Tolerance's improvement of flexible bronchoscopy by Ericksonian hypnosis: The BREATH study.

AIM: The aim of this study was to determine whether the use of Ericksonian hypnosis may allow an improvement of the tolerance of flexible bronchoscopy. METHODS: A comparative, two parallel-group, prospective, randomized monocentric clinical trial was conducted. After randomization, patients were divided into two groups: a standard group, in which bronchoscopy was performed according to the official French good practice guidelines and a study group, in which bronchoscopy was performed under hypnosis. RESULTS: Sixty-seven patients were included, 7 patients were excluded and 60 patients were randomized. No significant differences in age, gender, examination indication and duration were observed between both groups. Two patients of the standard group removed the endoscope by themselves, resulting in a premature termination of bronchoscopy and they were excluded from the statistical analysis. In the standard group, the levels of anxiety, cough, dyspnoea and pain increased during the examination and the addition of local anaesthesia was more often required. In the hypnosis group, levels of anxiety, cough, dyspnoea decreased, whereas only the level of pain increased. There was a statistic significative difference in favour of hypnosis for all the other variables. Moreover, the behaviour score was higher in the standard group: 19.5±14.5 versus 7.3±4.7 (P<0.001), indicating a better tolerance in the hypnosis group. In the standard group, 14 patients refused a new examination under the same conditions versus 7 in the hypnosis group, and 12 patients asked for general anaesthesia in case of a new examination versus 7 in the hypnosis group. CONCLUSION: This randomised control trial is the first to test the faisability and the potential usefulness of Ericksonian hypnosis during flexible bronchoscopy. Our results indicates an improvement of tolerance and a positive effect on all studied parameters except pain. This method could be widely offered to all patients undergoing flexible bronchoscopy.

Validation of experimental charge densities: refinement of the macrolide antibiotic roxithromycin.

Multipole refinements of larger organic molecules have so far been limited to a few exceptional cases. We report an investigation of the detailed experimental electron-density distribution (EDD) of roxithromycin, a macrolide antibiotic consisting of 134 atoms. Although the experimental multipole refinement on high-resolution synchrotron data converged smoothly, validation of the electron density by calculation of an `experiment minus invariom' difference density revealed conformational disorder of the H atoms. Hydrogen disorder is shown to affect the EDD, the electrostatic potential and atomic properties as defined by Bader's quantum theory of atoms in molecules. A procedure to obtain the electron density distribution in the presence of disorder is proposed.

Social structure and facultative mating systems of hoary marmots (Marmota caligata).

Mate-choice theory predicts different optimal mating systems depending on resource availability and habitat stability. Regions with limited resources are thought to promote monogamy. We tested predictions of monogamy in a social rodent, the hoary marmot (Marmota caligata), at the northern climatic extreme of its distribution. Mating systems, social structure and genetic relationships were investigated within and among neighbouring colonies of marmots within a 4 km(2) valley near Kluane National Park, Yukon, Canada, using 21 microsatellite loci. While both monogamous and polygynous populations of hoary marmots have been observed in the southern reaches of this species' range; northern populations of this species are thought to be predominantly monogamous. Contrary to previous studies, we did not find northern hoary marmot social groups to be predominantly monogamous; rather, the mating system seemed to be facultative, varying between monogamy and polygyny within, as well as among, social groups. These findings reveal that the mating systems within colonies of this species are more flexible than previously thought, potentially reflecting local variation in resource availability.