Effects of hand catalepsy on subjective trance perception and relative parasympathetic tone in healthy volunteers during pleasant hypnotic session: a randomized controlled study.

This study was designed to evaluate the effects on hand catalepsy on parasympathetic tone assessed using Analgesia/Nociception Index (ANI) and on subjective rating of absorption, dissociation, and time perception among healthy volunteers. This was a randomized controlled trial including participants to a medical hypnosis congress in France. Ninety volunteers were randomized in two arms, all receiving a fifteen-minute positive hypnotic trance, with or without hand catalepsy. The relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index), heart rate and respiratory rate were recorded at different times of the study protocol. The actual duration of the hypnotic session, calculated from eye closing to eye opening, was also recorded. At the end of the hypnotic trance, participants subjectively rated their level of absorption and dissociation on a 0-10 scale. They were also asked to estimate the duration of the hypnotic session from eye closing to eye opening. In total, ninety subjects were included in the study. One subject was excluded because of deviation in the protocol standard, leaving eighty-nine subjects for analysis. Subject characteristics were similar between groups. There was a statistically different increase in ANI and decrease in both heart rate and respiratory rate over time with no difference with or without hand catalepsy. There was no statistically significant difference in absorption and dissociation subjective scales between groups. The median [Q1-Q3] actual duration of hypnotic sessions was similar between the catalepsy and the control groups (9 [8-10] min vs. 8 [7-10] min, respectively). However, subjects in the catalepsy group estimated a longer duration of the hypnotic session (12 [10-15] min) than in the control group (10 [5-10] min) with a mean ± SD overestimation of 3 ± 4 min (p < 0.001). Parasympathetic comfort increased during the hypnotic trance with no difference between groups. However, adding hand catalepsy to a pleasant hypnotic trance did not appear to increase feelings of absorption or dissociation but created time distortion on the longer side that could be useful in some clinical settings. Nevertheless, further study is still needed to determine more precisely the physiological and psychological effects on hand catalepsy during the hypnotic trance.

Effects of hypnosis on the relative parasympathetic tone assessed by ANI (Analgesia/Nociception Index) in healthy volunteers: a prospective observational study.

Hypnosis has shown an effect on the regulation of the autonomic nervous system by increasing parasympathetic activity. The Analgesia/Nociception Index (ANI) is derived from heart rate variability and represents the relative parasympathetic tone. We investigated the effects of hypnosis on ANI in healthy volunteers. Participants to the 2016 International Hypnosis congress, Saint Malo, France were recruited in this prospective observational study. After comfortable positioning of the subject in the sitting position (T0), the hypnotic trance was induced (T1) then conducted with suggestions of comfort (T2) before return to normal consciousness (T3). The ANI, heart rate (HR) and respiratory rate (RR) were recorded at the different time-points. Forty subjects were enrolled (31 women, 9 men). The mean ± SD ANI at T2 (84 ± 12) was significantly greater than at T0 (60 ± 10), T1 (62 ± 9) and T3 (59 ± 11). The median [25th-75th percentile] ANI values at T2 were significantly greater in women (90 [83-95]) than in men (74 [68-83]). There were no significant variations of HR during time. The median [25th-75th percentile] RR at T1 (16 [14-18] breaths/min) and T2 (14 [12-16] breaths/min) were significantly smaller than at T0 (18 [16-20] breaths/min) and T3 (18 [16-20] breaths/min). This study shows that hypnosis induces an increase in the relative parasympathetic tone assessed by ANI in healthy volunteers, with greater ANI values observed in women. These results suggest that ANI monitoring may provide an objective tool for the measurement of the intensity of the hypnotic process, although this should be confirmed by further studies.

Functionalization of pectin with laccase-mediated oxidation products of ferulic acid.

Pectin is a natural biopolymer extracted mostly from citrus peel, sugar beet and apple pomace. In order to improve its functional properties and then to enlarge the field of its potential applications, functionalization reaction of citrus pectin with ferulic acid (FA)-oxidation products was performed in aqueous medium, at 30°C and pH7.5, in the presence of Myceliophthora thermophila laccase as biocatalyst. The conjugation between FA-oxidation products and pectin was confirmed using FTIR, UV-Vis and LC-MS analyses. The obtained results suggested that covalent bonds were between the pectin carboxyl groups and FA-oxidation products between the pectin carboxyl groups and FA-oxidation products. The determination of the total phenolic content showed that the modified pectin contained 5 times more phenols than the native pectin. In view of these results, this enzymatic procedure appears as a promising way to provide new pectin-based polymers that are expected to present new properties of interest.

["Malaise" at an emergency department. Diagnostic approach]. / Les "malaises" dans un service d'urgence. Approche diagnostique.

From a prospective study of 152 patients admitted to an emergency department on account of "malaise" (i.e. dizziness with or without syncope), the authors have extracted a number of interesting points. After 24 hours under observation with questioning, physical examination and measurement of blood alcohol, glucose and carbon dioxide levels, the cause of the "malaise" could be determined in 84 per cent of the patients. Among 37 patients who were detained for more than 24 hours, only 3 additional diagnoses were made. Patients with syncope had the same cause of dizziness as those without syncope. One hundred and nineteen patients were followed up for one year. The mortality rate in patients with a cardiovascular cause of "malaise" was significantly higher than in patients with other causes. Patients with dizziness of unknown origin had the same mortality rate. Patients of more than 70 years of age had a mortality rate (50 per cent) significantly higher than that of patients aged less than 70 (25 per cent). Finally, the patient's history and physical examination proved to be the most helpful aids in establishing the cause of the "malaise".

[Ambulatory Essure implant placement sterilization procedure for women: prospective study comparing general anesthesia versus hypnosis combined with sedation]. / Étude prospective comparant l'hypnosédation et l'anesthésie générale pour la pose de dispositif de stérilisation intratubaire en ambulatoire.

OBJECTIVE: implant placement Essure, sterilization procedure for women, were performed under hypnosedation (HYP) and compared to the operative anxiety and analgesia of 12 patients operated-on under general anesthesia (GA). STUDY DESIGN: prospective and comparative group study. PATIENTS AND METHODS: two groups of twelve patients were matched and compared based on the choice of anesthetic technique: hypnotics (HYP) with possible additional sedation by propofol and remifentanil or GA involving propofol, sevoflurane and remifentanil. The assessment of anxiety and pain based on a visual analogy scale (0-10) and use of analgesics were studied in the recovery room and at discharge of hospital. The statistical analysis relies on nonparametric tests for paired data (Wilcoxon test). RESULTS: all patients were operated. The two groups are statistically comparable. The preoperative anxiety before premedication is lower in the HYP group (p<0.05). No conversion to general anaesthesia is necessary in the HYP group, but five patients were using sedatives drugs but doses are very low compared to general anaesthesia. The analgesic consumption was equivalent in both groups. CONCLUSION: we conclude that hypnosedation is a valuable alternative to traditional anesthetic techniques for ambulatory Essure implant. The use of hypnotic tool is an interesting alternative for the management of patients during invasive medical procedures or surgical, providing psychological benefits to the patient.

[Acute carbon monoxide poisoning in the emergency service. The importance of early signs. 90 cases]. / L'intoxication aiguë à l'oxyde de carbone en service d'urgence. Intérêt des signes de début. Quatre-vingt-dix observations.

The authors describe 90 cases of carbon monoxide poisoning admitted to their unit. The high incidence of accidental poisoning may be partly related to the energy crisis. They underline the importance of recognising the early symptoms, headache, vomiting, weakness of the legs, allowing early diagnosis before irreversible complication set in.

[Type E botulism. Two recent cases (author's transl)]. / Le botulisme de type E. Deux observations récentes.

Two brothers, aged 29 and 31, developed severe type E botulism 12 hours after eating salted herrings. The younger died rapidly, the other survived after treatment with type E botulinus antitoxin under intensive care. Limited electromyographic exploration of the surviving patient showed characteristic signs of presynaptic block. This method may be helpful in the diagnosis of atypical forms of the disease. Type E botulism is uncommon in France. It is almost exclusively transmitted by raw, smoked or salted fish and, for some obscure reason, rarely affects all those who shared the same meal. Contrary to types A and B botulism, it usually responds to its specific antitoxin, which must be administered as early as possible. The other therapeutic measures (tracheostomy, controlled ventilation, tube feeding) are the same for all types.