Psychomotor Stress Research Articles

Training model for control of an internal carotid artery injury during transsphenoidal surgery.

As the adoption of endoscopic endonasal approaches (EEA) continues to proliferate, increasing numbers of internal carotid artery (ICA) injuries are reported. The objective of this study was to develop a synthetic ICA injury-training model that could mimic this clinical scenario and be portable, repeatable, reproducible, and without risk of biological contamination. Based on computed tomography of a human head, we constructed a synthetic model using selective laser sintering with polyamide nylon and glass beads. Subsequently, the model was connected to a pulsatile pump using 6-mm silicon tubing. The pump maintains a pulsatile flow of an artificial blood-like fluid at a variable pressure to simulate heart beats. Volunteer surgeons with different levels of training and experience were provided simulation training sessions with the models. Pre- and posttraining questionnaires were completed by each of the participants. Pre- and posttraining questionnaires suggest that repeated simulation sessions improve the surgical skills and self-confidence of trainees. This ICA injury model is portable; reproducible; and avoids ethical, biohazard, religious, and legal problems associated with cadaveric models. A synthetic ICA injury model for EEA allows recurring training that may improve the surgeon's ability to maintain endoscopic visualization, control catastrophic bleeding, decrease psychomotor stress, and develop effective team strategies to achieve hemostasis. NA Laryngoscope, 127:38-43, 2017.

The Effect of Co-occurring Substance Use on Gamma-hydroxybutyric Acid Withdrawal Syndrome.

Gamma-hydroxybutyric acid (GHB) withdrawal is a complex syndrome which can be potentially life-threatening. Additionally, GHB-dependent patients frequently report co-occurring substance use of other psychoactive drugs. We assessed the add-on effect of co-use on GHB withdrawal symptoms. We conducted an open-label, pretest-posttest design study with 95 patients selected from 229 inpatients admitted for detoxification, who were divided into GHB only (GO, n = 40), GHB plus sedatives (GSE, n = 38), and GHB plus stimulants (GST, n = 17) groups. GHB withdrawal was evaluated by means of the Subjective Withdrawal Scale. Co-use add-on effects on the severity of withdrawal symptoms were evaluated 2.5 hours after the last illicit GHB self-administration (T1) when withdrawal was expected and 2.5 hours later, after administration of a very low dose of pharmaceutical GHB (T2). The GO group reported high scores of psychomotor retardation symptoms at both T1 and T2, and also high cravings, agitation, and restlessness at T1, and anxiety at T2. The GSE group reported the highest score in psycho-autonomic distress symptoms at both T1 and T2, whereas the GST group reported the highest score in psycho-motor stress factor at T2. There was no significant difference in withdrawal intensity in all symptom clusters between T1 and T2 for both GSE and GO groups. However, after 5 hours, the GST group reported significant decreases in intensity for all symptoms except for psycho-motor stress. At T1, GST and GSE groups reported more muscle twitches than the GO group as a significant add-on effect to the GHB withdrawal. At T2, the GST group experienced more agitation (P = 0.009), restlessness (P = 0.001), and rapid pulse (P = 0.034) than the GO group. Co-use, especially of stimulants, caused an add-on effect on the GHB withdrawal symptoms within the first 5 hours.

The Autonomic Regulation of Heart Rate of Athletes with Different Levels of Sensor Motor Response

With increasing sports qualification of Athletes, the speed of visual response is increased in order of the magnitude. In the competition conditions, the manifestation of neural and psychomotor abilities of athletes depends on the functional state of the organisms. The main physiological adaptation to sport activity is the requirements to psycho physiological functions and to the heart rate regulation system. The aim was to study the features of autonomic regulation of heart rate of athletes with different levels of sensory-motor response. 24 elite athletes (Greco-Roman Wrestlers) were examined. The age of the athletes was 20-25. The peculiarities of sensory-motor response were studied on individual-typological characteristics of nervous system. The autonomic regulation of the heart rhythm was performed using cardio monitor «Polar-S800» with the registration of the spectral characteristics of heart rate. The results show that the growth rate of sensory-motor response of elite athletes is accompanied by psychomotor stress, which leads to the stability of visual reaction. The rate of sensory-motor response has communication with the tension of regulation of heart rate at the expense of parasympathetic tone, which is consistent with a decrease in the duration and frequency of the oscillations cardio intervals of athletes with high speed of sensory-motor response. The presence of a stochastic organization of the functional system of regulation of heart rate in athletes with high speed sensory-motor response reflects the ability of an athlete to adapt to the intense muscular activity.

Anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette.

During cranial base surgery, use of a high-speed drill for osteotomy has become common. We performed anterior clinoidectomy and opening of the internal auditory canal using an ultrasonic bone curette, and we report the advantages and clinical applications of this method. The ultrasonic surgical equipment comprises a power supply unit, footswitch, and handpiece (weight, 110 g; diameter, 20 mm; length, 140 mm from tip to angled section). The handpiece tip is 2 mm wide, and the amplitude of longitudinal vibration can be varied from 120 to 365 microm at an ultrasonic frequency of 25 kHz. Cool-controlled irrigation fluid emerges near the tip, through the sheath. We performed anterior clinoidectomy in eight cases of paraclinoid aneurysm and opening of the internal auditory canal in six cases of acoustic neuroma without damage to the dura mater or nearby structures such as brain tissue, blood vessels, and cranial nerves. In addition, no damage to the facial nerve or labyrinthine organ resulted from heat or vibration caused by the ultrasonic bone curette. Ultrasonic bone curettage represents safe instrumentation for performance of anterior clinoidectomy and opening of the internal auditory canal without damage to surrounding structures. This technique allows surgeons to perform procedures on deep areas without incurring psychomotor stress.

Hemodynamics before and after physical endurance training in patients with myocardial infarction under various physical and psychomotor stress tests.

This hemodynamic study was done in 23 post myocardial infarction patients. The peripheral and central hemodynamics were examined by repeated ergometer tests, heart volume estimations, and heart catheterizations under various provocative techniques such as dynamic bicycle ergometer load, static hand grip load, volume load, atrial pacing, and psychomotor stress. After a 5-week period of endurance training we found a marked and statistically significant increase (40%) of maximal work tolerance and a significant decrease (10%) in heart rate and atrial blood pressure at rest and on equal levels of work load. No significant influence was seen on central (pulmonary) pressure readings at rest or on equal levels of work load beside the higher venous oxygen extraction. These peripheral effects of physical training were seen for all provocative tests, and also for those which were not trained as static and volume load and psychomotor stress.

Excretion of adrenaline and noradrenaline in human subjects.

The pressor substance in normal human urine demonstrated by Holtz et al. (1) was considered by them to be a mixture of adrenaline, noradrenaline and hydroxytyramine. A few years later Von Euler ect al. (2, 3) succeeded in separating all three amines from urine extracts by the use of chromatographic techniques. In a preceding paper (4) we reported observations regarding the nature of the adrenaline and noradrenaline in normal human urine. The present report concerns experiments which were conducted to determine the excretion of adrenaline (A) and noradrenaline (NA): 1) in sleep and in waking states; 2) after the infusion of A and NA into an adrenalectomized subject; 3) after psychomotor stress, operating the Hoagland-Werthessen pursuitmeter (5) under normal and hypoxic conditions; and 4) after the administration of ACTH.

VARIATIONS IN WHITE BLOOD CELLS FOLLOWING THE ORAL ADMINISTRATION OF GLUCOSE TO DIABETICS AND NONDIABETICS*

INTRODUCTION IN 1944, Dougherty and White (1) reported that the administration of adrenocorticotropic hormone (ACTH) or the 11-oxygenated corticosteroids resulted in a diminution in the number of circulating lymphocytes in mice, rats and rabbits. Recently, Forsham et al. (2) have reported similar results following the administration of ACTH to 100 patients and normal subjects. This was accompanied by an increased renal excretion of sodium, chloride, potassium, uric acid, and 17-ketosteroids. The maximum effect appeared four hours after the hormone was administered. Long (3) and Selye (4) have postulated that exposure to stress, through the mediation of the pituitary, results in increased adrenal cortical secretion. Pincus and his collaborators (5, 6, 7) have demonstrated that the exposure of normal human subjects to stress (e.g. increased temperature and psychomotor stress) causes a decrease in the number of circulating lymphocytes and an increased excretion of urinary 17-ketosteroids. The same workers re...

THE LYMPHOCYTE RESPONSE TO HEAT STRESS IN NORMAL AND PSYCHOTIC SUBJECTS

IN ACCOMPANYING papers report is made of the diurnal rhythm of lymphocytosis (3) and of lymphocyte responses to psychomotor stress (5). In this paper we present data on the concentration of circulating lymphocytes found before and after exposures to heat and high humidity. SUBJECTS AND METHODS Eleven healthy men ranging in age from 24 to 51 years were the control subjects and twenty-one psychotic subjects represented the patients. With four exceptions (Subjects 12, 13, 14, 15, Table 1) the patients had been admitted to the Worcester State Hospital within the previous six months and were chiefly men discharged from the military services. At 1:30 p.m. for three successive days samples of blood were taken from the lobe of an ear of each subject as indicated in the previous paper. Then, ordinarily in groups of six in any one week, they entered unclothed a hot room, maintained at from 40.5° C. (105° F.) to 44.0°C. (112° F.) and at 85% to 95% relative humidity.