Early intervention for conversion disorder: neurologists and psychiatrists working together

Objective To evaluate the efficacy of an early multidisciplinary (neurology and psychiatry) intervention for conversion disorder (CD). Methods Consecutive patients newly diagnosed with CD from 2005 to 2007 were compared to a control group of newly diagnosed CD patients receiving usual care. At 3 years, a questionnaire evaluated self‐rated subjective outcome, symptom severity, SF‐36 scores, employment status and medical care use. Results Data from 12 cases (mean age 25.5 ± 8.2; 9 females) and 11 controls (mean age 34.7 ± 13.5; 10 females) showed that 83% of cases had a good subjective outcome (symptom improved or cured) when only 36% of controls had a good outcome (p < 0.05). Cases significantly improved their SF‐36 scores on subscales involving physical complaints compared to controls. A minority (20%) of cases reduced or ceased professional activity when 70% of controls did (p < 0.001). Only 16% of cases sought further medical advice for the initial symptom when 73% of controls did. Both groups accepted psychiatric referrals (83% of cases and 73% of controls) and found it beneficial. Conclusions Early intervention involving both neurologists and psychiatrists is effective for CD in alleviating physical complaints, reducing sick leave and health care us

Follicular DEAs for two-way tactile communication

Follicular structures in skin combine sensing and actuation in a soft and compliant continuous surface. We have developed a tactile display device inspired by this structure, using a Dielectric Elastomer Actuator (DEA). DEAs allow for combined sensing and actuation, making possible two-way tactile communication between the user and the device. The device can obtain tactile information about the environment, or a user touching it, and it can also present tactile information to the user. We characterise the sensing properties of the tactile display device, and perform classification of tactile stimuli. We demonstrate two-way tactile interaction between a user and the device

Early intervention for conversion disorder: neurologists and psychiatrists working together.

To evaluate the efficacy of an early multidisciplinary (neurology and psychiatry) intervention for conversion disorder (CD). Consecutive patients newly diagnosed with CD from 2005 to 2007 were compared to a control group of newly diagnosed CD patients receiving usual care. At 3 years, a questionnaire evaluated self-rated subjective outcome, symptom severity, SF-36 scores, employment status and medical care use. Data from 12 cases (mean age 25.5 ± 8.2; 9 females) and 11 controls (mean age 34.7 ± 13.5; 10 females) showed that 83% of cases had a good subjective outcome (symptom improved or cured) when only 36% of controls had a good outcome (p &lt; 0.05). Cases significantly improved their SF-36 scores on subscales involving physical complaints compared to controls. A minority (20%) of cases reduced or ceased professional activity when 70% of controls did (p &lt; 0.001). Only 16% of cases sought further medical advice for the initial symptom when 73% of controls did. Both groups accepted psychiatric referrals (83% of cases and 73% of controls) and found it beneficial. Early intervention involving both neurologists and psychiatrists is effective for CD in alleviating physical complaints, reducing sick leave and health care use

Extravasation of albumin after cardiopulmonary bypass in newborns.

OBJECTIVE: The systemic inflammatory response to cardiopulmonary bypass (CPB) possibly increases microvascular permeability to plasma proteins, leading to capillary leak syndrome. The study was conducted to elucidate any protein leakage in newborns using Evans blue dye as tracer. DESIGN: Prospective controlled study. SETTING: University-affiliated heart center. PARTICIPANTS: Eleven neonates with transposition of the great arteries. INTERVENTIONS: Plasma interleukin-6 (IL-6), IL-10, fractional escape rate (FER) of an intravenous bolus of Evans blue, and colloid osmotic pressure (COP) were assessed before and after surgery (statistics: median and 25th-75th percentile, Friedman's 2-way analysis of variance, and Wilcoxon matched-pairs signed-rank test [before and after surgery]). MEASUREMENTS AND MAIN RESULTS: All patients had an uneventful intraoperative course. The demographic and operative data were age 11 (10-13) days, body weight 3.2 (3.0-3.3) kg, CPB time 132 (123-144) minutes, and aortic cross-clamp time 66 (64-78) minutes. The proinflammatory IL-6 increased 60-fold and the anti-inflammatory IL-10 only 3-fold after CPB. FER, however, was not changed, whereas COP was significantly reduced after CPB. CONCLUSIONS: In contrast to the expectation, the escape rate of Evans blue, reflecting the extravasation of albumin, was not increased after CPB. However, reduced COP, hypothermia, and also a reduced lymphatic drainage may contribute to edema formation. The present data do not support the hypothesis of a capillary leak after CPB in newborns