Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy.

OBJECTIVE: To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. STUDY DESIGN: Prospective, randomized, blinded, clinical trial. ANIMALS: A total of 29 female dogs with mammary tumors. METHODS: Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 µg kg-1 loading dose (LD) and 1 µg kg-1 hour-1; lidocaine 2 mg kg-1 LD and 3 mg kg-1 hour-1; ketamine 1 mg kg-1 LD and 0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 µg kg-1 LD and 9 µg kg-1 hour-1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test. RESULTS: More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. CONCLUSIONS AND CLINICAL RELEVANCE: Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.

Pharmacokinetics and pharmacodynamics of dextroketamine alone or combined with midazolam in Caiman crocodilus.

Pharmacokinetics studies of anesthetic agents are important for understanding of the pharmacology and metabolism of anesthetic agents in reptilians. This study was designed to examine the pharmacokinetic and pharmacodynamic properties of intravenous dextroketamine alone or combined with midazolam in Caiman crocodilus. Eight caimans were anesthetized with dextroketamine (10 mg/kg; group D) or dextroketamine and midazolam (10 and 0.5 mg/kg respectively; group DM) into the occipital venous sinus. The pharmacokinetic parameters were calculated by HPLC using a non-compartmental modeling. Serial blood samples were collected at baseline and within 15 and 30 min, and 11.5, 2, 4, 8, 12, 24 and 48 h of drug administration. Sedation status over time differed between groups. All animals in group D (8/8; 100%) showed signs of light sedation at t10. Half (4/8; 50%) of these caimans did not progress to deeper levels of sedation. In spite of light sedation at t10, animals in group DM were deeply sedated within 13.13 ± 7.04 min of anesthetic agent injection. The area under the plasma concentration-time curve (AUC0-48) and half-life of dextroketamine changed significantly after combination with midazolam. Even without significant changes in clearance, the almost two-fold increase in the half-life of dextroketamine suggests a slower rate of elimination.

Prevalence of ictal injuries in functional (psychogenic nonepileptic) seizures: A systematic review and meta-analysis.

OBJECTIVE: Ictal injuries have long been considered typical signs of epileptic seizures. However, studies have shown that patients with functional seizures (FS)-also named psychogenic nonepileptic seizures-can also present these signs, misleading physicians and delaying a correct diagnosis. This systematic review aimed to assess the prevalence of injuries from FS. METHODS: A literature search was performed in PubMed, Embase, LILACS (Latin American and Caribbean Health Sciences Literature), Scopus, Web of Science, PsycINFO, Google Scholar, OpenGrey, and ProQuest. Observational studies were included. The risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data. RStudio was used for meta-analyses. Cumulative evidence was evaluated according to Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. RESULTS: From the 2607 identified records, 41 studies were included in the qualitative synthesis, and 28 were included in meta-analyses. A meta-analysis of 13 studies, including 1673 individuals, resulted in an overall lifetime prevalence of injuries due to FS per person of 25% (95% confidence interval [CI] = 19%-32%, I2 = 88%). Considering a limited period (video-electroencephalographic [VEEG] monitoring days), a meta-analysis of 13 studies, including 848 individuals, resulted in an injury prevalence due to FS per person of .7% (95% CI = 0%-3%, I2 = 73%). Also, a meta-analysis of eight studies, including 1000 individuals, resulted in a prevalence of injuries per FS of .1% (95% CI = 0%-.98%, I2 = 49%). The certainty in cumulative evidence assessed by GRADE was rated "very low" for lifetime prevalence of injuries per person, "low" for prevalence per person during VEEG monitoring, and "moderate" for prevalence per number of FS. SIGNIFICANCE: Overall pooled lifetime prevalence of injuries due to FS per person was 25%. In comparison, the prevalence of injuries per person during VEEG monitoring and per functional seizure was .7% and .1%, respectively. [Correction added on 07 October 2023, after first online publication: In the preceding sentence, 'consecutively' was corrected to 'respectively'.] The evidence of the occurrence of injuries due to FS breaks the paradigm that epileptic seizures can cause injuries but FS cannot.

The Association between Pesticide Exposure and the Development of Fronto-Temporal Dementia-Cum-Dissociative Disorders: A Review.

Pesticides are chemicals used in agricultural fields for the prevention or destruction of pests. Inappropriate use of these substances, as well as handling them without using personal protective equipment, may result in serious health problems such as neurodegenerative diseases and mental disorders. Previous studies have demonstrated the adverse effects of pesticides on brain function. However, some researchers have associated pesticide poisoning with the development of disorders such as dissociative amnesia, multiple personality disorders, and depersonalization disorder. The objective of this work was to perform a bibliographic review of the relationship between pesticide poisoning and the development of dissociative disorders. Previous studies suggest that the duration of pesticide exposure is a major determinant in the development of dissociative diseases and disorders. The information obtained in this review suggests that there is no specific relationship between dissociative disorders and pesticide poisoning. However, these results point to associating the most representative symptoms of dissociative disorder (such as amnesia and memory loss) with pesticide exposure. Based on the bibliographic search, possible mechanisms of action were suggested in an attempt to explain a possible association between exposure to pesticides and the appearance of dissociative disorders.

Awake or Sleeping? Maybe Both A Review of Sleep-Related Dissociative States.

Recent studies have begun to understand sleep not only as a whole-brain process but also as a complex local phenomenon controlled by specific neurotransmitters that act in different neural networks, which is called "local sleep". Moreover, the basic states of human consciousness-wakefulness, sleep onset (N1), light sleep (N2), deep sleep (N3), and rapid eye movement (REM) sleep-can concurrently appear, which may result in different sleep-related dissociative states. In this article, we classify these sleep-related dissociative states into physiological, pathological, and altered states of consciousness. Physiological states are daydreaming, lucid dreaming, and false awakenings. Pathological states include sleep paralysis, sleepwalking, and REM sleep behavior disorder. Altered states are hypnosis, anesthesia, and psychedelics. We review the neurophysiology and phenomenology of these sleep-related dissociative states of consciousness and update them with recent studies. We conclude that these sleep-related dissociative states have a significant basic and clinical impact since their study contributes to the understanding of consciousness and the proper treatment of neuropsychiatric diseases.

Acupuncture in the Anesthetic Recovery of Bitches Submitted to Ovariohysterectomy.

Background: Cardiorespiratory depression caused by anesthesia decreases the quality and increases the time of postoperative recovery. The acupoint Governor Vessel 26 (GV26) is a resuscitation point that can reverse this depression and can be safely used without side effects. Objectives: The objective of this study was to evaluate the stimulation and anesthetic recovery time of GV26 in bitches submitted to ovariohysterectomy (OH) under dissociative anesthesia. Methods: As pre-anesthetic protocol, acepromazine 0.2% (0.1 mg/kg) and tramadol hydrochloride (2 mg/kg) was used, and induction was performed using midazolam (0.5 mg/kg) and ketamine (10 mg/kg). For the control group, standard procedure was performed for OH, with anesthetic recovery and post-surgical procedures. For the acupuncture group (AP), the stimulation of acupoint GV26 was performed 20 minutes after the anesthetic induction and maintained for 5 minutes. Respiratory rate, amplitude (superficial, normal or deep), type of respiratory movement (abdominal, abdominocostal or thoracoabdominal), heart rate, capillary filling time, temperature, presence or absence of laryngotracheal reflex, presence or absence of interdigital reflexes were assessed immediately before PAM application, and 2 (T1), 5 (T2), 10 (T3), 15 (T4), 20 (T5), 25 (T6) and 30 (T7) minutes after treatment. The results were tabulated and statistically analyzed. Results: When comparing the AP group with the control group, an improvement in amplitude of the chest cage was observed at all times, where the animals remained in normal or deep respiratory amplitude. The heart rate was significantly higher for the AP group (155.5 ± 34.4 bpm) than the control group at T1 (105.1 ± 15.4 bpm), while recovery time was lower for the AP group (54.1 ± 14.9 min) when compared to control group (79.9 ± 17.9 min). Conclusion: The present paper demonstrated the efficacy of GV26 in maintaining adequate respiratory amplitude and decreasing the anesthetic recovery time.

Anesthetic effects of isoflurane and fentanyl infusion in capuchin monkeys (Sapajus sp) undergoing salpingectomy or deferentectomy, previously chemically restrained with ketamine-midazolam or ketamine-dexmedetomidine.

BACKGROUND: This study evaluated the anesthetic and cardiorespiratory effects of two anesthetic protocols for salpingectomy or deferentectomy in capuchin monkeys (Sapajus sp). MATERIALS AND METHODS: Five capuchin monkeys (5 per group) received ketamine (20 mg/kg) combined with midazolam (0.5 mg/kg; group KM) or dexmedetomidine (5 µg/kg; group KD) intramuscularly. Anesthesia is induced with propofol intravenously and maintained with isoflurane. Before the start of surgery, fentanyl 3 µg/kg was administered IV, and continuous infusion (10 µg/kg/min) IV was started. Times and quality of anesthetic recovery were evaluated postoperatively. RESULTS: KM and KD resulted in adequate chemical restraint. KD resulted in bradycardia. Intraoperative heart rate and systolic blood pressure were higher in KM than in KD. Both groups had smooth recovery. Time to standing was longer in KM than in KD. CONCLUSION: Both protocols allowed the performance of surgeries, with few cardiorespiratory effects. Anesthetic recovery was smooth and shorter in KD group.

La importancia del cribado orgánico. A propósito de un caso clínico

Introducción: Antes de catalogar un proceso morboso como trastorno mental, es imprescindible tener presente la importancia del diagnóstico precoz de causas de origen no psiquiátrico para una posible presentación clínica. Por ello, trataremos de reflejar este hecho, que se antoja necesario recordar aunque sea bien sabido, ya que puede pasarse por alto en situaciones de urgencia en el ámbito hospitalario, con las consecuencias derivadas de un cribado incompleto y con el potencial riesgo vital para el paciente. Presentación del caso: Adolescente mujer, de 13 años, que presentó un cuadro clínico agudosugestivo de carácter disociativo. Se precisó su ingreso hospitalario para la aclaración diagnóstico-terapéutica, y mediante neuroimagen se diagnosticó inicialmente como lesión neoplásica en el tronco del encéfalo y, finalmente, como lesión isquémica de origen vasculítico en dicha localización. Discusión: Se planteó un diagnóstico diferencial a través de las diferentes etiologías tanto psíquicas como no psíquicas del cuadro clínico, pero fue necesaria la intervención del servicio de pediatría hospitalario para la orientación y filiación definitiva, ante la sospecha de enfermedad no psiquiátrica tras una evolución tórpida a pesar de intervenciones psicoterapéuticas y psicofarmacológicas. Conclusiones: A través de la presentación y revisión de un caso clínico que sucedió en nuestro hospital de trabajo, se debe insistir en un adecuado abordaje integral del paciente, especialmente con población infanto-juvenil, ante una presentación clínica aguda y sin previas evaluaciones físicas de relevancia.

Introduction: Before cataloguing a morbid process as a "mental disorder", it is essential to bear in mind the importance of early diagnosis of causes of non-psychiatric origin for a possible clinical presentation. For this reason, we will try to reflect this fact, which it seems necessary to remember even though it is well known, since it can be overlooked in emergency situations in the hospital setting, with the consequences derived from an incomplete diagnosis and with the potential life-threatening risk for the patient. Case presentation: A 13-year-old female adolescent, who presented an acute clinical picture suggestive of dissociative disorder. She required hospital admission for diagnostic-therapeutic clarification, and neuroimaging findings led to an initial diagnosis of a neoplastic lesion in the brain stem and, finally, as ischaemic lesion of vasculitic origin in said location. Discussion: A differential diagnosis was proposed through the different psychic and nonpsychic aetiologies of the clinical picture, being the intervention of the hospital's paediatric service necessary for orientation and definitive affiliation, given the suspicion of non-psychiatric illness after a torpid evolution in spite of psychotherapeutic and psychopharmacological interventions. Conclusions: Through the presentation and review of a clinical case that happened in our hospital, we must insist on an adequate comprehensive approach to the patient, especially with the child-adolescent population, when faced with an acute clinical presentation and without previous studies at a relevant physical level.

Cultural issues: Perspectives and experiences of patients with dissociative seizures in Argentina.

PURPOSE: To explore patients' subjective experience when receiving a diagnosis of Dissociative Seizures (DS) in Buenos Aires, Argentina, and their explanatory models about DS. METHOD: A qualitative approach using semi-structured interviews was used to gain an in-depth and contextual understanding of the perspectives of 19 patients with DS. Data collection and analysis were followed by an inductive and interpretive approach informed by the principles of thematic analysis. RESULTS: Four main themes emerged: 1) Reactions to the Diagnosis; 2) Ways of Naming the Disease; 3) Own Explanatory Models; 4) External Explanatory Models. CONCLUSIONS: This information might help achieve an adequate knowledge of the local characteristics of patients with DS. Most patients could not express any emotions or considerations about being diagnosed with DS, and they related their seizures to a personal or social-emotional conflict and environmental stress; however, family members related patients' seizures to a biological cause. It is important to analyze cultural differences in patients with DS in order to develop appropriate interventions for this specific population.

Dissociative Experiences Scale: Psychometric Analysis in Puerto Rico and Contributions to the Discussion of the Factor Structure / Escala de Experiencias Disociativas: Análisis Psicométrico en Puerto Rico y Aportaciones a la Discusión sobre la Estructura Factorial

Introduction: The Dissociative Experiences Scale (DES-II) is a widely used psychometric tool to assess dissociative symptoms. Over the years, it has been the subject of numerous studies and research in various fields of psychology and psychiatry. Numerous studies have supported the validity and reliability of the DES-II as a reliable measure of dissociative experiences. The most problematic aspect of the DES-II is the inconsistency in its factor structure. Objective: This research aimed to examine the psychometric properties of the DES-II in a clinical and non-clinical sample from Puerto Rico. Method: This research had an instrumental design. An availability sampling of 341 adult participants was used. Several competing models of the DES-II were analyzed, including a bifactor model. Result: Psychometric analyses concluded that the scale has a unidimensional structure, strong reliability, and construct validity. All 28 items met adequate discrimination values. Participants with dissociative disorders obtained higher means on the DES-II than the other diagnostic groups. Furthermore, the more adverse experiences in childhood, the more dissociative experiences in adulthood. Conclusion: The DES-II should be treated and interpreted as a unidimensional dissociation index rather than a multidimensional instrument. This study will advance further research on dissociation and dissociative disorders in Puerto Rico and Latin America.

Introducción: La Escala de Experiencias Disociativas (DES-II) es una herramienta psicométrica ampliamente utilizada para evaluar síntomas disociativos. A lo largo de los años, ha sido objeto de numerosos estudios e investigaciones en diversos campos de la psicología y la psiquiatría. Numerosos estudios han respaldado la validez y la fiabilidad de la DES-II como una medida confiable de las experiencias disociativas. El aspecto más problemático del DES-II es la inconsistencia de su estructura factorial. Objetivo: Esta investigación tuvo como objetivo examinar las propiedades psicométricas de la DES-II en una muestra clínica y no clínica de Puerto Rico. Método: Esta investigación tuvo un diseño instrumental. Se utilizó un muestreo por disponibilidad compuesto por 341 participantes adultos. Se analizaron varios modelos competitivos de la DES-II, incluyendo un modelo bifactorial. Resultados: Los análisis psicométricos concluyeron que la escala posee una estructura unidimensional y una sólida confiabilidad y validez de constructo. Los 28 ítems cumplieron con valores adecuados de discriminación. Los participantes con trastornos disociativos obtuvieron medias más altas en la DES-II que los otros grupos diagnósticos. Además, a mayores experiencias adversas en la infancia, mayores experiencias disociativas en la adultez. Conclusión: La DES-II debería tratarse e interpretarse como un índice unidimensional de disociación y no como un instrumento multidimensional. Este estudio permitirá el avance de nuevas investigaciones sobre disociación y trastornos disociativos en Puerto Rico y América Latina.

Effects of ketamine, midazolam and methadone, combined with local anesthesia, in cats undergoing orchiectomy / Efeitos da cetamina, midazolam e metadona, associados à anestesia local, em gatos submetidos à orquiectomia

Different anesthetic combinations are used for orchiectomy in cats. This study aimed to evaluate the anesthetic and cardiopulmonary effects on the physiological variables of ketamine (10 mg/kg), midazolam (0.2 mg/kg) and methadone (0.3 mg/kg), combined with local anesthesia, in cats undergoing orchiectomy (n = 19 cats). The time for lateral recumbency, degree of sedation, muscle relaxation and nociception were recorded preoperatively. The propofol rescue dose was recorded. The time to head up and quality of recovery were evaluated postoperatively. The time for lateral recumbency was 5 ± 2 minu-tes. Fifteen minutes after the administration of the ketamine-midazolam-methadone combination, a greater sedative effect, muscle relaxation and less response to noxious stimulation were observed. Propofol was administered to twelve cats under local anesthesia, at a total dose of 1.5 ± 0.8 mg/kg. Surgery was started 28 ± 5 minutes after the administration of ketamine--midazolam-methadone combination. There were no differences in the physiological variables evaluated over the other evalu-ation times (p > 0.05). The recovery quality scores were adequate, and the time to head up was 51 ± 10 minutes. Under the conditions of this study, the ketamine-midazolam-methadone combination did not allow local anesthesia for orchiectomy. Many cats required propofol rescue prior to surgery. This combination promoted minimal changes in physiological variables and prolonged anesthetic recovery.(AU)

Diferentes combinações anestésicas são usadas para orquiectomia em gatos. O objetivo deste estudo foi avaliar o efeito anestésico e as alterações promovidas nas variáveis fisiológicas pela cetamina (10 mg/kg), midazolam (0.2 mg/kg) e metadona (0.3 mg/kg), combinados com anestesia local, em gatos submetidos à orquiectomia (n = 19 gatos). O tempo para adoção do decúbito lateral, grau de sedação, relaxamento muscular e nocicepção foram registrados no pré-operatório. A dose de resgate de propofol foi registrada. O tempo para o gato erguer a cabeça e a qualidade da recuperação foram avaliados no pós-operatório. O tempo para adoção do decúbito lateral foi de 5 ± 2 minutos. Quinze minutos após a administração da associação cetamina-midazolam-metadona, observou-se maior efeito sedativo e relaxamento muscular, e menor resposta à estimulação nociva. O propofol foi administrado em doze gatos para realização de anestesia local, utilizando a dose total de 1.5 ± 0.8 mg/kg. A cirurgia foi iniciada 28 ± 5 minutos após a administração de cetamina-midazolam-metadona. Não houve diferença nas variáveis fisiológicas avaliadas em relação aos demais tempos de avaliação (p > 0.05). Os escores de qualidade de recuperação foram adequados e o tempo para o gato erguer a cabeça foi de 51 ± 10 minutos. Nas condições deste estudo, cetamina-midazolam-metadona não permitiu a realização da anestesia local para orquiectomia. Muitos gatos precisaram de resgate com propofol antes de iniciar a cirurgia. Essa associação promoveu alterações mínimas nas variáveis fisiológicas e longa recuperação anestésica.(AU)

Association of S(+) ketamine, dexmedetomidine and butorphanol for chemical restraint in scarlet macaws (Ara macao) / Associação cetamina S(+), dexmedetomidina e butorfanol na contenção química de araracangas (Ara macao)

The present study aimed at assessing the effects of combining 20 mg/kg S(+) ketamine with 25 µg/kg dexmedetomidine and 0.4 mg/kg butorphanol on the physiological parameters and anesthetic recovery time and score of eight captive scarlet macaw (Ara macao) specimens. These specimens were captured at the Marabá Zoobotanic Foundation (Fundação Zoobotânica de Marabá), Pará, using butterfly and mist nets, and subsequently subjected to the proposed protocol. The following physiological parameters were evaluated: heart rate (HR), respiratory rate (RR), saturation of peripheral oxygen (SpO2), body temperature (BT), and non-invasive blood pressure 5 min after drug administration (M0) and every 10 min thereafter (M1‒M5), with a total of 55 min of analysis of anesthetic effects. Glycemia was measured 5 min after drug administration and every 30 min thereafter. Anesthetic induction and recovery times were also determined. Among the parameters evaluated in this study, both HR and BT significantly decreased throughout the anesthetic period, with the lowest levels at 55 min after drug administration (M5). In contrast, RR did not significantly differ, and all animals remained stable, maintaining an RR close to a mean of 20 ± 8 cpm. Throughout the anesthetic period, SpO2was 92 ± 5%, with no significant difference. The birds remained under spontaneous ventilation and without oxygen supplementation. Systolic, diastolic, and mean blood pressures remained stable, with no significant differences in any of these measurements. At M0 and M3, the glycemia decreased slightly, albeit with no significant difference justifying an adverse effect or even hypoglycemia. The anesthetic induction time, from M0 to decubitus, was 2.4 ± 0.7 min. The anesthetic recovery time, from M0 to effortless bipedal position and adequate phalangeal flexion, was 99.3 ± 32.4 min. The sedation was assessed as intense, and the anesthetic recovery was rated excellent in 62.5% and good in 37.5% of the animals.(AU)

O presente estudo objetivou avaliar os efeitos do uso da cetamina S(+) 20 mg/kg associada à dexmedetomidina 25 µg/kg e butorfanol 0,4 mg/kg sobre os parâmetros fisiológicos, tempo e qualidade da recuperação anestésica de araracangas (Ara macao). Foram utilizados oito espécimes de Ara macao cativas da Fundação Zoobotânica de Marabá, Pará. A captura foi realizada com o uso de puçá e rede de contenção e em seguida as aves foram submetidas ao protocolo proposto. Foram avaliados: frequência cardíaca, frequência respiratória, saturação parcial da oxihemoglobina (SpO2), temperatura corporal e pressão arterial não-invasiva a partir de 5 minutos após a aplicação dos fármacos (M0) e a cada 10 minutos seguintes (M1, M2, M3, M4 e M5), totalizando 55 minutos de contemplação dos efeitos anestésicos. A glicemia foi avaliada aos 5 minutos da aplicação dos fármacos e repetida após 30 minutos. Também foi determinado o tempo de indução e de recuperação. Dentre os parâmetros avaliados, a frequência cardíaca e a temperatura demonstraram queda estatisticamente significativa ao longo do período anestésico, ambas com os menores valores registrados aos 55 minutos após a aplicação dos fármacos (M5). A frequência respiratória não apresentou diferença estatística e todos os animais se mantiveram estáveis e com a frequência próxima a média de 20±8mpm. A saturação da oxihemoblobina (SpO2) ao longo do período anestésico foi de 92±5%, não houve diferença estatisticamente relevante, as aves permaneceram sob ventilação espontânea e sem suplementação de oxigênio. As pressões arteriais sistólica, diastólica e média, mantiveram-se estáveis e não houve diferença estatística para nenhuma dessas medidas. A glicemia, mensurada em M0 e M3 demonstrou queda discreta, sem diferença significativa capaz de justificar um efeito adverso ou mesmo hipoglicemia. O tempo de indução, desde aplicação dos anestésicos até o decúbito, foi de 2,4±0,7 minutos. O tempo de recuperação, compreendido desde a aplicação dos fármacos (M0) até a constatação da posição bipedal sem esforço e adequada flexão das falanges, foi de 99,3±32,4 minutos. A qualidade de sedação foi considerada intensa e a recuperação anestésica foi classificada como ótima para 62,5% e boa para 37,5% dos animais.(AU)

Insights of Fe2O3 and MoO3 Electrodes for Electrocatalytic CO2 Reduction in Aprotic Media.

Transition metal oxides (TMO) have been successfully used as electrocatalytically active materials for CO2 reduction in some studies. Because of the lack of understanding of the catalytic behavior of TMOs, electrochemical methods are used to investigate the CO2 reduction in thin-film nanostructured electrodes. In this context, nanostructured thin films of Fe2O3 and MoO3 in an aprotic medium of acetonitrile have been used to study the CO2 reduction reaction. In addition, a synergistic effect between CO2 and the TMO surface is observed. Faradic cathodic processes not only start at lower potentials than those reported with metal electrodes, but also an increase in capacitive currents is observed, which is directly related to an increase in oxygen vacancies. Finally, the results obtained show CO as a product of the reduction.

The mind possessed: well-being, personality, and cognitive characteristics of individuals regularly experiencing religious possession

Objective: To further our understanding of religious possession experiences by focusing on personality, cognitive, and quality of life outcomes. Methods: Data collection was undertaken at Umbanda sessions in Brazilian cities. Participants were mediums who regularly experienced possession (n=334) or those who attended the same rituals but had never been possessed (n=54). Results: We found that mediums were not significantly different across variables from the control group, except for anxiety, which was lower among mediums. Correlational and regression analysis showed that the level of meaningfulness attributed to possession and fusion with the spiritual entity were strongly positively correlated with most quality-of-life dimensions, and negatively with anxiety; in addition, level of meaningfulness predicted lower anxiety, and psychological quality of life was predicted by level of fusion and meaningfulness. Contrary to expectations, there were no detrimental effects of a lower level of bodily control over the possession experience. Conclusion: Together, these results suggest that individuals regularly experiencing possession within a religious context are psychologically similar to those who attend the same rituals without experiencing possession, and that the way they appraise their experiences as meaningful, as well as the level of spiritual fusion, are predictors of well-being.

Calidad de vida en pacientes con epilepsia y crisis no epilépticas psicógenas: una revisión sistemática / Quality of life in patients with epilepsy and psychogenic nonepileptic seizures: a systematic review

Resumen Se han revisado artículos que estudiaron la calidad de vida en las personas con crisis no epilépticas psicógenas (CNEP) y crisis epilépticas. Se siguió la guía PRISMA y, previo a la búsqueda, se realizó un protocolo publicado en PROSPERO. Se incluyeron estudios aleatorizados y no aleatorizados, de tipo cuantitativo o mixtos, de corte transversal o longitudinal, escritos en lengua inglesa o española publicados hasta el año 2020, y cuyos participantes fueran mayores de 16 años. Luego de filtrar los resultados según los criterios de selección, se incluyeron 11 artículos y una tesis doctoral cuyos años de publicación datan de 1998 a 2020. En su mayoría, se informaba que las personas con CNEP tenían menor calidad de vida, asociadas a presencia de psicopatología, así como también a la toma de medicación antiepiléptica, factores sociodemográficos y relacionados con las crisis (frecuencia, severidad y duración de enfermedad), funcionamiento familiar, trauma y somatización.

Abstract Psychogenic non epileptic seizures (PNES) are disruptive changes in behaviour, thought, or emotion that resemble an epileptic seizure, but without paroxysmal neuronal discharge detectable by electroencephalography (EEG), and are not caused by another medical condition. On the other hand, epileptic seizures (ES) are defined as clinical events that reflect the presence of hypersynchronous discharges of neurons located in the cerebral cortex, which have the particularity of starting and ending abruptly. The diagnosis of epilepsy is made when an epileptic seizure was experienced and there is a risk of having another. The objective of this paper is to present the results of a systematic review of articles that have studied quality of life in people with PNES and ES. This review has been performed following the PRISMA guide (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Prior to the beginning of the search, a protocol was carried out and it is published for consultation in the International prospective register of systematic reviews (PROSPERO). The review includes randomized and non-randomized, quantitative or mixed, cross-sectional or longitudinal studies, published in English or Spanish until 2020. In addition, participants had to be over 16 years old. PNES diagnosis must have been confirmed by video-electroencephalography (VEEG) or a similar procedure-which is considered the gold standard for the diagnosis of PNES.

The mind possessed: well-being, personality, and cognitive characteristics of individuals regularly experiencing religious possession.

OBJECTIVE: To further our understanding of religious possession experiences by focusing on personality, cognitive, and quality of life outcomes. METHODS: Data collection was undertaken at Umbanda sessions in Brazilian cities. Participants were mediums who regularly experienced possession (n=334) or those who attended the same rituals but had never been possessed (n=54). RESULTS: We found that mediums were not significantly different across variables from the control group, except for anxiety, which was lower among mediums. Correlational and regression analysis showed that the level of meaningfulness attributed to possession and fusion with the spiritual entity were strongly positively correlated with most quality-of-life dimensions, and negatively with anxiety; in addition, level of meaningfulness predicted lower anxiety, and psychological quality of life was predicted by level of fusion and meaningfulness. Contrary to expectations, there were no detrimental effects of a lower level of bodily control over the possession experience. CONCLUSION: Together, these results suggest that individuals regularly experiencing possession within a religious context are psychologically similar to those who attend the same rituals without experiencing possession, and that the way they appraise their experiences as meaningful, as well as the level of spiritual fusion, are predictors of well-being.

Cognitive Health and Differential Cortical Functioning in Dissociative Trance: An Explorative Study About Mediumship.

Aim: To evaluate the cognitive functioning of subjects practicing trance mediumship in Brazil. Method: The study was based on the measurement of cognitive functions of 19 spirits mediums through neuropsychological tests such as the Brief Cognitive Screening Battery (BCSB), the Verbal Fluency Test (FAS), the digit span test, the cube test, the five digit test (FDT) and an evaluation of mental health through scales such as the Beck Depression Inventory (BDI), the Self-Report Questionnaire (SRQ), and the Trauma History Questionnaire (THQ). The sample included the participation of spirit mediums divided into two groups. The more experienced group (MEG) with 11 subjects had more than 10 years of mediumistic practice, while the other less experienced group (LEG) with 8 subjects had 1-5 years of experience. The inclusion criteria were psychophonic mediums (who have the ability to communication when deceased beings communicate directly via speaking) with regular trance practices for at least one year. The data collected were analyzed using the SPSS statistical package. Results: Regarding performance on the BCSB and digit span test, all subjects reached scores at the median or higher in comparison to standardized scores of Brazilians. Scores of 90% on the cube test and 42% on the FAS were reached in comparison to median or higher values, versus the median of standardized scores among Brazilians. On the FDT, we found statistical significance (p = 0.038) in the choice stage, with higher performance of subjects whose initial age of trance recognition occurred before 21 years old. On the BDI scale, no participant met the criteria for major depression. The SRQ showed an incidence of common mental disorders in 21% of the sample, which was more prevalent in the LEG (p = 0.008). Conclusion: The cognitive functioning of subjects who practice trance mediumship in Brazil is associated with cognitive health. Executive dysfunction may be a tendency in LEG. However, an incidence of common mental disorders in the LEG was observed. Executive processing was higher in the subgroup with early practices of recognizing the phenomenon.

Determination of the effective dosage of tiletamine-zolazepam-ketamine-xylazine, with or without methadone, in dogs.

OBJECTIVE: To determine the effective dosage of the combination tiletamine-zolazepam-ketamine-xylazine (TKX), with or without methadone, in dogs. STUDY DESIGN: Prospective, randomized, experimental study. ANIMALS: A total of 29 dogs. METHODS: Dogs were randomly administered TKX (group TKX, n = 13) or combined with 0.3 mg kg-1 of methadone (group TKXM, n = 16) intramuscularly. The TKX solution contained tiletamine (50 mg mL-1), zolazepam (50 mg mL-1), ketamine (80 mg mL-1) and xylazine (20 mg mL-1). The effective dosages for immobility in 50% and 95% of the population (ED50 and ED95) were estimated using the up-and-down method. Approximately 20 minutes after drug administration, a skin incision was performed and the response was judged as positive or negative if the dogs moved or did not move, respectively. The TKX volume for the subsequent dog in the same group was increased or decreased by 0.005 mL kg-1 if the response of the previous dog was positive or negative, respectively. Heart and respiratory rates, and sedation/anesthesia scores (range 0-21) were recorded before and 15 minutes after drug administration. RESULTS: Estimated ED50 and ED95 (95% confidence intervals) were: TKX, 0.025 (0.020-0.029) and 0.026 (0.010-0.042) mL kg-1; TKXM, 0.022 (0.018-0.025) and 0.033 (0.017-0.049) mL kg-1. Median (interquartile range) scores for sedation/anesthesia were 17 (16-18) and 17 (15-20), and times until lateral recumbency were 5 (4-6) and 6 (4-10) minutes in TKX and TKXM, respectively (p > 0.05). In both groups heart and respiratory rates decreased, but values remained acceptable for anesthetized dogs. CONCLUSIONS AND CLINICAL RELEVANCE: The results provide a guide for volumes of TKX and TKXM in dogs requiring restraint for minimally invasive procedures. Inclusion of methadone in the TKX combination did not influence ED50.

[Systematic revision of the neural bases of dissociative amnesia]. / Las bases neurales de la Amnesia Disociativa (AD): una revisión sistemática de la bibliografía.

INTRODUCTION: Dissociative amnesia (DA) is a retrograde amnesia characterized by an alteration in episodic memory. AIM: Establish the neural bases which underlie the development of dissociative amnesia. METHODS: Systematic and evaluative bibliographic review of qualitative type. RESULTS: The bibliography found suggested functional inhibition in the hippocampus, amygdala, temporal lobes, prefrontal cortex and thalamus. Also, hypoglycemia was observed in right cerebral cortex, at the fronto-temporal junction. An inhibition in the potential action P300 was also stated. CONCLUSIONS: There is enough evidence to say that dissociative amnesia is an objectifiable biologically based pathology. There is a need to review the current conceptualization of this syndrome and to establish new criteria that would allow us to distinguish DA from organic amnesias.