Ventilatory effects of pneumoperitoneum monitored with continuous spirometry

Inspiratory and expiratory tidal volume, peak and plateau airway pressure, compliance of the respiratory system, pressure-volume and flow-volume loops were monitored continuously and recorded in seven women undergoing laparoscopy with carbon dioxide insufflation to an intra-abdominal pressure of 1.6 kPa. All patients were anaesthetised using a total intravenous technique and a constant minute ventilation was maintained. Peak airway and plateau airway pressures increased by 50% and 81% respectively, whilst the compliance of the respiratory system decreased by 47% during the period of increased intra-abdominal pressure. Following release of the pneumoperitoneum, peak and plateau pressures remained elevated by 37% and 27% respectively, and the compliance was 86% of the pre-insufflation value. On-line monitoring of respiratory volumes, pressures and compliance may be helpful during general anaesthesia for laparoscopic procedures to avoid the potential harmful effects of increased airway pressures occurring with increased intra-abdominal pressure.Journal ArticleSCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Subjective cognitive complaints one year after ceasing adjuvant endocrine treatment for early-stage breast cancer

In the BIG 1-98 trial objective cognitive function improved in postmenopausal women 1 year after cessation of adjuvant endocrine therapy for breast cancer. This report evaluates changes in subjective cognitive function (SCF).Journal ArticleRandomized Controlled TrialResearch Support, N.I.H. ExtramuralResearch Support, Non-U.S. Gov'tSCOPUS: ar.jinfo:eu-repo/semantics/publishe

Working across species down on the farm: Howard S Liddell and the development of comparative psychopathology, c. 1923 to 1962

Seeking a scientific basis for understanding and treating mental illness, and inspired by the work of Ivan Pavlov, American physiologists, psychiatrists and psychologists in the 1920s turned to nonhuman animals. This paper examines how new constructs such as “experimental neurosis” emerged as tools to enable psychiatric comparison across species. From 1923 to 1962, the Cornell “Behavior Farm” was a leading interdisciplinary research center pioneering novel techniques to experimentally study nonhuman psychopathology. Led by the psychobiologist Howard Liddell, work at the Behavior Farm formed part of an ambitious program to develop new preventative and therapeutic techniques and bring psychiatry into closer relations with physiology and medicine. At the heart of Liddell’s activities were a range of nonhuman animals, including pigs, sheep, goats and dogs, each serving as a proxy for human patients. We examine how Pavlov’s conceptualization of ‘experimental neurosis’ was used by Liddell to facilitate comparison across species and communication between researchers and clinicians. Our close reading of his experimental system demonstrates how unexpected animal behaviors and emotions were transformed into experimental virtues. However, to successfully translate such behaviors from the animal laboratory into the field of human psychopathology, Liddell increasingly reached beyond, and, in effect, redefined, the Pavlovian method to make it compatible and compliant with an ethological approach to the animal laboratory. We show how the resultant Behavior Farm served as a productive “hybrid” place, containing elements of experiment and observation, laboratory and field. It was through the building of close and more naturalistic relationships with animals over extended periods of time, both normal and pathological, and within and outside of the experimental space, that Liddell could understand, manage, and make useful the myriad behavioral complexities that emerged from the life histories of experimental animals, the researchers who worked with them, and their shared relationships to the wider physical and social environments