A different perspective: anesthesia for extreme premature infants: is there an age limitation or how low should we go?
Curr Opin Anaesthesiol. 2018 Feb 22;:
Authors: Lönnqvist PA
PURPOSE OF REVIEW: To put in perspective, the various challenges that faces pediatric anesthesiologists because of the recently lowered limits with regards to the viability of a fetus. Both medical and ethical considerations will be highlighted.
RECENT FINDINGS: Issues related to: who should anesthetize these tiny babies; can we provide adequate and legal monitoring during the anesthetic; does these immature babies need hypnosis and amnesia and the moral/ethical implications associated with being involved with care of doubtful long-term outcome are reviewed.
SUMMARY: There does currently not exist sufficient research data to provide any evidence-based guidelines for the anesthetic handling of extreme premature infants. Current practice relies on extrapolations from other patient groups and from attempting to preserve normal physiology. Thus, focused research initiatives within this specific field of anesthesia should be a priority. Furthermore, in-depth multiprofessional ethical discussions regarding long-term outcome of aggressive care of extremely premature babies are urgently needed, including the new concepts of disability-free survival and number-need-to-suffer.
PMID: 29474212 [PubMed - as supplied by publisher]
Ligustrazine enhances the hypnotic and analgesic effect of ketamine in mice.
Biol Pharm Bull. 2018 Feb 21;:
Authors: Liu C, Li Z, Huang Z, Zhang K, Hu C, Zuo Z, Li Y
The purpose of this study was to determine the effects of different concentrations of ligustrazine, an extract from Chinese herb, on ketamine requirement for hypnosis and analgesia in mice. In the hypnotic response study, mice were randomly allocated to receive saline or ligustrazine at 10 mg·kg-1, 20 mg·kg-1, 40 mg·kg-1, 80 mg·kg-1 or 160 mg·kg-1 by intraperitoneal injection. Ketamine was administrated 15 min after ligustrazine injection. The hypnotic response was determined by assessing loss of the righting reflex (LORR) after ketamine injection. The dose of ketamine was determined by modified Dixon's up-and-down method in each group. In the analgesia study, different doses of ligustrazine were administrated 15 min before 50 mg·kg-1 ketamine injection. The analgesia effects (pain threshold) were determined by heat radiation-induced tail-flick latency and evaluated before ligustrazine administration or 5 min, 15 min, 30 min and 60 min after ketamine administration. The 50% effective dose (ED50) [95% confidence interval (CI)] for hypnosis induced by ketamine was 54.1 (44.8, 65.3) mg·kg-1. Ligustrazine dose-dependently decreased the ED50 for ketamine to induce hypnosis, which was [31.6 (26.2, 38.1)] mg·kg-1 with the addition of 80 mg·kg-1 ligustrazine and [27.7 (22.6, 33.7)] mg·kg-1 with the addition of 160 mg·kg-1 ligustrazine, respectively (p < 0.05). Ligustrazine at 160 mg·kg-1 also increased pain threshold in the presence of ketamine. Ligustrazine enhanced the hypnotic effect of ketamine in a dose-dependent manner. Ligustrazine at a large dose also increased the analgesic effect of ketamine.
PMID: 29467345 [PubMed - as supplied by publisher]
Eliminating age differences in children's and adults' suggestibility and memory conformity effects.
Dev Psychol. 2017 May;53(5):962-970
Authors: Otgaar H, Howe ML, Brackmann N, van Helvoort DHJ
We examined whether typical developmental trends in suggestion-induced false memories (i.e., age-related decrease) could be changed. Using theoretical principles from the spontaneous false memory field, we adapted 2 often-used false memory procedures: misinformation (Experiment 1) and memory conformity (Experiment 2). In Experiment 1, 7- to 9-year-old children (n = 33) and adults (n = 39) received stories containing associatively related details. They then listened to misinformation in the form of short narratives preserving the meaning of the story. Children and adults were equally susceptible to the misinformation effect. In Experiment 2, younger (7- to 8-year-olds, n = 30) and older (11- to 12-year-olds, n = 30) children and adults (n = 30) viewed pictures containing associatively related details. They viewed these pictures in pairs. Although the pictures differed, participants believed they had viewed the same pictures. Participants had to report what they could recollect during collaborative and individual recall tests. Children and adults were equally susceptible to memory conformity effects. When correcting for response bias, adults' false memory scores were even higher than children's. Our results show that age trends in suggestion-induced false memories are not developmentally invariant. (PsycINFO Database Record
PMID: 28358537 [PubMed - indexed for MEDLINE]
Latent variables underlying the memory beliefs of Chartered Clinical Psychologists, Hypnotherapists and undergraduate students.
Memory. 2017 Jan;25(1):57-68
Authors: Ost J, Easton S, Hope L, French CC, Wright DB
In courts in the United Kingdom, understanding of memory phenomena is often assumed to be a matter of common sense. To test this assumption 337 UK respondents, consisting of 125 Chartered Clinical Psychologists, 88 individuals who advertised their services as Hypnotherapists (HTs) in a classified directory, the Yellow PagesTM, and 124 first year undergraduate psychology students, completed a questionnaire that assessed their knowledge of 10 memory phenomena about which there is a broad scientific consensus. HTs' responses were the most inconsistent with the scientific consensus, scoring lowest on six of these ten items. Principal Components Analysis indicated two latent variables - reflecting beliefs about memory quality and malleability - underlying respondents' responses. In addition, respondents were asked to rate their own knowledge of the academic memory literature in general. There was no significant relationship between participants' self reported knowledge and their actual knowledge (as measured by their responses to the 10-item questionnaire). There was evidence of beliefs among the HTs that could give rise to some concern (e.g., that early memories from the first year of life are accurately stored and are retrievable).
PMID: 26728198 [PubMed - indexed for MEDLINE]
Trauma memories on trial: is cross-examination a safeguard against distorted analogue traumatic memories?
Memory. 2017 Jan;25(1):95-106
Authors: Segovia DA, Strange D, Takarangi MK
Trauma memories can feel more disorganised than more mundane memories. That may be problematic in legal contexts. Here we examined: (a) whether that disorganised feeling makes people more susceptible to suggestive questioning during direct examination; and (b) whether cross-examination is the safeguard it is purported to be: that is, we examined whether cross-examination can uncover and correct distorted trauma memories. We showed participants a film depicting a graphic car accident. For some participants, the film unfolded in a temporally disorganised way. We then interviewed participants immediately after the film regarding what they had seen: this 'direct examination' included free recall, cued recall and yes/no questions, some of which were misleading. Then, 48 hours later, a second interviewer cross-examined participants. Contrary to our predictions, neither manipulation of the film's temporal organisation, nor participants' self-reported feelings of event disorganisation significantly affected their accuracy of the film during direct or cross-examination nor their recognition memory of the film. Instead, we found that regardless of whether participants' memories were distorted by the direct examination, the suggestive nature of the cross-examination introduced sufficient doubt that participants were willing to change their answers. We conclude that traumatic memories are vulnerable to suggestive questioning and, unfortunately, cross-examination is not the legal system's fail-safe corrective influence.
PMID: 26715010 [PubMed - indexed for MEDLINE]