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1.
Acta bioeth ; 26(1): 107-116, mayo 2020.
Article in Spanish | LILACS (Americas) | ID: biblio-1114604

ABSTRACT

La comprensión de la conciencia ha sido durante siglos uno de los caballos de batalla del devenir intelectual, en tanto contexto en el que se han definido y redefinido las diferentes percepciones socioculturales, científicas, filosóficas e ideológicas del ser humano. Lejos de tratarse de un problema superado, se trata de una cuestión que, reformulada una y otra vez, en distintos ámbitos y contextos, retorna sin cesar al epicentro del debate intelectual, dadas sus consecuencias epistémicas y necesariamente éticas. En este trabajo se trata de mostrar cómo tal debate y sus posturas se alimentan de una percepción que se estima "anticuada" del problema, al afrontarlo desde una óptica esencialista (cifrada sobre un modelo de pensamiento basado en esquemas de razón-objeto), a la par que se propone una reformulación de la cuestión en términos procesuales, inspirada en la propuesta del emergentismo sistémico. Con ello, se pretende aportar un enfoque superador de un modelo intelectual que se estima obsoleto, a la par que se propicia una reflexión ética en torno a las consecuencias intelectuales ideológicas y prácticas devenidas de un sostenimiento artificioso del mismo en el ámbito de la ciencia.


For centuries, the understanding of conciousness has been one of the topic issues of intellectual development, and a context in which the different sociocultural, scientific, philosophical and ideological perceptions of the human being have been defined and redefined. Far from being a solved problem, it's a theme that, reformulated again and again in different fields and contexts, returns endlessly to the epicenter of intellectual discussion because it has, necessarily, trascendental epistemic and ethical consequences. This paper tries to show how such confrontation and its positions are fed by an "outdated" perception of the problem, when faced it from an essentialist perspective (encrypted on a model of thought based on reason-object schemes). Therefore is proposed a reformulation of the question in procedural terms inspired by the theory of systemic emergentism. So, it is intended to provide an overcoming approach to an intellectual model that is considered obsolete, while fostering an ethical reflection on the ideological intellectual consequences and practices derived from its artificial support in the field of Science.


A compreensão de consciência tem sido, durante séculos, um dos cavalos de batalha do tornar-se intelectual, no contexto em que se definiu e se redefiniu as diferentes percepções socioculturais, científicas, filosóficas e ideológicas do ser humano. Longe de se tratar de um problema superado, trata-se de uma questão que, reformulada uma ou outra vez, em distintos âmbitos e contextos, retorna ao epicentro do debate intelectual, dadas suas consequências epistêmicas e necessariamente éticas. Tratamos demonstrar neste trabalho como tal debate e suas posturas alimentam-se de uma percepção que se estima ser "antiquada" do problema, ao enfrenta-lo a partir de uma visão essencialista (codificada sobre um modelo de pensamento baseado em esquemas de razão-objeto), ao mesmo tempo em que se propõe uma reformulação da questão em termos processuais, inspirada na proposta do emergentismo sistêmico. Com isto, pretende-se aportar um enfoque que supera um modelo intelectual que se estima obsoleto, ao mesmo tempo em que se propicia uma reflexão ética em torno das consequências intelectuais ideológicas e práticas decorrentes de um apoio artificial do mesmo no âmbito da ciência.


Subject(s)
Philosophy , Conscience , Knowledge , Consciousness
2.
Pesqui. prát. psicossociais ; 14(4): 1-13, out.-dez. 2019.
Article in Portuguese | LILACS (Americas), INDEXPSI | ID: biblio-1115072

ABSTRACT

Neste artigo, o número é abordado como um fenômeno psíquico, sendo analisado a partir de suas possibilidades e particularidades simbólicas. Para tanto, foram consultados textos históricos, antropológicos, filosóficos, mitológicos e religiosos sobre o conhecimento matemático. Esses textos foram selecionados em periódicos indexados e livros científicos conceituados. Em seguida, foi realizado um movimento de compreensão, a partir da fundamentação teórica da Psicologia Analítica de Carl Gustav Jung. Como fenômeno psíquico, o número é entendido como um arquétipo que adveio à consciência e como um símbolo, isto é, como um mistério que tem um sentido passível de compreensão. Nesse contexto, o número ocupa o lugar de imagem psíquica central de nossos interesses, ao redor do qual foram efetuadas analogias (amplificação), procedimento característico do método hermenêutico-simbólico da Psicologia Analítica.


In this article, the number is approached as a psychic phenomenon, being analysed from its possibilities and symbolic particularities. Therefore, historical, anthropological, philosophical, mythological, and religious texts on mathematical knowledge were consulted. These texts have been selected in indexed periodicals and well-known scientific books. Then, a movement of understanding was made, based on the theoretical basis of Analytical Psychology by Carl Gustav Jung. As a psychic phenomenon, the number is understood as an archetype that came to consciousness, and as a symbol, that is, as a mystery that has a comprehensible sense. In this context, the number occupies the place of the central psychic image of our interests, around which analogies were made (amplification), a characteristic procedure of the hermeneutic-symbolic method of Analytical Psychology.


En este artículo, el número se aborda como un fenómeno psíquico y se analiza a partir de sus posibilidades y particularidades simbólicas. Para ello se consultaron textos históricos, antropológicos, filosóficos, mitológicos y religiosos sobre el conocimiento matemático. Estos textos fueron seleccionados de revistas indexadas y libros científicos de renombre. Luego, se realizó um movimiento de comprensión desde la base teórica de la Psicología Analítica. Como fenómeno psíquico, el número se entiende con un arquetipo que llegó a la consciencia y como un símbolo, es decir, como un misterio que tiene un sentido comprensible. En este contexto, el número ocupa el lugar de la imagen psíquica central de nuestros intereses, alrededor de cual se fueron hechas analogías (amplificación), un procedimiento característico del método hermenêutico-simbólico de la Psicología Analítica.


Subject(s)
Psychology , Jungian Theory , Symbolism , Conscience , Consciousness , Knowledge , Comprehension , Hermeneutics , Neuropsychological Tests
3.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-787438

ABSTRACT

BACKGROUND: Terminally ill cancer patients suffer from refractory symptoms, and the last option of treatment is to consider sedatives. However, due to concerns that sedation may shorten survival time, some people prefer not to take sedatives. The purpose of this study was to investigate the effects of sedative administration on survival time among terminally ill cancer patients.METHODS: Two hundreds and thirty-seven patients who were hospitalized to the hospice care unit of public hospitals in Seoul from January, 2015 to March, 2016 were analyzed retrospectively. The univariate and multivariate Cox's proportional hazard regression model was used to determine independent factors related to survival time.RESULTS: The usage of sedation was necessary because the incidence of insomnia was 61.4% in the lorazepam only group, and the incidence of delirium was highest in the haloperidol group and the haloperidol with lorazepam group. Interestingly, multivariate analysis showed that male (HR, 1.766; P < 0.001), decreased consciousness (HR, 1.803; P=0.003), anorexia (HR, 1.506; P=0.012), resting dyspnea (HR, 1.757; P < 0.001), elevated serum bilirubin (HR, 1.657; P=0.001), and the haloperidol with lorazepam group (HR, 0.535, P < 0.001) were each significantly associated with survival time. Furthermore, patients in the haloperidol with lorazepam group survived longer than patients with no such medications.CONCLUSION: There is no evidence that treatment with sedative medication shortens the survival time of patients with terminally ill cancer with refractory symptoms.


Subject(s)
Anorexia , Bilirubin , Consciousness , Delirium , Dyspnea , Haloperidol , Hospice Care , Hospices , Hospitals, Public , Humans , Hypnotics and Sedatives , Incidence , Lorazepam , Male , Multivariate Analysis , Palliative Care , Retrospective Studies , Seoul , Sleep Initiation and Maintenance Disorders , Terminally Ill
4.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-787397

ABSTRACT

Dementia with Lewy bodies(DLB) is the second most common neurodegenerative disease. However, DLB might not be adequately diagnosed due to its variety of clinical symptoms. The authors present 65-year-old Mrs. A. who showed Parkinson's movement, cognitive decline, psychological symptoms, and autonomic dysfunction. According to the clinical features and biological markers in the recently revised DLB criteria, Mrs. A. was diagnosed with probable DLB. Differential diagnoses of delirium, Parkinson's dementia, and Alzheimer's dementia were discussed. Psychopharmacological treatments of antidepressants or anxiolytics caused intolerable side effects and showed little efficacy to Mrs. A. She experienced two episodes of hyponatremia during her one-year treatment. Recovery from neurological symptoms due to the first hyponatremia was time-consuming, and in the second, it was associated with changes in the level of consciousness despite relatively mild hyponatremia. A fall that occurred in the latter part of treatment triggered remarkable deterioration of DLB symptoms and daily life function. Prevention of falls is important for maintaining the quality of life of patients with DLB.


Subject(s)
Accidental Falls , Aged , alpha-Synuclein , Anti-Anxiety Agents , Antidepressive Agents , Biomarkers , Consciousness , Delirium , Dementia , Diagnosis , Diagnosis, Differential , Humans , Hyponatremia , Lewy Bodies , Neurodegenerative Diseases , Quality of Life
5.
Article in English | WPRIM (Western Pacific) | ID: wprim-764385

ABSTRACT

BACKGROUND: We aimed to assess the dose needed to achieve the propofol effect-site concentration using target-controlled infusion in intellectually disabled patients and to detail the most effective method for achieving a safe level of consciousness without hemodynamic changes as well as detail any resulting adverse effects. METHODS: We performed a retrospective review of sedation service records of 138 intellectually disabled patients (51, mental retardation; 36, autism; 30, brain lesion, 12 genetic diseases, 9 dementia) aged over 15 years and weighing over 30 kg. These patients had received propofol via target-controlled infusion in the special care dental clinic of Seoul National University Dental Hospital from May 2008 to September 2018 for restorative treatment (112), minor surgery (13), prosthodontics (7), periodontics treatment (5), and implant (1). RESULTS: For all groups, the duration of dental treatments was 43 ± 18 minutes, total sedation time was 73 ± 23 minutes, and total BIS values was 57 ± 12. The propofol maintenance dosage values for each group were: mental retardation, 3 ± 0.5 (2–4) µg/ml; autism, 3.1 ± 0.7 (2–5) µg/ml; brain lesion, 2.8 ± 0.7 (1.5–5) µg/ml; genetic disease, 2.9 ± 0.9 (1–4) µg/ml; and dementia 2.3 ± 0.7 (1–3.4) µg/ml. CONCLUSIONS: The dementia group needed a lower dosage to reach a safe, effective propofol effect-site concentration than the other groups. Since there were no complications, deep sedation is a great alternative to general anesthesia for dental treatment of intellectually disabled patients.


Subject(s)
Anesthesia, General , Autistic Disorder , Brain , Consciousness , Deep Sedation , Dementia , Dental Clinics , Hemodynamics , Humans , Intellectual Disability , Methods , Minor Surgical Procedures , Periodontics , Propofol , Prosthodontics , Retrospective Studies , Seoul
6.
Article in English | WPRIM (Western Pacific) | ID: wprim-764335

ABSTRACT

BACKGROUND AND PURPOSE: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is the most common type of autoimmune encephalitis. This study aimed to explore the possible factors affecting the response to first-line treatments in patients with anti-NMDAR encephalitis. METHODS: We enrolled 29 patients who were diagnosed as anti-NMDAR encephalitis between January 1, 2015, and June 30, 2018. They were divided into the remission and nonremission groups according to their response to first-line treatments. The demographics, clinical manifestations, main ancillary examinations, follow-up treatments, and prognosis of patients were recorded. The symptoms reported on in this study occurred before treatments or during the course of first-line treatments. RESULTS: There were 18 patients (62.07%) in the remission group and 11 patients (37.93%) in the nonremission group. Compared to the remission group, a higher proportion of the patients in the nonremission group exhibited involuntary movements, decreased consciousness, central hypoventilation, lung infection, and hypoalbuminemia. The nonremission group had a high incidence of increased intracranial pressure and significant elevations of the neutrophil-to-lymphocyte ratio in peripheral blood (NLR), aspartate aminotransferase, and fibrinogen. Six patients (54.55%) in the nonremission group received second-line immunotherapy. Only one patient (3.45%) died, which was due to multiple-organ failure. CONCLUSIONS: Anti-NMDAR-encephalitis patients with more symptoms—especially involuntary movements, disturbance of consciousness, central hypoventilation, and accompanying hypoalbuminemia and pulmonary infection—may respond poorly to first-line treatments. Positive second-line immunotherapy therefore needs to be considered. Admission to an intensive-care unit, increased cerebrospinal fluid pressure, and increased NLR might be the significant factors affecting the response to first-line treatments.


Subject(s)
Anti-N-Methyl-D-Aspartate Receptor Encephalitis , Aspartate Aminotransferases , Cerebrospinal Fluid Pressure , Consciousness , Demography , Dyskinesias , Encephalitis , Fibrinogen , Follow-Up Studies , Humans , Hypoalbuminemia , Hypoventilation , Immunotherapy , Incidence , Intracranial Pressure , Lung , Prognosis
7.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-766392

ABSTRACT

This study examined the perception and behavior of fast food restaurant customers toward ordering kiosk nutrition information. Specifically, the influence of nutrition information transparency and information quality on behavioral intention and revisit intention were identified. In addition, the difference in the nutrition information transparency and information quality was analyzed according to the health consciousness of the customers. The study employed a self-administered survey that was distributed both online and offline from November 8~22, 2018. The sample of the study was customers who had experienced ordering from the kiosk in a fast food restaurant in the six months prior to taking the survey. A total of 250 (98.0%) respondents completed the survey, which was used for data analysis. As a result, there was a significant relation between transparency and nutrition information quality (P<0.001). The higher the visibility and inferability of the nutrition information, the better the nutrition information quality. Nutrition information quality has a significant impact on the levels of customer satisfaction and revisit intention (P<0.001). For the differences in the transparency and nutrition information quality by health consciousness of customers, the results indicated that groups with high health consciousness (3.74 or higher) perceived a higher transparency and nutritional information quality than those with a lower health consciousness. These findings can form the basis of a strategy in developing nutrition information of ordering kiosks in restaurants. In addition, it can be applied to academia and industry.


Subject(s)
Consciousness , Fast Foods , Intention , Restaurants , Statistics as Topic , Surveys and Questionnaires
8.
Article in English | WPRIM (Western Pacific) | ID: wprim-765921

ABSTRACT

BACKGROUND: Patients with persistent vegetative state (PVS) show no evidence of awareness of self or their environment, and those with minimally conscious state (MCS) have severely impaired consciousness with minimal but definite behavioral evidence of self or environmental awareness after stroke. Neuroimaging and clinical characteristics separating these two close consciousness states after stroke were insufficiently studied. METHODS: We conducted a hospital-based cohort study of all patients with stroke (2011 to 2017) who underwent 3T magnetic resonance imaging and consciousness assessment after 3 months of inclusion. Univariate and multivariate regression analyses were used to estimate the relative risk of neuroimaging markers for differentiation of PVS and MCS. RESULTS: Of 3,600 eligible subjects, 323 patients (0.09%) had PVS and 93 (0.02%) had MCS (mean age, 62.25±13.4 years). Higher stroke volume was strongly associated with PVS compared to MCS (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.98 to 1.00; P=0.001). On univariate analysis, cingulate gyrus (OR, 2.7; 95% CI, 1.62 to 4.36; P=0.001) and corpus callosum (OR, 2.1; 95% CI, 1.28 to 3.44; P=0.003) involvement was significantly associated with PVS. However, on multivariate analysis, only cingulate gyrus involvement was independently associated with PVS (OR, 2.2; 95% CI, 1.33 to 3.72; P=0.002). CONCLUSION: Our results indicate that PVS and MCS are different consciousness states according to clinical and neuroimaging findings. To predict outcome, cognitive performance of these patients should be well questioned after stroke.


Subject(s)
Cognition Disorders , Cohort Studies , Consciousness , Corpus Callosum , Gyrus Cinguli , Humans , Magnetic Resonance Imaging , Multivariate Analysis , Neuroimaging , Persistent Vegetative State , Stroke Volume , Stroke
9.
Article in English | WPRIM (Western Pacific) | ID: wprim-764985

ABSTRACT

BACKGROUND: Most depth of anesthesia (DOA) monitors rely on the temporal characteristics of a single-channel electroencephalogram (EEG) and cannot provide spatial or connectivity information. Phase lag entropy (PLE) reflects DOA by calculating diverse connectivity from temporal patterns of phase relationships. The aim of this study was to compare the performance of PLE and bispectral index (BIS) monitors for assessing DOA during anesthesia induction, nerve integrity monitoring (NIM), and anesthesia emergence. METHODS: Thirty-five patients undergoing elective thyroid surgery with recurrent laryngeal nerve NIM received propofol and remifentanil via target-controlled infusion. After applying PLE and BIS monitors, propofol infusion was initiated at a calculated effect site concentration (Ce) of 2 µg/mL and then increased in 1-µg/mL Ce increments. After propofol Ce reached 5 μg/mL, a remifentanil infusion was begun, and anesthesia induction was considered complete. During NIM, PLE and BIS values were compared at a specific time points from platysma muscle exposure to subcutaneous tissue closure. PLE and BIS values were recorded continuously from preanesthetic state to full recovery of orientation; bias and limits of agreement between monitors were calculated. RESULTS: PLE and BIS values decreased progressively with increasing propofol Ce during anesthetic induction and increased by stages during emergence. The prediction probabilities of PLE and BIS for detecting propofol Ce changes were 0.750 and 0.756, respectively, during induction and 0.749 and 0.746, respectively, during emergence. No aberrant PLE or BIS values occurred during NIM. Correlation coefficients for BIS and PLE were 0.98 and 0.92 during induction and emergence, respectively. PLE values were significantly higher than BIS values at full recovery of orientation. Estimated bias between monitors was −4.16 ± 8.7, and 95% limits of agreement were −21.21 to 12.89. CONCLUSION: PLE is a reasonable alternative to BIS for evaluating consciousness and DOA during general anesthesia and during NIM. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003490


Subject(s)
Anesthesia , Anesthesia, General , Bias , Consciousness , Consciousness Monitors , Electroencephalography , Entropy , Humans , Information Services , Propofol , Recurrent Laryngeal Nerve , Subcutaneous Tissue , Superficial Musculoaponeurotic System , Thyroid Gland
10.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-764602

ABSTRACT

PURPOSE: The purpose of this study is to find out how much influence nursing students' environmental consciousness and knowledge of medical waste have on their attitudes toward medical waste. METHODS: The subjects were 211 nursing students recruited from 2 universities. Data were collected with a structured self-report questionnaire comprising measures of environmental consciousness, and knowledge of and attitude toward medical waste. Data analysis was conducted with the SPSS/WIN 25.0 program. RESULTS: A total of 211 copies of the questionnaire were used for the final analysis, except for 9 untrusted responses out of 220 that included missing values. Those subjects' environmental consciousness who received environmental education in middle and high schools was higher (t=3.15, p=.002). The higher their grades, the better their knowledge of medical waste (F=3.40, p=.035). Those subjects’ knowledge of medical waste who received medical waste education was relatively high (t=3.14, p=.002). Those subjects with clinical practice experience had more sensitive attitudes toward medical waste (t=2.06, p=.041). Those subjects' attitudes toward Medical waste who received medical waste education at the universities were relatively high (t=2.04, p=.043). The subjects' environmental consciousness was positively correlated with their attitudes toward medical waste (r=.44, p<.001). The most influential factor in their attitudes toward medical waste is their environmental attitudes and medical waste education. CONCLUSION: The higher the nursing students' environmental consciousness, the higher their attitudes toward medical waste. It is necessary to provide environment and medical waste education for nursing students in order to strengthen their environmental consciousness and attitude toward medical waste.


Subject(s)
Consciousness , Education , Humans , Medical Waste , Nursing , Statistics as Topic , Students, Nursing
11.
Article in English | WPRIM (Western Pacific) | ID: wprim-759989

ABSTRACT

Vertebral artery injuries associated with C1 lateral mass screw insertion rarely occur during C1-2 fusion. The posterior inferior cerebellar artery (PICA) is uncommonly located at the C1 lateral mass insertion position. A 71-year-old woman with atlanto-axial subluxation and cord compression underwent C1-2 fusion. Sixth nerve palsy and diplopia were detected postoperatively, and decreased consciousness occurred on postoperative day 4. Brain magnetic resonance image (MRI) and computed tomography (CT) revealed PICA infarction. In the preoperative CT angiography, the PICA originated between the C1 and C2 level. In the postoperative CT scan, the PICA was not visible. The patient was treated conservatively for two weeks and recovered. PICA originating between the C1 and C2 level comprises 1.1–1.3% of cases. Therefore, vertebral artery anomalies should be evaluated prior to C1-2 fusion to prevent vessel injuries.


Subject(s)
Abducens Nerve Diseases , Aged , Angiography , Arteries , Brain , Brain Infarction , Consciousness , Diplopia , Female , Humans , Infarction , Pica , Tomography, X-Ray Computed , Vertebral Artery
12.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-758482

ABSTRACT

Heat stroke is characterized by hyperthermia with an associated altered mental status. Most heat stroke patients experience a change in consciousness as the first symptom and show a variety of electrocardiography abnormalities. No prior case report has described heat stroke, in which the first symptom was cardiac arrest with ventricular fibrillation. A 67-year-old male presented to the emergency department with an altered mental status after a cardiac arrest. His electrocardiogram at the scene was ventricular fibrillation, and he recovered his spontaneous circulation after defibrillation. The heat stroke was treated with aggressive cooling. Emergency physicians should be aware that heat stroke can cause ventricular fibrillation and can be treated with defibrillation and aggressive cooling.


Subject(s)
Aged , Consciousness , Electrocardiography , Emergencies , Emergency Service, Hospital , Fever , Heart Arrest , Heat Stroke , Hot Temperature , Humans , Male , Ventricular Fibrillation
13.
Article | WPRIM (Western Pacific) | ID: wprim-763544

ABSTRACT

We report an extremely rare case of a patient with hypoxic-ischemic brain injury who recovered consciousness and motor and cognitive functions due to paradoxical response after zolpidem administration. A 32-year-old woman who had attempted suicide by hanging was admitted. The patient had stabilized in a state of drowsy mentality, quadriparesis, dysphagia, and impaired cognition. Brain magnetic resonance imaging was suggestive of hypoxic ischemic brain injury and unilateral infarction in the right posterior cerebral artery territory. Due to sleep disturbance, zolpidem was administered, and paradoxically consciousness level and function returned to near-normal during the duration of the drug-effect. In addition to previous reports, our case characteristically showed remarkable motor and cognitive function recovery, not only consciousness level. The drug-effect time was gradually decreased after 18 months and absent after 3 years. We have reviewed related literature and discussed possible neuropharmacological and neurobiological mechanism.


Subject(s)
Adult , Brain Injuries , Brain , Cognition , Consciousness , Deglutition Disorders , Female , Humans , Hypoxia-Ischemia, Brain , Infarction , Infarction, Posterior Cerebral Artery , Magnetic Resonance Imaging , Posterior Cerebral Artery , Quadriplegia , Suicide, Attempted
14.
Article in English | WPRIM (Western Pacific) | ID: wprim-762569

ABSTRACT

BACKGROUND: In the construction industry, maintaining health and safety of workers often challenging. Among the workers at construction sites, painters are at particular risk of respiratory diseases and neurotoxicity. However, in Korea there is weak enforcement of workers' health and safety practices in the construction industry in Korea. Poisonings frequently occur at (semi)closed construction sites. In this study, we report a case of acute organic solvent poisoning during construction site painting. CASE PRESENTATION: A 71-year-old man was found unconscious at a construction site and immediately transferred to the emergency room. The consciousness level was 'stupor state' and the body temperature was hypothermic, at 32 degrees (Celsius). There were no acute brain or cardiac lesions that would have accounted for the faintness. In addition, blood and urine tests did not indicate a cause of loss of consciousness. He had been painting epoxy to waterproof the basement floor before fainting. According to exposure simulation, the patient was overexposed to various organic solvents, such as approximately 316–624 ppm toluene during the work before fainting. Considering the ventilation status of the workplace and the status of no protection, it is considered that exposure through the respiratory tract was considerable. CONCLUSIONS: The patient in this case lost consciousness during the epoxy coating in a semi-enclosed space. It can be judged as a result of acute poisoning caused by organic solvent exposure and considered to be highly related to work environment.


Subject(s)
Aged , Body Temperature , Brain , Consciousness , Construction Industry , Emergency Service, Hospital , Humans , Korea , Occupational Diseases , Paint , Paintings , Poisoning , Respiratory System , Solvents , Syncope , Toluene , Unconsciousness , Ventilation
15.
Article in English | WPRIM (Western Pacific) | ID: wprim-785296

ABSTRACT

Awareness during general anesthesia occurs in approximately 0.1–0.2% of cases; nevertheless, particular attention is required because it can lead to critical complications including insomnia, depression, anxiety, and post-traumatic stress disorder. To prevent these complications, bispectral index (BIS) and end-tidal anesthetic gas (ETAG) concentration monitoring are commonly used to examine patient consciousness during surgery. In the present case, an 80-year-old man was scheduled for total gastrectomy. Anesthesia was maintained using desflurane 4.0–5.0% vol, oxygen, and nitrous oxide. The authors simultaneously monitored BIS, which was maintained between 37 and 43, and ETAG, which was maintained between 0.9 and 1.2 minimum alveolar concentration (MAC). After the operation, however, the authors were surprised to learn that the patient complained of awareness during anesthesia. Although BIS and ETAG concentration monitoring are useful in preventing awareness during anesthesia, they cannot be completely trusted. Even though BIS was maintained at approximately 40 and ETAG at 0.7–1.3 MAC, awareness during anesthesia occurred.


Subject(s)
Aged, 80 and over , Anesthesia , Anesthesia, General , Anxiety , Consciousness , Consciousness Monitors , Depression , Gastrectomy , Humans , Intraoperative Awareness , Nitrous Oxide , Oxygen , Sleep Initiation and Maintenance Disorders , Stress Disorders, Post-Traumatic
16.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-766766

ABSTRACT

Anti-Ma2-associated encephalitis is one of the paraneoplastic limbic and brainstem encephalitis characterized by decreased consciousness, parkinsonism and the limitation of vertical eye movement. It is usually associated with non-small cell lung cancer in male and female or germ cell tumor in male. Herein, we report a case of atypical anti-Ma2-associated encephalitis which presented with axonal sensorimotor polyneuropathy.


Subject(s)
Autoantibodies , Axons , Brain Stem , Carcinoma, Non-Small-Cell Lung , Consciousness , Encephalitis , Eye Movements , Female , Humans , Limbic Encephalitis , Male , Neoplasms, Germ Cell and Embryonal , Paraneoplastic Syndromes , Parkinsonian Disorders , Polyneuropathies
17.
Article in Korean | WPRIM (Western Pacific) | ID: wprim-766747

ABSTRACT

Posterior reversible encephalopathy syndrome (PRES) is characterized by neurotoxic symptoms and neuroimaging finding of reversible cerebral edema in association with various conditions including hypertension, eclampsia, and autoimmune diseases. The author experienced a 47-year-old woman with systemic lupus erythematosus and systemic sclerosis overlap syndrome who developed PRES. The patient presented with alteration of consciousness in association with hypertension and increased autoimmune activity. Magnetic resonance imaging revealed vasogenic edema in the bilateral cerebral cortex, subcortical white matter, basal ganglia, brainstem, and cerebellum.


Subject(s)
Autoimmune Diseases , Basal Ganglia , Brain Edema , Brain Stem , Cerebellum , Cerebral Cortex , Consciousness , Eclampsia , Edema , Female , Humans , Hypertension , Lupus Erythematosus, Systemic , Magnetic Resonance Imaging , Middle Aged , Neuroimaging , Posterior Leukoencephalopathy Syndrome , Pregnancy , Scleroderma, Systemic , White Matter
18.
Rev. bras. psiquiatr ; 40(3): 335-342, July-Sept. 2018. tab
Article in English | LILACS (Americas) | ID: biblio-959232

ABSTRACT

Objective: The mind-brain problem (MBP) has marked implications for psychiatry, but has been poorly discussed in the psychiatric literature. This paper evaluates the presentation of the MBP in the three leading general psychiatry journals during the last 20 years. Methods: Systematic review of articles on the MBP published in the three general psychiatry journals with the highest impact factor from 1995 to 2015. The content of these articles was analyzed and discussed in the light of contemporary debates on the MBP. Results: Twenty-three papers, usually written by prestigious authors, explicitly discussed the MBP and received many citations (mean = 130). The two main categories were critiques of dualism and defenses of physicalism (mind as a brain product). These papers revealed several misrepresentations of theoretical positions and lacked relevant contemporary literature. Without further discussion or evidence, they presented the MBP as solved, dualism as an old-fashioned or superstitious idea, and physicalism as the only rational and empirically confirmed option. Conclusion: The MBP has not been properly presented and discussed in the three leading psychiatric journals in the last 20 years. The few articles on the topic have been highly cited, but reveal misrepresentations and lack of careful philosophical discussion, as well as a strong bias against dualism and toward a materialist/physicalist approach to psychiatry.


Subject(s)
Humans , Psychiatry/statistics & numerical data , Psychophysiology , Publications/statistics & numerical data , Brain/physiology , Neurosciences , Consciousness/physiology , Journal Impact Factor
19.
Estud. pesqui. psicol. (Impr.) ; 18(2): 644-624, maio-ago. 2018. tab, ilus
Article in Portuguese | LILACS (Americas), INDEXPSI | ID: biblio-986357

ABSTRACT

A assistência ao parto passou por importantes transformações nos últimos séculos. Neste processo, o modelo tecnocrático tornou-se hegemônico, promovendo uma atitude passiva nas mulheres. Evidências mostram, entretanto, que em trabalho de parto a mulher é tomada por estados incomuns de consciência, conhecidos como partolândia, que a tornam ativamente apta ao efetivo trabalho de parto, e a uma experiência de vida positivamente marcante. Objetivou-se discutir como a emergência desses estados potencializa melhores desfechos de parto e promove o crescimento pessoal da mulher. Assim, realizou-se reflexão teórica baseada no modelo integral de Wilber, na teoria do território de nascimento de Fahy, levando em conta os modos contemporâneos de assistência ao parto (Davies-Floyd), e uma visão arquetípica de transformação feminina (Nogueira). A partolândia apresenta-se enquanto modificação na percepção de espaço e tempo, emocionalidade e intuição aguçadas, insights psíquicos, revivescência de traumas etc. Conhecer os estados de consciência da mulher no parto, e os meandros do território de nascimento no qual emergem, pode auxiliar na assistência à parturição, além de viabilizar transformações que impliquem em desenvolvimento psicológico para a mulher.(AU)


Childbirth care has undergone major transformations in recent centuries. In this process, the technocratic model became hegemonic, promoting a passive attitude in women. Evidence shows, however, that in labor the woman is taken by unusual states of consciousness, known as partolândia, which makes her actively fit for effective labor and a positively marked life experience. The objective was to discuss how the emergence of these states enhances better delivery outcomes and promotes women's personal growth. Thus, theoretical reflection based on Wilber's integral model, Fahy's birth territory theory, taking into account contemporary modes of childbirth care (Davies-Floyd), and an archetypal vision of female transformation (Nogueira). Partolândia presents itself as a modification in the perception of space and time, sharpened emotionality and intuition, psychic insights, revives of traumas etc. Knowing the states of consciousness of the woman in childbirth, and the meanders of the territory of birth in which they emerge, can help in the parturition assistance, besides making viable transformations that imply in psychological development for the woman.(AU)


La asistencia al parto ha pasado por importantes cambios en los últimos siglos. En este proceso, el modelo tecnocrático se volvió hegemónico, promoviendo una actitud pasiva en las mujeres. Las evidencias muestran, sin embargo, que en trabajo de parto la mujer es tomada por estados inusuales de conciencia, conocidos como partolandia, que la hace activamente apta al efectivo trabajo de parto, ya una experiencia de vida positivamente marcante. Se objetivó discutir cómo la emergencia de esos estados potencializa mejores resultados de parto y promueve el crecimiento personal de la mujer. Así, se realizó una reflexión teórica basada en el modelo integral de Wilber, en la teoría del territorio de nacimiento de Fahy, teniendo en cuenta los modos contemporáneos de asistencia al parto (Davies-Floyd), y una visión arquetípica de transformación femenina (Nogueira). La partolandia se presenta como modificación en la percepción de espacio y tiempo, emocionalidad e intuición agudas, insights psíquicos, revivescencia de traumas, etc. Conocer los estados de conciencia mujer en el parto, y las complejidades del territorio de nacimiento en el que emergen, pueden ayudar en la asistencia al parto, así como proporcionar las transformaciones que resultan en el desarrollo psicológico para las mujeres.(AU)


Subject(s)
Humans , Female , Labor, Obstetric/psychology , Power, Psychological , Consciousness , Spirituality , Midwifery
20.
Rev. chil. neuropsicol. (En línea) ; 13(1): 11-16, ago. 2018. ilus
Article in Spanish | LILACS (Americas) | ID: biblio-1097782

ABSTRACT

Desde la etapa neonatal, la detección temprana de marcadores conductuales de alteraciones sutiles en el neurodesarrollo, es un campo todavía en crecimiento. El objetivo de esta revisión es describir los mecanismos que subyacen a la conducta del neonato durante la aplicación de la subescala de habituación que forma parte de la Neonatal Behavioral Assessment Scale (NBAS), con especial énfasis en la vía visual. Se destacan el papel de la habituación y la regulación de los estados de conciencia como los mecanismos fundamentales durante el primer estímulo y del segundo al décimo estímulo, en dicha escala. Estos procesos representan una capacidad fundamental para la adaptación del recién nacido y se discuten sus posibles implicaciones en el desempeño cognitivo posterior.


Since the neonatal stage, early detection of behavioral markers of subtle impairments in neurodevelopment is a field still under growth. The objective of this review is to describe the mechanisms underlying neonatal behavior during the habituation scale of NBAS, that emphasizes the visual pathway. The role of habituation and the regulation of behavioral states are highlighted during the first stimuli and the second to ten stimuli, during performance of NBAS. Those processes represent a fundamental capacity for newborns´ adaptation and are discussed in line to later cognitive performance.


Subject(s)
Humans , Animals , Infant, Newborn , Child Development/physiology , Consciousness/physiology , Behavior Observation Techniques , Habituation, Psychophysiologic
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