this, we assessed 53 children who were in utero during the January 1998 Quebec ice storm. In June 1998 their mothers responded to questionnaires about their objective, cognitive, and subjective levels of stress from the ice storm. When children were 11 1/2 years old, T1-weighted structural magnetic resonance imaging (MRI) scans were obtained using a 3T scanner and analyzed to determine hippocampal volumes. We collected and genotyped the children's saliva DNA. Moderation analyses were conducted to determine whether either or both of the SNPs moderate the effect of PNMS on hippocampal volumes. We found that objective hardship was associated with right hippocampal volume in girls, and that the BDNF and COMT genotypes were associated with left hippocampal volume in boys and girls. In addition, SNPs located on COMT moderated the effect of maternal objective distress in boys, and subjective distress in girls, on both right hippocampal volume. Thus, we conclude that an individual's genotype alters their susceptibility to the effects of PNMS., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Cao-Lei, Yogendran, Dufoix, Elgbeili, Laplante and King.)

Published
2021
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17. Vital capacity and patient controlled sevoflurane inhalation result in similar induction characteristics.

Author

Yogendran S, Prabhu A, Hendy A, McGuire G, Imarengiaye C, Wong J, and Chung F

Subjects
Adult, Arthroscopy, Electroencephalography drug effects, Female, Hemodynamics, Humans, Laryngeal Masks, Male, Middle Aged, Monitoring, Intraoperative, Pain, Postoperative epidemiology, Patient Satisfaction, Postoperative Nausea and Vomiting epidemiology, Prospective Studies, Sevoflurane, Analgesia, Patient-Controlled, Anesthesia, Inhalation, Anesthetics, Inhalation, Methyl Ethers, Vital Capacity
Abstract

Purpose: To compare patient controlled inhalational induction (PCI) with the most commonly used sevoflurane induction technique, vital capacity inhalational induction (VCI)., Methods: Following approval of the Research Ethics Board, 124 outpatients undergoing knee arthroscopy were randomly assigned to receive either PCI or VCI sevoflurane followed by laryngeal mask airway (LMA) insertion and sevoflurane maintenance. In the PCI group, the circle circuit was not primed. The patients were asked to hold the facemask themselves and breathe normally with sevoflurane 8% in oxygen at a flow rate of 4 L x min(-1). In the VCI group, the circle circuit was primed and patients were asked to take vital capacity breaths with sevoflurane 8% at an oxygen flow rate of 8 L x min(-1). The LMA was inserted as soon as the patient's jaw was relaxed. Time from induction to LMA insertion was recorded and insertion conditions rated. The amount of sevoflurane used for LMA insertion was calculated. Vital signs were monitored at one-minute intervals until ten minutes after LMA insertion., Results: Demographic data were comparable. There were no differences with respect to LMA insertion time (PCI - 3.4 min vs VCI - 3.3 min), laryngospasm (PCI - 7% vs VCI - 5%), mean arterial pressure, heart rate, SaO(2) as well as patient's overall satisfaction., Conclusion: PCI was comparable to VCI in sevoflurane induction with respect to the speed of induction, side effects during induction and patient satisfaction. However, PCI requires no special training and is widely applicable to all patient populations.

Published
2005
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18. The assessment of postural stability after ambulatory anesthesia: a comparison of desflurane with propofol.

Author

Song D, Chung F, Wong J, and Yogendran S

Subjects
Adult, Anesthesia Recovery Period, Desflurane, Female, Gynecologic Surgical Procedures, Humans, Laparoscopy, Postoperative Complications, Propofol, Ambulatory Surgical Procedures, Anesthesia, Anesthetics, Inhalation, Anesthetics, Intravenous, Isoflurane analogs & derivatives, Postural Balance, Posture
Abstract

Unlabelled: We designed this study to evaluate postural stability in outpatients after either desflurane or propofol anesthesia. After IRB approval, 120 consenting women undergoing gynecological laparoscopic procedures were randomly assigned to receive either desflurane or propofol-based general anesthesia. After surgery, patients' postural stability was measured as body sway velocity by using a computerized force platform in the following conditions: 1) standing on a firm surface with eyes open versus closed and 2) standing on a foam surface with eyes open versus closed. These measurements were made before anesthesia, immediately after the patient achieved a Post-Anesthesia Discharge Score of 9, and at actual discharge home. At the time patients first achieved a Post-Anesthesia Discharge Score of 9, the body sway in the Propofol group was significantly more than in the Desflurane group when patients were asked to stand on a foam surface with eyes closed (testing the ability of using vestibular information for balance control). We concluded that the desflurane-based anesthetic was associated with better postural control than the propofol-based anesthetic in the early recovery period after outpatient gynecological laparoscopic procedures., Implications: The residual effects of the short-acting general anesthetics desflurane and propofol on patient's balance function during recovery after surgery were assessed with a computerized force platform. The results showed that desflurane seemed to be associated with better postural control than propofol in the early recovery period.

Published
2002
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19. Music increases satisfaction in elderly outpatients undergoing cataract surgery.

Author

Cruise CJ, Chung F, Yogendran S, and Little D

Subjects
Aged, Alfentanil administration & dosage, Analysis of Variance, Anesthesia, Intravenous, Anesthetics, Intravenous administration & dosage, Anxiety prevention & control, Blood Pressure, Elective Surgical Procedures, Eye innervation, Female, Fentanyl administration & dosage, Humans, Hypnotics and Sedatives therapeutic use, Male, Midazolam administration & dosage, Monitoring, Intraoperative, Nerve Block, Noise, Prospective Studies, Relaxation Therapy, Suggestion, Ambulatory Surgical Procedures, Cataract Extraction, Music, Patient Satisfaction
Abstract

Purpose: Music has long been known to reduce anxiety, minimize the need for sedatives, and make patients feel more at ease. The purpose of the study was to evaluate the effect of music in elderly outpatients undergoing elective cataract surgery with retrobulbar block and monitored anaesthetic care using fentanyl or alfentanil and midazolam., Methods: One hundred and twenty one patients were prospectively and randomly assigned to hear: relaxing suggestions, white noise, operating room noise or relaxing music via audio-cassette headphones. Vital signs were documented before and after retrobulbar block and every 15 min thereafter. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI) before and after surgery. Visual analogue scales (VAS) were used to assess anxiety and patient satisfaction postoperatively with a standardized questionnaire. Between group comparisons were made using Chi-Square, or ANOVA, where appropriate., Results: There were no differences between groups in STAI or anxiety VAS scores at any time. Differences were noted in systolic blood pressure, but not in other vital signs. Patients' ratings of the whole operative experience, satisfaction with the tape played, general level of relaxation and preference for the chosen tape for subsequent surgery were different (music > relaxing suggestions > white noise and OR noise, P < 0.05)., Conclusions: Elderly patients undergoing cataract surgery under retrobulbar block were more satisfied with their experience if they heard relaxing music, rather than relaxing suggestions or white noise or OR noise. The type of auditory stimuli to which the patients were exposed did not influence the level of anxiety.

Published
1997
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20. A prospective randomized double-blinded study of the effect of intravenous fluid therapy on adverse outcomes on outpatient surgery.

Author

Yogendran S, Asokumar B, Cheng DC, and Chung F

Subjects
Acetates administration & dosage, Adolescent, Adult, Anesthesia, General, Dizziness prevention & control, Double-Blind Method, Female, Gluconates administration & dosage, Humans, Infusions, Intravenous, Magnesium Chloride administration & dosage, Male, Middle Aged, Nausea prevention & control, Potassium Chloride administration & dosage, Preoperative Care, Prospective Studies, Sleep Stages, Sodium Acetate, Sodium Chloride administration & dosage, Thirst, Ambulatory Surgical Procedures, Fluid Therapy methods, Postoperative Complications
Abstract

This study investigated the impact of perioperative fluid status on adverse clinical outcomes in ambulatory surgery. Two hundred ASA grade I-III ambulatory surgical patients were prospectively randomized into two groups to receive high (20 mL/kg) or low (2 mL/kg) infusions of isotonic electrolyte solution over 30 min preoperatively. A standardized balanced anesthetic was used. A minimal amount of fluid was given during the intraoperative and postoperative periods. Adverse outcomes were assessed by an investigator blinded to the fluid treatment group at 30 and 60 min after surgery, at discharge, and the first postoperative day. The incidence of thirst, drowsiness, and dizziness was significantly lower in the high-infusion group at all intervals. We recommend perioperative hydration of 20 mL/kg for patients undergoing general anesthesia for short ambulatory surgery.

Published
1995
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