Altered Dopamine and Serotonin Metabolism in Motorically Asymptomatic R6/2 Mice

The pattern of cerebral dopamine (DA) abnormalities in Huntington disease (HD) is complex, as reflected by the variable clinical benefit of both DA antagonists and agonists in treating HD symptoms. In addition, little is known about serotonin metabolism despite the early occurrence of anxiety and depression in HD. Post-mortem enzymatic changes are likely to interfere with the in vivo profile of biogenic amines. Hence, in order to reliably characterize the regional and chronological profile of brain neurotransmitters in a HD mouse model, we used a microwave fixation system that preserves in vivo concentrations of dopaminergic and serotoninergic amines. DA was decreased in the striatum of R6/2 mice at 8 and 12 weeks of age while DA metabolites, 3-methoxytyramine and homovanillic acid, were already significantly reduced in 4-week-old motorically asymptomatic R6/2 mice. In the striatum, hippocampus and frontal cortex of 4, 8 and 12-week-old R6/2 mice, serotonin and its metabolite 5-hydroxyindoleacetic acid were significantly decreased in association with a decreased turnover of serotonin. In addition, automated high-resolution behavioural analyses displayed stress-like behaviours such as jumping and grooming and altered spatial learning in R6/2 mice at age 4 and 6 weeks respectively. Therefore, we describe the earliest alterations of DA and serotonin metabolism in a HD murine model. Our findings likely underpin the neuropsychological symptoms at time of disease onset in HD

Different strokes for different folks: the rich diversity of animal models of focal cerebral ischemia

No single animal model is able to encompass all of the variables known to affect human ischemic stroke. This review highlights the major strengths and weaknesses of the most commonly used animal models of acute ischemic stroke in the context of matching model and experimental aim. Particular emphasis is placed on the relationships between outcome and underlying vascular variability, physiologic control, and use of models of comorbidity. The aim is to provide, for novice and expert alike, an overview of the key controllable determinants of experimental stroke outcome to help ensure the most effective application of animal models to translational research

Implementation of chain of survival initiatives to improve pre-hospital return of spontaneous circulation rates

Batt, AM ORCiD: 0000-0001-6473-5397To evaluate adherence to the chain of survival and its effects on Return of Spontaneous Circulation (ROSC), the interventions performed and outcomes of resuscitation attempts were reported to the Pan-Asian Resuscitation Outcomes Study (PAROS). PAROS is a collaborative research group, which through the creation of a platform helps support and stimulate research into effective strategies to improve survival rates from cardiac arrest

Preparing for the worst : National Ambulance and the 2014 Ebola Virus epidemic

Background: Ebola virus disease (EVD) is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. It is a type of viral haemorrhagic fever (VHF). The 2014 Ebola outbreak in West Africa is the largest the world has ever seen, and the first Ebola epidemic in history. As of April 15th 2015, there have been a total of 25,826 suspected, probable, and confirmed cases, with 10,704 deaths (41% mortality rate).1 National Ambulance Response: National Ambulance LLC implemented a variety of procedural, educational and engineering controls designed to protect clinical staff from harm and provide safer patient care. This included the provision of a high-risk personal protective equipment (PPE) training programme, a trained observer programme, and increased PPE supply to clinical staff. National Ambulance staff also began screening of passengers on West African flights in Abu Dhabi International Airport in November 2014 to identify potentially infected persons. Key point: Conformance with Centre for Disease Control recommendations regarding personal protective equipment, screening of potentially infected patients and management of suspected cases of EVD was a key component in National Ambulance’s response to the threat posed by the epidemic. Conclusion: The current outbreak of EVD in West Africa has challenged many healthcare systems, including ambulance services, across the globe. No case of Ebola has been detected in the United Arab Emirates to date. Through a process of continuous updating, meeting international best practice recommendations and education delivery, National Ambulance staff are prepared to deal safely and effectively with patients presenting References: 1. Centre for Disease Control (2015) 2014 Ebola Outbreak in West Africa - Case Counts. Available at: http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/case-counts.htm

Proof of concept of video laryngoscopy intubation: Potential utility in the pre-hospital environment by Emergency Medical Technicians

We sought to evaluate this equipment to determine whether in the hands of novice providers this equipment could prove an effective airway management adjunct

Implementation of chain of survival initiatives to improve pre-hospital return of spontaneous circulation rates

To evaluate adherence to the chain of survival and its effects on Return of Spontaneous Circulation (ROSC), the interventions performed and outcomes of resuscitation attempts were reported to the Pan-Asian Resuscitation Outcomes Study (PAROS). PAROS is a collaborative research group, which through the creation of a platform helps support and stimulate research into effective strategies to improve survival rates from cardiac arrest

Impact of a pain management education intervention for prehospital care providers

Background & Introduction: Under-treatment of pain in the prehospital setting is a common occurrence [1]. Routine clinical audit identified an inadequate level of analgesia administration to medical and trauma patients reporting pain on a Numeric Rating Scale (NRS; 0-10 scale). Anecdotal evidence from informal discussion with clinical staff revealed this was primarily due to an education gap existing. We sought to address this clinical deficiency through a proven method of a targeted educational intervention (EI). [2, 3] Methods: Thirty clinical staff participated in an eight-hour pain management EI facilitated by two experienced Clinical Educators. Pre- and post-course surveys were provided to participants. Participation was anonymous and voluntary. The EI consisted of didactic lectures addressing the physiological response to pain, pharmacological and non-pharmacological analgesia options, documentation of analgesia and scenario-based simulated clinical cases requiring application of clinical knowledge to patient care. Results: Post-EI, participants reported their understanding of the physiological process of pain as having improved. Participants also declared an improved knowledge of pharmacological and non-pharmacological pain relief options. Ability to calculate medication dosages was also reported as improved. Subsequent clinical audit displayed an improved level of appropriate analgesia administration to patients reporting pain as per NRS in the one-month period following the EI. Conclusion: A targeted EI addressing deficiencies identified by a rigorous clinical audit process resulted in improved baseline knowledge, improved psychomotor skills, and subsequent improved clinical management of pain. These results suggest both initial and ongoing continuing education addressing pain management is of benefit to prehospital care providers