The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Bruno Bissonnette - One of the best experts on this subject based on the ideXlab platform.
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Pupillary Reflex dilation and skin temperature to assess sensory level during combined general and caudal anesthesia in children
Pediatric Anesthesia, 2004Co-Authors: John F. Emery, Leslie Mackeen, Elise Héon, Bruno BissonnetteAbstract:Summary Background: Regional anesthesia causes sympathetic blockade, vasodilation and higher skin temperature in anesthetized dermatomes. Measurement of skin temperature changes might provide a useful estimate of the level of caudal anesthesia in children. Pupillary Reflex dilation (PRD) allows estimation of the sensory level during combined general/epidural anesthesia in adults, but has not been assessed in children. This study was designed to evaluate skin temperature and PRD as methods of estimating sensory level in children receiving combined general/caudal epidural anesthesia. Methods: Twenty ASA I and II children aged 10 months–5 years were enrolled. Anesthesia was induced with sevoflurane and N2O in O2 and maintained with 1 MAC isoflurane and air in O2. Caudal epidural anesthesia was achieved by injection of 1 ml·kg−1 0.25% bupivacaine. Skin temperature was measured by rapid response infrared thermometry. PRD was measured using an ophthalmic ultrasound biomicroscope (UBM). The three criteria used to estimate sensory level were a drop in skin temperature of 0.5°C between dermatomes, PRD of 50% and PRD of 0.2 mm. Results: A drop in skin temperature of 0.5°C between dermatomes allowed estimation of the sensory level in only 20% of patients. PRD of 50%, and PRD of 0.2 mm allowed estimation of the sensory level in 45 and 100% of patients, respectively. PRD was significantly greater above the T10 dermatome compared with L2 (P < 0.01). The maximum Pupillary dilation was significantly greater in children over 2 years of age [1.3 ± 0.8 mm sd)] compared with children less than two years of age [0.6 ± 0.3 mm sd)]. Conclusions: Skin temperature cannot be used to estimate sensory level during combined general/caudal epidural anesthesia. PRD of 0.2 mm is sensitive to the loss of analgesia but is not clinically useful. PRD may be useful above 2 years of age.
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Pupillary Reflex dilation and skin temperature to assess sensory level during combined general and caudal anesthesia in children.
Paediatric anaesthesia, 2004Co-Authors: John F. Emery, Leslie Mackeen, Elise Héon, Bruno BissonnetteAbstract:Summary Background: Regional anesthesia causes sympathetic blockade, vasodilation and higher skin temperature in anesthetized dermatomes. Measurement of skin temperature changes might provide a useful estimate of the level of caudal anesthesia in children. Pupillary Reflex dilation (PRD) allows estimation of the sensory level during combined general/epidural anesthesia in adults, but has not been assessed in children. This study was designed to evaluate skin temperature and PRD as methods of estimating sensory level in children receiving combined general/caudal epidural anesthesia. Methods: Twenty ASA I and II children aged 10 months–5 years were enrolled. Anesthesia was induced with sevoflurane and N2O in O2 and maintained with 1 MAC isoflurane and air in O2. Caudal epidural anesthesia was achieved by injection of 1 ml·kg−1 0.25% bupivacaine. Skin temperature was measured by rapid response infrared thermometry. PRD was measured using an ophthalmic ultrasound biomicroscope (UBM). The three criteria used to estimate sensory level were a drop in skin temperature of 0.5°C between dermatomes, PRD of 50% and PRD of 0.2 mm. Results: A drop in skin temperature of 0.5°C between dermatomes allowed estimation of the sensory level in only 20% of patients. PRD of 50%, and PRD of 0.2 mm allowed estimation of the sensory level in 45 and 100% of patients, respectively. PRD was significantly greater above the T10 dermatome compared with L2 (P
John F. Emery - One of the best experts on this subject based on the ideXlab platform.
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Pupillary Reflex dilation and skin temperature to assess sensory level during combined general and caudal anesthesia in children
Pediatric Anesthesia, 2004Co-Authors: John F. Emery, Leslie Mackeen, Elise Héon, Bruno BissonnetteAbstract:Summary Background: Regional anesthesia causes sympathetic blockade, vasodilation and higher skin temperature in anesthetized dermatomes. Measurement of skin temperature changes might provide a useful estimate of the level of caudal anesthesia in children. Pupillary Reflex dilation (PRD) allows estimation of the sensory level during combined general/epidural anesthesia in adults, but has not been assessed in children. This study was designed to evaluate skin temperature and PRD as methods of estimating sensory level in children receiving combined general/caudal epidural anesthesia. Methods: Twenty ASA I and II children aged 10 months–5 years were enrolled. Anesthesia was induced with sevoflurane and N2O in O2 and maintained with 1 MAC isoflurane and air in O2. Caudal epidural anesthesia was achieved by injection of 1 ml·kg−1 0.25% bupivacaine. Skin temperature was measured by rapid response infrared thermometry. PRD was measured using an ophthalmic ultrasound biomicroscope (UBM). The three criteria used to estimate sensory level were a drop in skin temperature of 0.5°C between dermatomes, PRD of 50% and PRD of 0.2 mm. Results: A drop in skin temperature of 0.5°C between dermatomes allowed estimation of the sensory level in only 20% of patients. PRD of 50%, and PRD of 0.2 mm allowed estimation of the sensory level in 45 and 100% of patients, respectively. PRD was significantly greater above the T10 dermatome compared with L2 (P < 0.01). The maximum Pupillary dilation was significantly greater in children over 2 years of age [1.3 ± 0.8 mm sd)] compared with children less than two years of age [0.6 ± 0.3 mm sd)]. Conclusions: Skin temperature cannot be used to estimate sensory level during combined general/caudal epidural anesthesia. PRD of 0.2 mm is sensitive to the loss of analgesia but is not clinically useful. PRD may be useful above 2 years of age.
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Pupillary Reflex dilation and skin temperature to assess sensory level during combined general and caudal anesthesia in children.
Paediatric anaesthesia, 2004Co-Authors: John F. Emery, Leslie Mackeen, Elise Héon, Bruno BissonnetteAbstract:Summary Background: Regional anesthesia causes sympathetic blockade, vasodilation and higher skin temperature in anesthetized dermatomes. Measurement of skin temperature changes might provide a useful estimate of the level of caudal anesthesia in children. Pupillary Reflex dilation (PRD) allows estimation of the sensory level during combined general/epidural anesthesia in adults, but has not been assessed in children. This study was designed to evaluate skin temperature and PRD as methods of estimating sensory level in children receiving combined general/caudal epidural anesthesia. Methods: Twenty ASA I and II children aged 10 months–5 years were enrolled. Anesthesia was induced with sevoflurane and N2O in O2 and maintained with 1 MAC isoflurane and air in O2. Caudal epidural anesthesia was achieved by injection of 1 ml·kg−1 0.25% bupivacaine. Skin temperature was measured by rapid response infrared thermometry. PRD was measured using an ophthalmic ultrasound biomicroscope (UBM). The three criteria used to estimate sensory level were a drop in skin temperature of 0.5°C between dermatomes, PRD of 50% and PRD of 0.2 mm. Results: A drop in skin temperature of 0.5°C between dermatomes allowed estimation of the sensory level in only 20% of patients. PRD of 50%, and PRD of 0.2 mm allowed estimation of the sensory level in 45 and 100% of patients, respectively. PRD was significantly greater above the T10 dermatome compared with L2 (P
Orlando Graziani Povoas Barsottini - One of the best experts on this subject based on the ideXlab platform.
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Teaching Video NeuroImages: Disorder of sweat, tonic pupil, and aReflexia: Ross syndrome.
Neurology, 2020Co-Authors: Igor De Assis Franco, Rodrigo De Andrade Da Silva, Rafael Pereira Pinto, Ane Maria Dos Anjos Florinda, Elerson Da Silva Peixoto, José Luiz Pedroso, Orlando Graziani Povoas BarsottiniAbstract:A 40-year-old man presented with a 10-year history of excessive sweating on the right side, progressing to absence of sweat, rough skin, heat intolerance, and blurred vision. Examination showed anhidrosis (right side), diffuse aReflexia, and Adie tonic pupils. Starch iodine test showed absence of sweating (figure). Pupillary Reflex was poor (video 1). Skin biopsy was unremarkable. Ross syndrome was diagnosed.
Bruce A. Pappas - One of the best experts on this subject based on the ideXlab platform.
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Retinal and optic nerve degeneration after chronic carotid ligation: time course and role of light exposure.
Stroke, 2002Co-Authors: W. Dale Stevens, Teresa Fortin, Bruce A. PappasAbstract:Background and Purpose— Carotid artery disease can cause chronic retinal ischemia, resulting in transient or permanent blindness, Pupillary Reflex dysfunction, and retinal degeneration. This experi...
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Chronic cerebral hypoperfusion: loss of Pupillary Reflex, visual impairment and retinal neurodegeneration.
Brain research, 2000Co-Authors: Christopher M. Davidson, Bruce A. Pappas, W. Dale Stevens, Teresa Fortin, Steffany A. L. BennettAbstract:Adult rats underwent permanent bilateral occlusion of the common carotid arteries (2VO) to determine the effect of chronic cerebral ischemia on vision and retina. They were monitored post-surgically for the presence of the Pupillary Reflex to light. Some rats were tested for 6 months post-surgically on a radial arm maze task and then tested in another water-escape task which explicitly tested visual function. Another group of rats were tested post-surgically for 3 months on a task which simultaneously assessed visual and tactile discrimination ability. The thicknesses of the retinal sub-layers were then measured for some rats. Fourteen of the 25 rats that underwent 2VO lost the Pupillary Reflex. This seemed to occur within 5 days. Rats that lost the Pupillary Reflex but not rats whose Reflex was intact, were impaired on all visually guided mazes. Tactile discrimination ability was unaffected. Only rats that lost the Pupillary Reflex showed reduced thickness of the retinal outer nuclear and plexiform layers, reduced cell density in the retinal ganglion cell layer and astrocytosis and degeneration of the optic tract. We conclude that 2VO can eliminate the Pupillary Reflex. Photoreceptors and retinal ganglion cells degenerate, but it is unclear if these are the cause(s) or result(s) of the loss of the Pupillary Reflex. These effects are accompanied by impairment of visually guided behavior. The possibility that visual system damage may also occur in acute ischemia merits further investigation.
Dora Fix Ventura - One of the best experts on this subject based on the ideXlab platform.
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Relationship between Daytime Sleepiness and Intrinsically Photosensitive Retinal Ganglion Cells in Glaucomatous Disease
Journal of ophthalmology, 2016Co-Authors: Carolina P. B. Gracitelli, Gloria L. Duque-chica, Ana Laura De Araújo Moura, Marina Roizenblatt, Balázs Nagy, Geraldine Ragot De Melo, Paula Borba, Sergio H. Teixeira, Sergio Tufik, Dora Fix VenturaAbstract:Patients with glaucoma showed to have higher daytime sleepiness measured by Epworth sleepiness scale. In addition, this symptom was associated with Pupillary Reflex and polysomnography parameters. These ipRGC functions might be impaired in patients with glaucoma, leading to worse quality of life.
