The effects of a chiropractic upper cervical adjustment on the autonomic nervous system and cardiovascular system

M.Tech.This study was conducted to determine whether Chiropractic Spinal Adjustment Therapy (SAT) of the upper cervical spine has an effect on the normal physiological reactions that take place in the Autonomic Nervous System and Cardiovascular System whilst using the Electrocardiogram as a monitoring device. This area within Chiropractic research calls for further studies to be conducted. One hundred and twenty normotensive participants between the ages of 18 and 30 years were recruited to partake in the study via an advertisement placed in and around the University of Johannesburg Doornfontein Campus (Appendix A). Participants were assessed for exclusion criteria by completing a Full Case History (Appendix B), Pertinent Physical Examination (Appendix C), Cervical Spine Regional Examination (Appendix D) and a S.O.A.P. note (Appendix E). Participants were excluded from the study if it was revealed that they have contra-indications to Chiropractic SAT (Appendix F). The participants demonstrating upper cervical spine dysfunction were treated with a Chiropractic upper cervical SAT (Appendix J) while they were monitored for 3 minutes before, during treatment and 3 minutes after treatment by means of the Electrocardiogram to monitor the cardiovascular response. Participants were asked to read and sign the Subject Information and Consent form (Appendix G). Participants were required to complete the Patient Biographical Information Sheet (Appendix H) and the Patient Questionnaire regarding treatment experience (Appendix I

Severe aortic regurgitation due to endocarditis in a horse

A 4-year-old Belgian Warmblood mare was presented because of fever, exercise intolerance, a loud diastolic cardiac murmur and a remarkable bounding pulsation that was palpable all over the body. This bounding pulsation appeared simultaneous with the cardiac contractions. Cardiac ultrasound revealed a vegetation on the aortic valve with severe aortic regurgitation and a second vegetation at the sinus of Valsalva. A reverse flow in the common carotid artery was present during diastole. Left heart catheterization showed left ventricular and aortic pressure curves characteristic of a rather acute development of the lesion. The strong bounding pulsation was caused by severe aortic regurgitation that resulted in a very wide pulse pressure with the occurrence of "Watson's water hammer pulse". Due to the grave prognosis, treatment was not attempted. Necropsy confirmed aortic valve endocarditis

Robotic simulators for tissue examination training with multimodal sensory feedback

Tissue examination by hand remains an essential technique in clinical practice. The effective application depends on skills in sensorimotor coordination, mainly involving haptic, visual, and auditory feedback. The skills clinicians have to learn can be as subtle as regulating finger pressure with breathing, choosing palpation action, monitoring involuntary facial and vocal expressions in response to palpation, and using pain expressions both as a source of information and as a constraint on physical examination. Patient simulators can provide a safe learning platform to novice physicians before trying real patients. This paper reviews state-of-the-art medical simulators for the training for the first time with a consideration of providing multimodal feedback to learn as many manual examination techniques as possible. The study summarizes current advances in tissue examination training devices simulating different medical conditions and providing different types of feedback modalities. Opportunities with the development of pain expression, tissue modeling, actuation, and sensing are also analyzed to support the future design of effective tissue examination simulators

Minimally Invasive Mitral Valve Surgery II: Surgical Technique and Postoperative Management.

Techniques for minimally invasive mitral valve repair and replacement continue to evolve. This expert opinion, the second of a 3-part series, outlines current best practices for nonrobotic, minimally invasive mitral valve procedures, and for postoperative care after minimally invasive mitral valve surgery