#neurosurgery is more on the physiological side but

[dolyx]

(whitney it's ur turn on the blender.)

[lenvitz7]

The Key Advantages of Using Lateral Position Gel Pads in Neurosurgery

As is well known, there is a great importance of patient positioning in neurosurgery for the procedure and its safety. Lateral position gel pads are now considered an important product for positioning needs, especially for patients requiring a lateral or side lying position. All these gel pads are advantageous in many ways to achieve both the comfort of the patient and accuracy of procedure to be conducted. In this paper, we discuss how lateral position gel pads have advantages in neurosurgical procedures specifically in relation to patient positioning, pressure management, and maintaining surgical stability.

1. Enhanced Patient Comfort and Safety

The primary benefit of utilizing lateral position gel pads is reduce pain experienced by the patient and overall increase patient safety. Most neurosurgical operations may be time consuming and patients may maintain position for a long time. Some of the traditional positioning methods many times put pressure on particular areas of the body and it becomes uncomfortable or even painful. Lateral position gel pads help to distribute the weight of the patient so as to minimize any chance of development of pressure sores or nerve injuries. These pads are soft and come with contour shapes that guarantee that patients do not have to feel uncomfortable during prosthetic surgeries and more especially when the surgery takes a long time into consideration, skin breakdown becomes a huge issue.

2. Improved Surgical Access and Precision

The position is often used in neurosurgical operations including occipital or frontal area operations that are hard to implement when the patient is lying flat. With the help of lateral position gel pads used by the surgical team, the correct positioning is obtained and maintained throughout the procedure causing minimum interference with the patient’s comfort. These pads provide good support and balance, factors that enable any surgeon to be precise in his work. The pads assist in maintaining the physiologic position of the patient, especially when moving the body in a specific direction during surgery is unwanted.

3. Compatibility with Head Rings and Other Positioning Equipment

An important aspect of neurosurgery is immobilizing the patient’s head; More often a head ring is used. Lateral position gel pads are used in combination with the head rings and most other types of patient positioning accessories. These pads when coupled with a head ring ensure that the head of the patient stays in place hence reducing incidence of movement.

4. Reduction of Pressure Injuries

Pressure injuries including bedsores pose serious risk when patients are positioned laterally for long periods of time. Lateral position gel pads reduce this risk by allowing equal distribution of pressure on all parts of a patient’s body. These pads come with features that ensure that such a patient assumes the conforming shape thus relieving pressures commonly felt at certain regions such as shoulders, hips and knees respectively. This is relevant where the position of the patient might not change for instance in neurosurgery operations, and pressure relief can reduce chances of Entwicklung, which might prolong a patient’s stay or affect efficacy of the surgery.

5. Easy to Use and Clean

Lateral position gel pads are not only useful but are also very convenient to apply. They can be easily positioned and put in the right place for they do not require constant readjustment or lose their position often. Moreover, these pads are usually easy to clean/sterilize; the operating environment remains hygienic since the pads are easily replaced with clean ones. This way, the agents can be reused severally in performing several procedures thereby minimizing the expenses on procedures without compromising quality.

Conclusion

Lateral position gel pads are one of the most valuable tools in neurosurgical practice. They afford support, improve the exposure to the operative site, and may be applied in conjunction with head rings and other positioning apparatuses. Thanks to their efficacy at minimizing risk injuries and enhancing the general stability of a patient, these pads have a major input in the area of safety and sterility of surgery. Thus, sitting in neurosurgery with the increases in the demands on the specialists, the function of Patient Positioning Gel pads in the optimization of the positioning of patients stays significant.

[lupinepublishers-ojnbd]

Lupine Publishers| Sleep is for Life: an Essential Part of Everyday Life

Lupine Publishers| Journal of Neurology and Brain Disorders

Abstract

Sleep is essential for basic survival as well as for optimal physical and cognitive performance in both human beings and animals. Sleep is a normal human function that is detrimental to sustaining life yet; individuals are affected differently by their sleep schedule. However, the community at large often underestimates sleep and its importance, therefore leading people to not be as concerned with a proper night’s sleep, thereby preventing them from performing at peak efficiency. Sleep plays a vital role in learning and when a person fails to obtain enough sleep the night prior, neurons in the brain might not fire properly, the body becomes out of synch, and it can even lead to accidental physical injuries. As many studies have been conducted, the majority have seemed to come to similar conclusions: a lack of sleep can have detrimental side effects on the human mind and body and by regularly obtaining enough sleep each night; a person can function more efficiently.

Introduction

Go to

Sleep is one of the great unsolved mysteries of biology. Actually a large part of the population spends one third of his life asleep, it is therefore not surprising that this phenomenon has always been a great fascination for humanity. It is an important physiological process responsible for the physical, mental and emotional health of a living being. A good sleep is one of the most satisfying human experiences with a role to play in maintaining a good mood and cognitive acuity as well as in promoting physiologic balance and resilience [1]. Sleep is a regular physiological state of natural life and is observed in majority of organisms [2]. Sleep is a naturally persistent reversible state of rest state characterized by reduced or absence of consciousness, suspended sensory activity, and inactivity of voluntary muscles. Sleep is a heightened anabolic state, accentuating the growth and rejuvenation of the immune, nervous, skeletal and muscular systems [3]. It is generated by complex but specific brain neuronal circuitry and heavily influenced by various factors such as biological rhythms, hormonal changes and environmental factors [4,5]. Sleep is an essential element of the human condition, which allows us to perform critical daily functions at peak optimization when obtaining in the correct amount. Sleep is important because it has a determining role in mental and physical health, along with quality of life [6,7]. Sleep, a complex phenomenon, is not merely the result of physical fatigue or decrease in activity; instead it is a complicated behavioural state requiring the integration of several neuronal processes [8].

Sleep Stages

Sleep is a reversible, physiological state with reduced motility. It is subdivided into REM sleep (rapid eye movement sleep, paradoxical sleep, active sleep, D sleep or deep sleep, REMS), and NREM sleep (SWS or slow wave sleep, non-REM sleep, NREMS). REMS is characterized by muscle atonia, activation of several brain areas, including the cortex and physically occurring eye movements, muscle twitches and changes in pulse rate, blood pressure and respiration. NREMS is characterized by body rest [9].

Functions of Sleep

Sleep is a global state, the control mechanisms of which are manifested at every level of biological organization: from genes and intracellular mechanisms to networks of cell populations, and to all central neuronal systems that control movement, arousal, autonomic functions, behaviour and cognition [10]. Sleep boosts up the immune functions has a role in brain maturation and helps in energy conservation. [11,12].Sleep contributes to memory consolidation possibly by enhancing synaptic plasticity [13]. Xie and colleagues reported that during sleep, waste products of brain metabolism are removed from the interstitial space among brain cells where they accumulate this is due to change in the brain’s extracellular space between sleep and waking states [14]. In sleep, metabolic rates decrease and reactive oxygen species generation is reduced allowing restorative processes to take over. It is theorized that sleep helps facilitate the synthesis of molecules that help repair and protect the brain from these harmful elements generated during waking [15].

Though sleep is essential for life, it is difficult to enumerate its functions. Sleep is needed to regenerate certain parts of the body, mainly the brain, so that it may continue to function optimally. One of the important functions of sleep is to promote synaptic plasticity and neuronal recovery for proper brain functioning. Memory consolidation, brain growth and repair are other functions proposed for sleep [16,17]. Various Behavioural and electrophysiological studies have revealed that sleep plays a crucial role in long-term memory storage [18].

It is stated that sleep is essential for restoration and recovery. Energy conservation is one function that is proposed for sleep. It is thought that sleep may help the body conserve energy and other resources that the immune system needs to mount an attack on diseases. Sleep may help to discharge emotions through dreaming [17]. Many experiments have shown that we retain newly acquired knowledge or a newly learned skill more effectively the day after a good night’s sleep and because the hippocampus is known to be heavily involved in encoding memories, REM sleep may thus contribute to learning and memory [19]. The amygdala– hippocampus–medial prefrontal cortex network involved in emotional processing, fear memory and valence consolidation shows strongest activity during REM sleep [20].

Summary

Although sleep occupies approximately a third of the human lifespan, the amount of time humans spend awake has increased over the years. Many neurological diseases from Alzheimer’s to stroke and dementia are associated with sleep disturbances. Lack of sleep could have a causal role, by allowing the byproducts to build up and cause brain damage. Sleep is one of the important needs like oxygen and nutrition for survival. Sleep is a basic drive of nature. Sufficient sleep helps us think more clearly, complete complex tasks better and more consistently and enjoy everyday life more fully. “You probably develop damage if you don’t get your sleep.”

“Sleep that knits up the ravelled sleave of care, The death of each day’s life, sore labour’s bath, Balm of hurt minds, great Nature’s second course, Chief nourisher in life’s feast.”

For more Lupine Publishers Open Access Journals Please visit our website: https://lupinepublishers.us/

For more Open Access Journal of Neurology & Neurosurgery articles Please Click Here:

https://lupinepublishers.com/neurology-brain-disorders-journal/

[literaturepublisher]

Case reports in Neuroscience

Journal of clinical Images and Case Reports journal (CICRJ) of Clinical Neuroscience distributes articles on clinical neurosurgery or nervous system science and the related neurosciences, for example, neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The Journal mainly focus on publication of major clinical and lab inquire about, just as distributing requested original copies on explicit subjects from specialists, case reports and other data important to clinicians working in the clinical neurosciences

Neuroscience is the part of inside medication, which deals the analysis, treatment of scatters identified with nervous system. Such research incorporate both central and peripheral nervous system. Neuroscience is the research of the nervous system that manages physiology, life structures, working, and clutters of the system. It examines about the demonstrative strategies, instruments, and cure for sicknesses including the central and peripheral nervous system. Case reports in Neuroscience has a long history of transmitting significant clinical data across numerous ages for the improvement of patient care Case reports in Neuroscience contribute a lot to the doctor's information base from which treatment theories and thoughts structure.

 Nervous system science research can be both fundamental researches just as applied research. Essential Neurology includes improving comprehension of the working of the nervous system at the tissue or cell level, and recognizing explicit qualities or proteins implicated in neurological illnesses. Applied Neurology is planned for creating and refining cures for neurological scatters. Case reports offer exceptional incentive to the body of medical information by depicting new diseases, illness instruments, therapeutic methodologies, and adverse or useful impacts of medications. The demonstration of recording, talking about with associates, and distributing clinical perceptions as case reports stays basic to the specialty of medication and patient care. Components of an advance case report, as introduced in the case reports rules, incorporate the theoretical, presentation, case introduction, conversation, end, patient's point of view, and assent articulation. The areas are described here, just as the utilization of Case reports rules to a published case report in neuroscience

In giving details by description of the side effects, signs, analysis, treatment, and follow-up of an individual patient, Case reports in Neuroscience reflect clinical experience and support clinical advancement. By structure, the organization needs factual testing, putting it at the base of the chain of clinical proof. Case reports in Neuroscience do include controls, have restricted example size (one to a couple of people), and are unblinded, constraints that require a cautious approach to interpretation of discoveries. The doctors, who has some expertise in the field of nervous system science are called neurologist.

Submit your Case Reports in Neuroscience via Online Submission at: http://www.literaturepublishers.org/submit.html

Or as an e-mail attachment to the Editorial Office at E-mail id: editor.cicrj@literaturepublishers.org

For More Details Visit: http://www.literaturepublishers.org/journal/case-reports-in-neuroscience.html

[scifigeneration]

2018 Nobel Prize in Physiology or Medicine: a turning point in the war on cancer

by Duane Mitchell

James P. Allison and Tasuku Honjo win the 2018 Nobel Prize in Physiology or Medicine for their foundational work on cancer immunotherapy. The University of Texas MD Anderson Cancer Center and Kyoto University, CC BY-SA

There are moments in the history of scientific achievement that benchmark the end of an era and the beginning of a new phase of reality for mankind.

The significance of these inflection points is sometimes readily apparent. NASA astronaut Neil Armstrong’s first step onto the surface of the moon on July 20, 1969, marked a new phase of space exploration. Other advances take many years for the historical significance to manifest, with an impact that appreciates over decades. That was the case with the development of the mechanized clock of the 15th century and the invention of the telephone in 1876.

Attempts to rid people of their cancer burden date back to 1600 B.C. when the disease was first recognized. But the idea of using a patient’s own immune system to eliminate aggressive cancers is more recent. Nobel laureate Paul Ehrlich first postulated that the immune system might control tumors more than 120 years ago. Since then, researchers have tried to boost the immune system to wipe out cancers.

This week, the 2018 Nobel Prize in Physiology or Medicine was awarded to James P. Allison and Tasuku Honjo for discoveries that have led to new medicines that activate the immune system and drive it to fight cancers. These therapies can defeat even the deadliest malignancies.

Allison and Honjo have revolutionized our understanding of how the immune system recognizes tumor cells and have created a paradigm shift in clinical oncology that will likely alter how we treat cancer for the foreseeable future.

Standard weapons for fighting cancer

Nobel winner James Allison talks about the impact of his invention.

To date, our best tools for treating aggressive cancers that have spread beyond the range of curative surgery have been radiation therapy and systemic chemotherapy agents.

For the most part these treatments kill rapidly dividing tumor cells by damaging their DNA or disrupting other essential cellular processes. This has led to most of the significant treatment advances we have achieved in terms of long-term survival in patients with advanced cancers.

I believe that soon cancer immunotherapy will equal, or rival, the impact of radiation and chemotherapy for patients diagnosed with cancer.

To understand the significance of Allison and Honjo’s discoveries, one must appreciate researchers have been trying to rally a powerful immune response against tumor cells for the past century. Prior to Allison and Honjo’s work, researchers believed that aggressive cancers grew unchecked because the immune response was too weak. The consensus was that if one could stimulate the immune system, it would respond and destroy the invasive tumor cells.

Immune checkpoints

Allison and Honjo, however, made a critical leap when they characterized two very important and potent pathways – called “immune checkpoints” – that can shut down the immune response. These pathways inhibit T cells – white blood cells that are charged with destroying virus-infected cells and tumor cells – and prevent them from “seeing” and attacking the tumor.

Allison and Honjo identified and characterized two different proteins, called CTLA-4 and PD-1, respectively, that sit on the surface of T-cells. When these proteins interact with matching proteins on tumor cells or other immune cells – the way a key fits a lock – the T-cells fall into “sleep mode” and don’t attack the tumor.

In many patients with cancer, these CTLA-4 and PD-1 pathways shut down anti-tumor immune activity. Without immune surveillance, the tumors grow and spread. This meant that our early attempts to activate the immune system were like trying to drive a car with the brake pedal pressed to the floor. No matter how we tried, or stepped on the gas, the brakes thwarted any progress.

But Allison and Honjo’s research led to the development of a new type of drug: monoclonal antibodies that block the regulatory pathways controlled by CTLA-4 and PD-1. These drugs, called immune checkpoint inhibitors, basically attach to the CTLA-4 and PD-1 proteins and prevent them from switching off the T-cells. These new antibody-drugs have led to dramatic tumor regressions. The results are so impressive that the FDA has approved their use for a variety of advanced cancers such as: metastatic melanoma, lung cancer, kidney cancer, bladder cancer, head and neck cancers, and other tumors.

Antibodies that block PD-1 and CTLA-4, called immune checkpoint inhibitors, are used in cancer immunotherapy to block signals from tumor cells and other regulatory cells. This activates the immune system and leads to an increase in T cells which then kill tumor cells. Lan Hoang-Minh, Ph.D., University of Florida Brain Tumor Immunotherapy Program, CC BY-SA

A new arsenal of checkpoint inhibitor drugs

The excitement surrounding cancer immunotherapy is due, in no small part, to the fact that these new medicines are revolutionizing how we treat advanced malignancies in which chemotherapy, surgery and radiation have failed. Furthermore, cancer immunotherapy has already become the preferred first option treatment for some cases of metastastic melanoma, the deadliest form of skin cancer. It is currently being evaluated as the first line option over traditional chemotherapy in other cancers.

CTLA-4 and PD-1 represent only the first two well-characterized immune checkpoints among an expanding list of targets that have been identified on immune cells and are believed important for modulating T-cell tumor fighting.

There are more than a dozen immune checkpoint inhibitors that have already entered clinical development and there are endless possibilities for combining these new inhibitors with those that have already been shown to improve clinical responses in treated patients.

See how the immune system destroys tumor cells with cancer immunotherapy therapy.

The risks of unleashing the immune system

Although immune therapy is a breakthrough, it is not without risks to the patient. Taking the brakes off of the immune system can trigger undesirable and in some cases deadly consequences for patients treated with drugs. The killing power of the immune system is tightly regulated to protect normal cells from attacks that can damage critical tissues. Removing the brakes with immune checkpoint inhibitors can cause damaging inflammation in the skin, gut, heart, lungs and other vital organs. These risks can add up when these potent inhibitors are combined. And, the long-term side effects of immune checkpoint inhibition are not fully understood.

While the clinical responses to these treatments can be dramatic, long-term tumor regressions are achieved only in a minority (usually less than 20 to 30 percent depending on the tumor type) of treated patients. Also, the use of the PD-1 and CTLA-4 checkpoint inhibitors has not proven effective against all tumor types. In our own studies of malignant brain tumors, my colleagues and I have identified unique properties that make them resistant to immunotherapy and have begun to identify strategies for overcoming this treatment resistance.

Thus, we have much still to learn and significant room for improvement in order to maximize the benefits of immunotherapy for all patients. Nonetheless, we have definitively entered a new era of clinical medicine with an accelerated progress in oncology treatments.

More than one in three individuals will be diagnosed with cancer during their lifetime. Despite our continued advances in cancer prevention and early detection, a significant proportion of these individuals will be faced with advanced disease. With continued rapid progress building on Allison’s and Honjo’s pioneering discoveries, it is increasingly likely that a patient’s own immune system will prove the most effective strategy and final defense against an advancing and relentless malignancy.

About The Author:

Duane Mitchell is Professor of Neurosurgery at the University of Florida

This article is republished from our content  partner, The Conversation, under a Creative Commons license. 

[tarryloesinne]

OMNITRANYL - 13. Old Friend

Charmcaster extends her arms upward and tries to stretch the muscles of her spine. A pop is heard from one of the vertebrae. Now it is the turn of the neck. She rotates her head from side to side. Two more snaps. Sitting in her chair for hours, studying one book after the other, made her muscles tense after a while.

She looked at the old clock stuck on the wall. It's so late already! She almost misses dinner.

The sorceress got up from her chair and headed for one of the corridors formed by the bookshelves. Every six meters, a space appeared between one bookcase and another, forming a new corridor that cut through all the others. And it was while passing through one of these intersections that she saw her archenemy.

Gwendolin was standing in front of a huge bookcase. Behind her, two stacks of books floated, waiting to be read or re-read. Another three books lay open, levitating in front of the young woman's face. She looked up to the top shelf of one bookcase and pointed to a book with a green cover. The object moved from its position and joined the other floating open books.

Charmcaster stopped looking at the teenager, with the disinterest of someone who gives up watching a TV show, and continued walking between the bookshelves to the back of the library ― restricted to authorized personnel only ― in search of her dinner.

◇───────◇───────◇

The sorceress had always been in the habit of going to bed late. Many times, because she was wrapped up in her studies and in the knowledge that her uncle's library could offer her, she ended up going to bed a few hours before the sun woke up. Several times she only went to bed because her body practically forced her to.

He also had the habit of checking all the library's security systems before lowering his guard for activities that expose such fragility as sleeping. He checked the two alarms, the three magical protective barriers, the time clamp and the lock on the front door. It may seem like overkill for all this energy and equipment used in protecting a place like a library, but the presence of the lock made all the difference.

Everything being in place, Charmcaster headed down the upper corridor towards her room. With a mug of hot chocolate in hand, she blew the smoke that came out and drank it in small gulps to test the temperature. From the parapet of the corridor, it was possible to observe the many bookshelves that spread out like a great labyrinth. And in the middle of it, Gwen, standing, reading five books at the same time. The stacks of books that followed her were now three in number.

Go to sleep, girl, and get the hell out of my library! she thought. And she made her way to her room, taking slightly bigger sips of her chocolate.

◇───────◇───────◇

As soon as she woke up from the little sleep she had managed to get, Charmcaster went towards the common area of the library. Her hope: to prove to herself that this story of determination was bullshit and that sooner or later, everyone had to give up at some point.

But no...

Gwen stood in front of the bookshelves, with five stacks floating behind her and two more open books in front of her. The young woman used her right index finger to follow the reading through the pages, being careful not to get too close and end up crossing the object.

How! thought Charmcaster.

How does she manage to stay out of her body for so long?

For what?

For whom?

◇───────◇───────◇

Charmcaster didn't even pretend to herself anymore.

Every half hour, she would go to her arch-nemesis and check if she was still there, always taking care not to be seen. And even if she wanted to be seen, I don't think she could get Gwen out of her almost absolute concentration.

On one of the occasions ― it would be maybe the fourth or fifth, I had already lost count ― the Charmcaster focused her attention on the books that accompanied her: Human Anatomy; Charms of Rurquart; Physiology; Surgical Magic; Neuroanatomy; The Tharkiniol; Neurosurgery; How to invade the mind and convince people to obey you in 47 illustrated steps; Psychobiology; The Scientific and Magical Basis of Sleep...

Suddenly, Charmcaster began to notice that Gwen's image started to fade slightly. He looked at the girl's face and saw her eyelids begin to make a progressive falling motion, like a ball dropping and bouncing on the floor. She was beginning to doze off!

She looked around for something that might catch Gwen's attention, make some noise, whatever! Then she realized that she was surrounded by books. Charmcaster picked up a thick hardcover and threw it hard to the floor. The noise echoed throughout the library.

Gwen was startled. Her heart raced and, above all, her astral image returned to the definition it had been before.

Charmcaster took the book in hand and strode down the corridor, beside Gwen, with a look of disdain. When she realized that she was being followed by the young woman's gaze, she turned and said:

"What's wrong girl? The book just fell out when I went to pick it up." And she continued walking with the young woman's confused look following her.

Why the hell did I justify myself to her! he thought.

◇───────◇───────◇

Gwen looked away from the open books and watched Charmcaster approach, walking down the corridor with her staff in one hand. When she was at a sufficient distance for a polite handshake, she stopped.

Standing still and silent, she remained so for a few seconds.

Gwen, not understanding anything, just stared at her. Would she kick her out of the library again?

"Here," said Charmcaster. In her hand was a blue-covered book with the word Somnus in silver letters.

"You know I can't touch it," replied Gwen.

Charmcaster let go of the book, which floated away, and stood in front of Gwen.

"Maybe it will help you with what you're looking for."

Gwen pointed to the book, which opened, and the pages flipped with the invisible help of the library. On the pages were exactly what she had been looking for all this time.

"For the Ebhardy civilization," said Charmcaster, "coma is seen not only as a consequence of neurological damage, but is sometimes the way the person's mind finds to force the individual to deal with his fears, anxieties and afflictions."

The young woman lifted her gaze from the pages and said smiling:

"Thank you, Charmcaster."

"If you say that again, I'll kill you."

"One question: how did you know that this is what I was looking for?"

The Sorceress bangs her staff on the floor. A violet light fills the room, forcing Gwen out of her spell.

When she opened her eyes, she was back in the Medical Ward companion chair. In front of her, Ben was still unconscious, hooked up to various devices. In his lap, the sorceress' blue book.

Gwen felt tired, but at the same time, something was taking over her being and made her forget the tiredness, at least for the moment.

"Hope", an old friend who had not appeared for some time.

[crimsonpublishers-neurosurgery]

Deep Brain Stimulation in Parkinson’s Disease_Crimson Publishers

Deep Brain Stimulation in Parkinson’s Disease by Amit Kumar Ghosh in  Techniques in Neurosurgery & Neurology

https://crimsonpublishers.com/tnn/fulltext/TNN.000548.php

Deep brain stimulation (DBS) is an universally accepted therapy for medically refractory Parkinson’s disease (PD). Both globus pallidus internus (GPi) and subthalamic nucleus (STN) stimulation are effective in improving the symptoms of PD and reducing dyskinesias. STN DBS is the most commonly performed operation for PD as compared to GPi DBS. Ventral intermediate nucleus (Vim) DBS is used occasionally in selected cases as an alternative for tremor predominant PD patients.

Patient selection is very much essential in achieving good outcomes. Good response to levodopa challenge is most important predictor of favourable long-term outcomes. The DBS surgery is typically performed in an awake state and involves stereotactic frame application, CT/MRI imaging, anatomical targeting, electrophysiological confirmation and intra-operative clinical monitoring for efficacy and adverse effects after intra-operative stimulation and implantation of the DBS lead and pulse generator.

Anatomical targeting consists of direct visualization of the target and anterior and posterior commissure in MR images, reformatting with stereotactic atlases, CT-MRI fusion, getting the entry point and trajectory from the computer-based software and accordingly getting the frame co-ordinates.

Physiological verification is achieved by microelectrode recording followed by implantation of the DBS lead and intraoperative test stimulation to assess benefits and side effects. The various aspects of DBS surgery will be discussed.

For more open access journals in Crimson Publishers please click on link: https://crimsonpublishers.com/

For more articles in Journal of Neurosurgery please click on link: https://crimsonpublishers.com/tnn/

[zenruption]

Carving Career in Medical Field - 3 Emerging Branches

According to the statistics, it is expected that global healthcare spending is going to reach over 10 trillion dollars by the next year. The healthcare industry is more than direct patient care as it also involves healthcare support options. Either, you choose to be a doctor or a specialist handling the technical part of things, it is indeed very rewarding. It certainly feels very satisfying to be able to care for the sick and help them to get better. In any form, a job in the medical sector means a lifelong dedication towards giving excellent care. For a career in the healthcare industry, there are many jobs that you can go for. With time the medical industry has made remarkable improvements. And this has resulted in many new employment fields which are worth considering for having a good career. This article is about 3 career paths that can help you if you have been looking for a life in the medical field. Radio Therapy Modern times are witnessing more and more cancer cases every day which is now fueling the demand for more professionals in this field. Radio Therapy deals with high-energy radiations to affect the DNA of cancer cells thus stopping them from reproducing further. This helps to kill and destroy their ability to actively spread cancer further in the body. Radiation Therapy helps to cure about half of such cases and relieve or alleviate other symptoms and pain in the rest. The field is emerging at a fast rate as it helps to retain the normal and healthy cells while just targeting the precise cancer cells. Thus minimizing side effects and other damages. Neuro Surgery This field of emergency medicine has expanded a lot as compared to the older times. Like other fields, neurosurgery has also benefited greatly from the advent of technology. New methods and gadgets have made it easier for professionals to ensure better and foolproof treatment plans. The CT scans and modern devices are much more advanced and developed now. This has resulted in taking a lot of pressure off the physicians in manual accuracy and effectiveness. This is a big reason why medical students are now feeling more encouraged to get into this stream. What’s more, given the awareness it is garnering, there are medical scholarships available for worthy students. As the experts from The Ferrari Foundation Site opine, students looking to dedicate their lives for the betterment of differently abled patients with neurological disorders are driving newer studies. Thus, bringing about the advancements and the changes in the career prospects. Biomedical Engineering This area of expertise is frequently hailed as “the engineering field of the future”. This interdisciplinary science includes biological and medical sciences with knowledge about mechanical, electronic, chemical, and computer engineering. This study further helps a person to be aware of the intricacies involved in Bioinstrumentation, Biomaterials, Biomechanics, Clinical Engineering, Systems Physiology, and Rehabilitation Engineering. This field is growing rapidly as Biomedical Engineers are responsible to design and develop devices, software, and procedures used in healthcare. They also conduct research to assure quality and solve clinical problems. The Sum Up Every day, there are great innovations and discoveries being made in the medical sciences. Unlike the previous times, there are several other new genres that can aid a person to realize their dreams in this field. Thus we are hopeful that this article helps you to choose your subject according to your choice.

[cadledelhi]

Best Hair Loss Treatment in South Delhi

What is PRPPlatelet-rich plasma (PRP) is concentrated blood plasma which contains approximately three to five times the number of platelets found in normal circulating blood. In addition to the platelets, it contains growth factors and other bioactive proteins that aid in wound healing and hair growth.

If you are looking for the best hair loss treatment in Delhi or baldness treatment in Delhi then you are at the right place as we offer hair restoration services like hair transplant and PRP.

At Pulastya’s Cadle, we have been performing PRP therapy as a proactive therapeutic option for male and female patients experiencing hair loss. PRP is an exciting non-surgical therapeutic option for patients who require stimulation of hair growth for hair loss conditions.

Recent scientific research and technology provide the medical community with new understandings of wound and tissue healing. As a result of these scientific studies, we recognize PRP is an all-natural autologous medical procedure performed in physicians’ offices for scalp, skin, and hair stimulation.

HOW DOES PRP WORK?

Human blood contains mesenchymal stem cells and autologous blood products that contain essential and specific growth factors that assist in tissue regeneration and healing. Published medical literature from Europe and the United States confirms the safety and use of PRP therapy. It has been used a medial adjunct therapy for over two decades for skin and wound healing.

PRP therapy has established itself to be effective as a medical treatment modality in the specialty fields of oral surgery, neurosurgery, plastic and cosmetic surgery, sports medicine and orthopedics. It has been used extensively in these specialties for the last twenty years with generally positive outcomes and success. In the field of hair restoration, evidence supports PRP therapy as a promising treatment option to promote hair growth. While PRP is in the early stages of scientific research in hair restoration, PRP is not meant to replace current FDA approved therapies such as DHT blockers and Minoxidil. But it is a promising non-surgical therapeutic option for those patients with hair loss.

HOW DO YOU PERFORM THE PROCEDURE?

Blood is drawn in our office as though you are having routine blood testing at your primary care physician’s office. The blood is spun in a centrifuge and the PRP is separated and removed from the rest of the blood.

The PRP is taken from your body and is specially prepared by spinning down the blood cells to a high concentration. Platelets are concentrated on 3X normal blood values. The system eliminates granulocytes which hurt tissue regeneration and wound healing. An anesthesia block is given to nerves of the scalp so the patient does not feel any pain. The highly concentrated platelet-rich plasma (PRP) is then injected into the scalp. The patient’s hair is then washed and the patient may drive home without any assistance. No sedation or any medication is given during the procedure to inhibit the ability to drive or use machinery.

ADVANTAGES OF PRP·

 A progressive non-surgical healing treatment in a variety of fields.

A fraction of autologous blood with a supraphysiological concentration of platelets and their associated growth factors. 

Upon activation, platelet-derived α granules release autologous growth factors involved in cell proliferation, angiogenesis, collagenases, and matrix remodeling (PDGF/ TGF/ VEGF/ EGF/ FGF/ IGF, etc.).

 Autologous (from the patient’s own blood).

 Easy to use, rapid and effective system.

Requires a small sample of blood (10ml).

Optimal Platelet Concentration for ALL specialties.

Biocompatible, and xeno-free, minimizing safety concerns and rejection.

Control of PRP volume by discarding PPP.

Increases platelet concentration.

Virtually eliminating granulocytes from the PRP, which are considered not beneficial in terms of the regeneration process and may contribute to a catabolic effect by secreting catabolic mediators, including metalloproteinases.

Eliminating undesired erythrocytes, which have been shown to significantly decrease fibroblast proliferation and augment apoptosis in vitro.

Remnant of mononuclear cells present in the PRP assists in fighting infection and is thought to enhance the anabolic effects of PRP.

PRP contains many growth factors that stimulate the hair follicle’s growth. PRP can be used preoperatively, intraoperatively, or postoperatively. Some patients chose to have PRP performed every three (3) to four· (4) Months as early data suggest regular or semiannual PRP treatments that may stimulate hair growth.

THE SCIENCE OF PRP

PRP contains special cells called Platelets, that can theoretically cause the growth of the hair follicles by stimulating the stem cells and other cells in the microenvironment of the hair follicle. These special Platelet cells promote healing, accelerates the rate and degree of tissue healing and regeneration, respond to injury, and formation of new cellular growth. The primary purpose of using PRP in hair restoration is to stimulate inactive or newly implanted hair follicles into an active growth phase.

Inside the Platelets are many intracellular structures such as glycogen, lysosomes, and alpha granules. These granules within the PRP contain clotting and growth factors that are eventually released during the healing and repair process.

PRP SPECIFIC CELLS THAT CAUSES HAIR GROWTH INCLUDE:

Platelet-Derived Growth Factor (PDGF)—promotes blood vessel growth, cell replication, skin formation;

Transforming Growth-Factor-Beta (TGF-b)—promotes the growth of matrix between cells, bone metabolism;

Vascular Endothelial Growth Factor (VEGF)—promotes blood vessel formation.

Epidermal Growth Factor (EGF)—promotes cell growth and differentiation, blood vessel formation, collagen formation;

Fibroblast Growth Factor-2 (FGF-2)—promotes the growth of specialized cells and blood vessel formation; and,

Insulin-Like Growth Factor - (IGF)—a regulator of normal physiology in nearly every type of cell in the body

DOES PRP WORK?

Individual results vary with each patient. No guarantees of success can be made but PRP preliminary studies indicate patients can respond to PRP therapy. Some hair restoration surgeons apply PRP to the scalp for those patients who are not surgical candidates every three (3) to four (4) months. Other protocols will use PRP before or during surgery to insure graft survivability.

PRP is a potential emerging non-surgical based therapy for natural hair follicle stimulation for thinning hair. Larger clinical studies are pending but the current medical literature contains numerous optimistic results. Although a few controlled studies exist, anecdotal and case reports are the primary sources reflecting success with PRP therapy.

WHO SHOULD NOT HAVE PRP TREATMENT?

Patients with a history of heavy smoking, drug, and alcohol use. Medical diagnoses such as platelet dysfunction syndromes, thrombocytopenia’s, hyperfibrinogenaemia, hemodynamic instability, sepsis, acute and chronic Infections, chronic liver disease, anti-coagulation therapy, chronic skin diseases or cancer, metabolic and systemic disorders.

IS PRP FOR ME?

PRP has been used successfully in other medical and surgical disciplines for many years. The decision to use PRP is a personal decision and should be made after careful research, consideration, and consultation with a physician. PRP is safe and natural because the procedure concentrates the good cells from your scalp and injects them directly back into the area where it is needed. There is absolutely no chance of getting a blood infection from another human being. PRP involves using your own cells that are not modified or changed, and it will not be rejected by your immune system.

Extensive clinical trials are not complete and medical data is not yet published to establish the absolute effectiveness of PRP therapy in hair restoration. PRP should not be considered a “cure” for hair loss and no guarantee can be made about its individual effectiveness. No claim of PRP efficacy in promoting hair growth can be made because there is no FDA approval that would allow such claims to be made.

CAN I USE OTHER MEDICAL THERAPIES CONCURRENTLY?

Absolutely. In fact, we encourage it and prescribe PRP therapy as a complement to a nonsurgical approach for those patients who are not eligible for surgery or who want to delay hair restoration surgery. As a non-surgical treatment option, we recommend PRP therapy along with Minoxidil and DHT blockers or for those patients who can not tolerate or have side effects with these medications.

CONCLUSION

In summary, PRP therapy offers the opportunity for hair growth for those patients who are not candidates for surgery or those patients wanting a more aggressive nonsurgical approach to treatment. For our surgical patients, PRP therapy is performed on the same day as the hair restoration surgery.

Whether you are looking for additional hair stimulation, or are looking to have hair surgery with the addition of PRP, our Hair Restoration center is able to meet your needs. Results will vary from patient to patient, and PRP as a non-surgical option has not been offers patients with miniaturization and hair thinning improvement in hair caliber and thickness. For more such blogs please vist- https://www.delhidermatologist.com/resource/

[xxprincessjewelsxx]

He’s Not A Toy (Leo Voodoo!au Fic) Chapter 4 -  Tricked

Warnings: None

Princess Note: Just to kinda give a better picture on the backdrop of this story it’s like a mix of old and new where there is technology, but a lot of things are still what you think of when you imagine a world witches and werewolves and such (like Harry Potter sorta thing...)

Moodboards that correlate to this chapter can be found here:  N//Leo//Ken//Ravi//Hongbin//Hyuk

Ch. 1, Ch. 2, Ch. 3, Ch. 4, Ch. 5, Ch. 6

“Scientists?” I questioned.

He gave a small nod and reached over and pulled out a picture of from the broken down end table. “This mansion used to belong to my family, but I didn’t have all the use for the space, so when we began our experiments we just made a few changes...”

I looked at the photo; all six men did not look how they did today. No rings pierced in their skin, no glass, men who were held to high standards by society and even higher by themselves....

“What were you studying?” I questioned.

“We were going to be studying different ways to help the human body withstand more punishment...werewolves, vamps, mermaids, fairies, and even witches can withstand a lot more than humans can and we were trying to find some way to help strengthen the human body...” he replied.

“For what? War? Or....” I started and he let out an amused chuckled.

“I don’t blame you for thinking that, most would,” he said, “And while what we were working on could be used for that...we were focusing it more on being able to strengthen the body to withstand drastic temperature changes so that it would be easier for humans to do studies in areas of extreme heat or cold, plus we were hoping that with something like this if we were able to strengthen the human body if it ever got a sick with something like cancer the meds that were given for that wouldn’t break down the body as fast.”

“And how were you planning on testing this?” I questioned.

“On ourselves....”

I was momentarily shocked. “You tested on yourselves?”

Leo winced as he stood and walked over to the fencing. “None of us were going to put anyone through what we weren’t willing to go through ourselves...we had everything going right for us too...” 

He stopped and I got up and went and I went and looked where he was looking at. Ravi was scribbling against the glass of his room, mind anywhere else than in that room at the moment.

“Ravi is a brilliant mathematician,” Leo said, “He sees the world in numbers...you, me, the room....everything. Him and Hyuk who is a chemist worked together on finding the solution to our little quest.”

“What about N?” I questioned.

“He was our team lead and he is our expert on anatomy and physiology...”

“Would explain the mannequins in his room...”

He let out a scoff. “Myeong’s sick twisted reminder of the scientific ones in the lab...”

“What did Ken do?” I questioned.

“He was a cardiologist...anytime that we did any tests he would monitor how our hearts were holding up,” he replied.

“And Hongbin?”

“We worked closely together along with a lab assistant who...unfortunately isn’t with us anymore....” he stopped for a second before shaking his head, “I’m a neurologist and Hongbin is a psychologist.”

“So you what...kept an eye on what was going on in the brain uh...physically? And he made sure you were all mentally stable?” I questioned.

“I made sure none of the chemicals or pain we were putting our bodies through were resulting in an injury to the brain, Ken to the heart, N to the body, and Hongbin to our emotional stability....” he said trying to sum it up, “And you could say that Ravi and Hyuk are the brain trust behind the experiment.”

“How did Myeong become involved in all of this?”

It suddenly got really quiet in the room. His eyes flickered to each of the other five men as he tried to bring himself to say something that he had probably been holding back for a really long time.

“We were tricked...” a deep voice said. Looking over Ravi had his forehead pressed against the glass of his room and he was looking straight at us. “We were tricked...just tell her Taekwoon!”

“Taekwoon?” I questioned.

He bit his lip before speaking. “My real name...is Jung Taekwoon, lead physician in the department of neurology and neurosurgery at the Asia branch of magical medical academy.” (Asia Magical Medical Academy - AMMA)

“The AMMA? Didn’t they notice one of their lead physicians was missing?” I questioned.

There was a sigh from the room next door and Ken looked at me with a sad expression. “The medical academy tends to lose interest in those who don’t offer up results...”

I looked back at Leo who still had this look of shame on his face. “The hadn’t heard from us in any way, shape, or form...so they dropped us...they don’t waist their time with those who don’t give them what they want...”

“This still doesn’t explain how you ended up in these cages...” I said.

He took a deep breath before leaning against the fencing. “We had three assistants working with us. One worked alongside myself and Hongbin...she was a werewolf. Another, a vampire...worked with Hyuk in the lab, and then human like us that did general paperwork for us....well unlike us those three did not live in the mansion, they had then occasional crash on the couch, but that was it. One day the girl who did our paperwork didn’t show...but instead another woman did and she said she was from the academy....”

“The academy didn’t call and tell me that you would be filling in...I’ve gotten a call in the past when we would have a fill in for someone,” Taekwoon said, sitting back in his large wing-backed chair, motioning for the young woman to take a seat as well.

“It was such last minute, that when I got there they handed me the letter and told me not to be late,” she said as she took a seat on the sofa, the emerald green of her cloak standing out on the dark leather, “I can fully understand if you would rather have someone else though...especially with it being such short notice, I don’t even know if I’m fully prepared for today.”

As she chuckled at herself Taekwoon sighed and looked out of the corner of his eye. In all honestly HE shouldn’t be the one making this decision, but Hakyeon was busy checking over Hongbin after this recent round of testing. So it was up to him to make a decision.

His mind was other places as well. His mind wasn’t on the fact that there was someone to fill in for their constantly absent office assistant, if you want to call her that, with as little work as she got done, and his mind also wasn’t on today’s testing agenda.

Today was his anniversary and as much as he tried to keep his eyes and hands to himself, every time Yuri walked in the lab with something he couldn’t help but get near her.

“Sir?”

He was snapped out of his ever wandering thought about what he was going to do when he got his girlfriend out of her lab coat, and looked at the woman who was still waiting for him to answer. “Um....you know what...you’re here and the academy sent you so might as well put you to work...” 

“It was my fault,” Leo finally after a few moments of silence, “I had my mind in other places the day she showed up at the mansion and I just let her in.”

“None of us saw past the facade she put on,” N said, “None of us knew until it was too late.”

“Yes and now you’re all my precious little toys,” Myeong’s voice rang around the room with laughter following, “Now that you’ve had your time out Y/N...time to be a good girl and go straight to your room. But no dinner for you tonight.”

The door to Leo’s room opened and he nudged me with his elbow. “Go...”

“Leo...”

“Go...”

I sighed and though hesitant, I headed towards the door. There was more laughter as I walked and I stopped. “What the hell is so funny?”

“I was just thinking that Leo might be right....” Myeong said before appearing in front of me. She grabbed me and spun me around so that I was facing him, her grip tight on my chin to force me to look at him. “I heard what you said right before you got knocked out, Leo...maybe she is a bit like dear sweet pathetic little Yuri.”

“You shut up!” Leo snapped.

“Yuri was so quick to catch on to who I was and that I didn’t come here on the orders of your precious AMMA,” Myeong said, “Tell me...you were so neck deep in my voodoo...did you hear her screams of pain? She fought hard you know...to save you...to save all of you; she fought in her wolf form like a true warrior of the Red Moon Pack...but she died a screaming pathetic mess of a human.”

“You shut up!” Leo yelled before charging.

“Uh uh,” Myeong said wagging her finger and throwing him back against the fencing.

Quickly reaching back I put my hands against Meyong’s sides. ‘Feachd Wave’ I thought, sending her flying back and away from me. Leo dropped to the floor and I looked at him. “Who is Yuri, and why is she taunting you with her?”

“Get out...” he said lowly.

“Leo,” I said, “I-”

“GET OUT AND DON’T COME BACK!” he yelled at me. I backed away from him and made my way towards the door. “Just don’t come back...” he whispered, holding his head in his hands as he sad there on the floor.

‘Yuri...he was in love with her....’

To be continued...

Feachd Wave - Force Wave

[juniperpublishers-oajnn-blog]

How Refractory is Super-Refractory Status Epilepticus- A Personal View!

Authored by  Riaz Ahmed Syed*

Abstract

Super-refractory status epilepticus is named for those continuous un-abated ,prolonged seizure activity, despite aggressive treatment including general anesthesia, lasting more than 24 hours. There is ongoing serious damage to the neuraxis, in such cases, if seizures continue, over longer time and the important issue in the management is to prevent the damage by interfering its activity, liberally in the initial stage of the seizures, itself. As the seizures prolong, structural as well molecular changes of the neurons could interfere in the management profile also, however aggressive, it could be.

Go to

Introduction

The word, super-refectory is coined recently in status epilepticus (SE) when the seizures continue unabated for a day or more, despite rigorous management , leading to subsequent neuronal injury, most of the times and even death [1]. The Super- Refractory Status Epilepeticus is a rare but not uncommon type of ongoing seizure activity and the exact pathophysiology is still not yet studied well. This type of seizure activity is commonly encountered in intensive care units but the exact frequency is not yet known. There were many retrospective studies in the recent past, revealing approximately 15% of cases admitted with status epilepticus, became refractory and Holktamp [2] reported 20% of his patients with SE had recurrence of ongoing SE after even general anesthesia was withdrawn and in some other studies nearly 50% of the those requiring anesthesia became super refractory in the various settings. In the ideal management protocol of SE, in staged approach, seizures of less than 30 minutes (early SE).

Benzodiazepines are administered by intravenous/rectal/intranasal/buccal and sometimes intramuscular routs, but the main aim is to rapidly abort the seizures by any means in order to arrest seizure propagation, further. In stage 2 seizure continuation (established SE), long acting anticonvulsants namely Phenytoin, sodium valproate and sometimes phenobarbitone are given by intravenous route and control is anticipated up to 2hrs. Beyond this period, if patient reaches stage 3 (refractory SE) within 120 mts, one should resort to general anesthesia, muscle relaxants to achieve burst suppression in EEG wherein seizures are aborted both by clinical but also by electrographic al methods. Many protocols have been laid down as algorithm flow charts in many centers , approved by international bodies and the main aim of such aggressive management is to abort the seizure propagation and avoid further neuronal damage [3].

Despite all these aggressive measures, then why some of the patients go on to develop resistance to treatment and become super refractory SE (24 hrs or more)? Although often encountered in patients with established epilepsy with underlying cryptogenic or secondary etiology (head trauma, infection, infarction, cerebral bleed) it is not uncommon to see this in previously healthy people also. Probably the normal physiological process that could terminate the seizure activity has failed in them, mostly the receptors of the axonal surface becoming externalized rather than internalization. In this process, there is considerable reduction in GABA receptors (inhibitory) and substantial increase in gluteminergic (excitatory) receptors.

Once the GABAnergic receptors levels are reduced the GABAnergic drugs (phenobarbitone, benzodiazepines) are likely to become ineffective in this ongoing process of seizure activity. Moreover, normal inhibitory GABA-A mediated currents in the external ionic milieu become excitatory with changes in extra cellular chloride concentrations. Besides, inflammatory cascade activation during ongoing seizure propagation, blood-barrier leakage leading to increase in extracellular potassium and mitochondrial failure with oxidative stress could also perpetuate the process of continued insult [4]. Additionally gene expression within few minutes of seizures and lack of synchrony of neuronal network could prevent seizure termination however aggressive the treatment is given. The underlying damage to the cerebral internal milieu is devastating with necrosis, gliosis and network reorganization, ultimately leading into cell death.

This is initiated first by excitotoxicity and further driven by gluteminergic receptor over-activity. Once the damage initiated, calcium influx into the cell triggers cascade of chemical reactions and lead to cell necrosis or apoptosis. This chain of events usually takes place after the continuation of the seizure process and lead to neuronal remodeling, activation of several molecular signal pathways to activate programmed cell death. As a result, in the long term histological structural changes namely neurogenesis, angiogenesis are seen. In order to prevent these irreversible events, aggressive management to the extent of general anesthesia to induce electrographic burst suppression is highly recommended and several neuro protective measures (barbiturate come, hypothermia, steroids, intravenous immunoglobulins, ketamine) are attempted to prevent sequel of excitotoxicity although the efficacy of later measures is unknown.

Go to

Discussion

The management of super refractory SE is very challenging and always managed in intensive care units with general anesthesia, endotracheal intubation and ventilation, cardio pulmonary monitoring. Maintaining the hemodynamic status is the main stay in the management portfolio as drugs used to control seizures at maximum doses would invariably give rise to hypotension, bradycardia and respiratory arrest. Midazolam infusion, thiopental, pentobarbital and propofol are preferred to induce deep sedation and burst suppression although there is low threshold for the later drug usage in many centers for children because of its potential lethal side effects (propofol infusion syndrome) [5].

Selection of the above medications depend upon the availability, personal experiences and acceptable limit of side effects. Midazolam is a safe medication as continuous infusion because of its strong and established anti-epileptic action but tachyphylaxis and rapid tolerance is the main disadvantage; as a result, seizure emerge in nearly 50% of the patients. Barbiturates infusion have been used conventionally in the past in SE and apart from its known anti epileptic action, hypothermia induced by this drug could be theoretically beneficial as neuro-protection. However, due to long half-life, the prolonged anesthetic effect even after the drug has been withdrawn may be a major problem of extubation. Ketamine, a NMDA receptor antagonist is used in some centers because of it least cardiac depressant effect and could be considered as second choice, if the anesthetic drugs fail.

What about anti epileptic drug armamentarium, apart from above? Many patients end up taking cocktail of several drugs namely carbamazepine, phenytoin, phenobarbitone, valproate, topiramate, levetiracetam, but there is no evidence that single drug is superior to other medications [6]. So it’s the choice for the treating neurologists to decide about the combinations as most of the times, theses patients are on polytherapy. However, it is recommended not to use more than two anti-epileptic medications with different mode of actions at higher doses and to avoid frequent and abrupt switch-over of the drugs. Magnesium sulfate infusion is a safe and least toxic medication and must be attempted in every patient with super refractory SE. what about steroids and immunomodulators? Recent evidence prove that inflammation play an important role in seizure propagation and moreover the recently evolved autoimmune encephalitis with increase in N methyl D aspartate antibody and status epilepticus, steroids or immunomodulators could only control seizure activity [7].

With this background, many centers use these medications, even inadvertently, in refractory SE with varying results. Other measures namely, ketogenic diet, hypothermia, electroconvulsive therapy are available and being tried as experimental modes of therapy with no conclusive evidence of its use. So in conclusion, super refractory SE is a grave situation in the stages of SE evolution with relatively high mortality and morbidity. Yet, there is no consensus opinion regarding effective management of this and one has to be aggressive and rational in the initial stages of treatment of SE and theoretically prevent patients progressing to this serious stage of SE. Treatable causes of SE must be identified early and managed appropriately. An acceptable treatment protocol and guidelines should be formulated in every center, agreed upon by the governing committee in concurrence with the neurologists and effectively treat the condition [8].

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Open Access Journal of Neurology & Neurosurgery in Full text in Juniper Publishers

https://juniperpublishers.com/oajnn/OAJNN.MS.ID.555589.php

[ruffoverthinksthings]

What would jane and carlos kids be like

Curious types, “thinkers” and “feelers,” probably as neurotic and nervous as their parents, if not more so, unless their parents have both managed to get over their respective psychological traumas and emotional problems, or rein them in to a level that their love and parenting skills shines through a lot more than their issues.

If going by the Disney trend of children becoming like their parents, a mix of both, or the complete opposite, their kids would likely be inventors like Carlos, future social workers like Jane, or creative and exploratory types, like:

Linus Santiago AKA “Linny” - Future neuroscientist with a specialization in discovering all the causes of psychological disorders, emotional issues, and mental biases from a physiological perspective, with the end goal of learning how to cure them through a variety of methods, such as that of hormone treatments curing imbalances, neurosurgery, and really, really, really good baked treats that could probably, literally cure some milder forms of depression (if only temporarily).

Alternately happy, chipper, and prone to skipping in delight, or on the verge of an emotional break down, panicked, and fits of running around screaming with his arms in the air, sobbing, and curling up into a ball on the floor, thanks to a mixture of EXTREMELY unique inherited biological/magical physiology that gives him a number of extreme anxieties, paranoid thoughts, and manic fits that swings on either end of the emotional scale.

The living embodiment of the warm, friendly smiling face with the one eye subtly twitching every few seconds. Honestly a Good person, just has a LOT of issues, but he’s “working on them, honest!”

Carmilla AKA “Carm,” “Pandora,” “Dora,” or “La-La” - Sarcastic, morbid, and proudly Goth, wears a pair of fake “Evil Fairy” horns, likes her clothes in different shades of black and red with a little copper-gold for visual interest, Will HURT YOU if any harm ever comes to her dog, Cerby. (Prounounced “Sir-bee”)

And yes, Cerby IS actually the spawn of Cerberus, the three-headed guardian of the gates of the Underworld, and she’ll have you know that her little (literal) hellhound is both housebroken and an absolute sweetheart, even if she does have the unfortunate habit of eating and/or chewing through anything, such as leather shoes, battleship grade steel, and raisins.

Out to prove to the world that you can be creepy and unnerving, sleep in a coffin, and write disturbing horror fiction as a hobby and eventual living while still being a Good person, driven largely by a desire to disprove the still existing stigma against VK’s while also scaring the crap out of people, which she enjoys greatly.

Also suffers from depression, self-confidence issues, and social anxiety, but she’s got other old friends alongside Darkness, don’t worry.

Parsley, Sage, Rosemary, and Thyme, AKA “The Four Fae of the Apocalypse” - Quadruplets, identified by the colour of the parts in their hair, 3/4 of one colour, 1/4 of another, and if put side-by-side in their exact birth order, gets you full heads of Brown, Red, Black, and White hair.

Artists, artisans, and creators, the four of them, with a focus on nature, be it in their paintings, their crafting, their clothing, or their music; four completely separate temperaments, coincidentally like the herbs they were named after; and all four of them whirling balls of chaos, destruction, and seemingly unlimited energy and enthusiasm, with the uncanny inability to see how their numerous plans, spells, and good intentions can go horribly, horribly, horribly wrong.

Basically the reason that Jane and Carlos both have grey/whiter hair than usual in their later years.

[cedarrrun]

Researchers are studying a myriad of powerful ways compassion practices can improve health and strengthen relationships. Here, we look at the latest findings so you can take a glimpse into what happens in your body and mind when you treat yourself and others with more care.

As a child, James Doty believed the world wasn’t a very kind place. He spent the summer before eighth grade riding his orange Schwinn Sting-Ray bicycle around his hometown of Lancaster, California. He’d saved his money from mowing lawns to buy the freedom to fiercely pedal away from the turbulent apartment he shared with his parents and brother.

His dad was struggling with alcohol addiction and frequently took off for days to weeks at a time, sometimes leaving the family without enough money for food. His mom was chronically depressed and rarely left her bed. When his dad was home, his parents argued constantly, leaving his mom in tears. Doty’s older brother was scrawny and bullied, which meant Doty got into a lot of fights in an effort to defend him. “I felt a lot of anger, despair, and shame,” Doty says. “I never knew what was going to happen next. Worse, I felt like somehow I deserved the situation I was in. ”

Then that summer, Doty met a woman who changed everything. She worked at a magic shop that he’d wandered into without any money. The woman behind the counter, Ruth, was so kind and warm that when she started asking Doty questions about his life, he answered truthfully. “This was rare for me, since I carried so much shame and fear of judgment,” he says.

“Self-compassion is a powerful built-in coping system we all have...”

Ruth told Doty that she could teach him a type of magic different from what the store sold—something that could change his life—if he’d come back to visit. So, he started riding to the shop every day. Ruth brought him lunch, and they’d sit in the shop’s office on metal chairs casually eating and talking. Doty opened up to her about how he perpetually worried about his mom and brother, and was angry with his father. In response, Ruth taught him how to meditate. She asked him to pay attention to what he was feeling in his body when he felt worried or angry or sad. She taught him a head-to-toe body-scanning exercise to help him deeply relax. She introduced him to breathwork, mantra, and self-affirmations such as: I am worthy, I am loved, I love myself, and I love others. And she taught him how to set intentions for the future.

See also 5 Ways To Practice Compassion—and Get Better at It

Most importantly, says Doty, Ruth taught him how to “open his heart” by concentrating on offering unconditional love to people in his life and to himself.

Doty, now 64, says the magic Ruth taught him was better than any card trick he could’ve cracked into his imaginary piggy bank to buy. “Ruth taught me true compassion,” he says, “and it not only changed how I interacted with the world, but also how the world interacted with me.”

It’s poetic to think about the special kind of magic Ruth taught Doty and how it sparked a new trajectory for the sad, scared, anxious little boy who walked into the shop that summer. Yet Doty, now a professor of neurosurgery and founder and director of the Center for Compassion and Altruism Research and Education at Stanford University, says there’s actual science behind the lessons Ruth imparted on him as a kid.

See also How to Cultivate Compassion

How Compassion Improves Your Health

In fact, there’s an emerging field of research that looks at how compassion and compassion training—often via meditation or self-affirmation practices—can improve health and strengthen social bonds. By using heart monitors, brain scans, blood tests, and psychological surveys, scientists are getting a window into what really happens in the human body and mind when we acknowledge suffering (our own or someone else’s) and approach it in a caring and loving way. Recent studies show that when people are compassionate, especially toward themselves, their heart-rate variability—the fluctuations in the timing between heartbeats—increases, which is linked to an improved ability to self-soothe when you’re stressed.

Consider this: A 2015 study published in the Journal of Traumatic Stress found that veterans who served in Iraq and Afghanistan who scored higher on a self-compassion scale were less likely to develop PTSD or commit suicide. Another study, published in 2016 by the American Diabetes Association, found that an eight-week self-compassion training for people with diabetes helped them stabilize their glucose levels. Countless other research has linked self-compassion to lower rates of depression, anxiety, and stress—and higher rates of happiness and improved immune function.

“Self-compassion is the earth into which the seeds of change can be planted...”

Think of self-compassion as a powerful, built-in coping mechanism we all have access to, says Kristin Neff, PhD, associate professor in the department of educational psychology at the University of Texas at Austin and co-author of The Mindful Self-Compassion Workbook. Neff has been studying the topic for more than a decade and developed the Self-Compassion Scale—a survey of questions that identifies whether someone rates high or low for self-compassion—which is commonly used in clinical studies. “There is a ton of research showing that whether you’re in combat or raising a special-needs child, dealing with cancer or going through a divorce, self-compassion gives you the strength to get through it,” she says. That’s because it has an effect on your physiology, says Doty: “When you practice compassion, such as through meditation, you stimulate your vagus nerve—which you can think of like a highway that sends messages to and from your brainstem and major organs, especially your heart.”

See also The Proven Healing Power of Compassion

The Link Between Compassion and Your Nervous System

The vagus nerve activates two key systems in the body that impact how you feel: the parasympathetic nervous system (a.k.a. what’s activated when you’re in rest-and-digest mode) and the sympathetic nervous system (your fight-flight-freeze mechanism). Compassion practices help you more readily turn on your parasympathetic nervous system. You become more calm and relaxed, and your brain functions at its best. Your blood pressure and heart rate go down, and your immune system gets more robust. On the flip side, when the sympathetic nervous system is engaged, blood pressure and heart rate increase. Your brain isn’t as sharp as usual, and stress hormones (like cortisol, epinephrine, and norepinephrine) as well as inflammatory proteins (which are associated with the onset of disease) are released into the bloodstream.

We evolved to toggle quickly between both systems, and high heart-rate variability is a sign that your parasympathetic nervous system is engaged, says Doty, who co-authored a 2017 paper published in Frontiers of Public Health recommending that heart-rate variability be used as a primary measure in studies and trainings in the field of compassion science. The good news, Doty says, is that when that toggling isn’t happening as it should, and you find yourself in fight-or-flight mode more often than not, compassion is one of the best ways to find your way back to health.

See also Compassion in Action

Softening Self-Criticism Can Lead to a Longer Life

While it’s great to know what’s happening physiologically when we show others and ourselves compassion (or don’t), it’s just as important to translate that learning into everyday life, says Neff. Take, for example, someone who is hard on herself. Chronic self-criticism engages the sympathetic nervous system, which isn’t up for the task of near-constant work.

“The sympathetic nervous system was designed to deal with physical threats, but now most of our threats are created in our minds,” says Neff. “It’s things like, ‘I’m not good enough.’ ” But by doing the opposite—by accepting and comforting ourselves, and tapping into the power of self-compassion—we can hold our pain and our brokenness in a kind and loving way, which de-activates the sympathetic nervous system and helps us heal.

Of course, coaching your inner voice to talk to yourself like you would to your best friend can be a tall task. It’s common for people to feel compassion for others yet lack the ability to show kindness to themselves, says Neff. However, here’s some motivation to change that: Improving self-compassion primes you to be more compassionate toward others. That’s because when you engage your parasympathetic nervous system (the one that helps you feel calm, relaxed, and safe) more often and effectively, you’ll be better able to show up in the world more present and kind.

See also These 6 Simple Exercises Can Help You Cultivate More Compassion For Yourself

It’s easier to do this than you might think. Doty and Neff both say the proof of this is in our hard-wired capacity to care and connect. “Mammals are born very immature,” says Neff. “It takes decades for parts of our brains to fully develop, so there had to be a biological system in place to help infants and children feel safe.” This is why we can be easily comforted by a kind, gentle tone of voice and can intuit people’s emotional states by reading their body language. It’s also why we sometimes mirror the behavior of others. “We’re attuned to respond to emotional states through facial expressions, intonation of voices, body language, and smells,” says Doty, “and we learn from and respond to these on a subconscious level.”

We can boost this innate attunement toward compassion and strengthen it within ourselves through practice. Research on how this is happening within the medical community is encouraging for both health-care professionals and their patients. One 2019 review in the journal BMC Medical Education found that medical students who underwent compassion training reported they were better able to manage work stress and had more positive interactions with patients. Another study published in the Journal of Clinical Oncology found that when hospital patients received just 40 seconds of a compassionate message, it lowered their anxiety. And according to a 2010 study in Health Services Research journal, patients who received compassionate care after a heart attack were at lower risk of dying within a year.

Academics studying this field are putting the results of research like this to work in their classrooms, too. Take Scott Plous, a professor of psychology at Wesleyan University, who ends his social psychology courses with what he calls “A Day of Compassion.” Plous challenges his students to focus on being compassionate for an entire day, then write about their experiences. Students commonly report that the exercise helps them to mend rifts with family members or leads them to reach out to neighbors.

See also 4 Ways to Practice Compassion in a Pinch

Regardless of how compassionate you tend to be, your yoga practice is likely to help bolster it. “One of the things that happens with yoga is we focus on the movement of our bodies or the movement of our breath, and we get out of our heads,” says Neff. “For a moment, we leave behind the storyline of our lives and what’s wrong with us. We use our bodies with intention and care and can actually be present with ourselves in a tender way. That’s self-compassion.”

After all, when you’re hypercritical of yourself, it’s easier to judge others. “If I’m not taking care of myself, then my relationships with others are a possible resentment waiting to happen,” says Aruni Nan Futuronsky, a life coach and faculty member at the Kripalu Center for Yoga and Health. “Self-compassion is the earth into which the seeds of change can be planted. Trying to change through force, will, and ego only work to a point. Through compassion, something greater than ourselves comes forth. We have a partner in life—call it grace, call it higher power, call it the wisdom of the body. We’re not alone. And change becomes sustainable.”

When Ruth asked Doty in 1968 what he wanted out of life, one of the first things he said was to be a doctor. She helped him to believe that it was possible for him to attend college and medical school. Today, he says the practices he learned from her are what keeps his breathing slow, his hands steady, and his body relaxed when he’s performing brain surgery. And these same practices are now embedded in the compassion trainings Doty teaches.

“Every day, each one of us has the capacity to change another person’s life through compassion,” Doty says. “When I was a young boy, Ruth told me, ‘Your heart is a compass, and it’s your greatest gift. If you are ever lost, just open it up, and it will steer you in the right direction.’ ” In teaching and studying compassion, Doty is doing his best to do just that—and to show others the magic, too.

See also Don't Be So Hard on Yourself! A Sequence to Practice Compassion

How to Practice Self-Compassion

Experts share their favorite, research-backed ways to cultivate more self-love.

Treat yourself like a friend

When you’re having a tough day or struggling with something, imagine a friend or close family member coming to you with the exact problem you’re dealing with. Ask yourself what you’d say to them. What tone of voice would you use? What would your body posture look like? Now apply your words, tone, and body language to yourself. “It will feel strange at first to say or think to yourself, ‘It’s OK; I’m here for you,’ but it starts to become habitual,” says Neff. “You stop constantly criticizing yourself and putting yourself down.”

Write a letter to your anxiety

When suffering starts to overwhelm you, Kripalu’s Futuronsky recommends that you create a dialogue with your overwhelm. For example, you might write something like, “Dear Aruni, I am your overwhelm. Let me tell you, this is way too much. I can’t do this. I’m terrified. What the hell is going to happen?” Then, write back. Something like, “Dear Overwhelm, Yep, I hear you. This is hard, and we’re going to just do one day at a time.” Research shows that letter writing can be particularly powerful. One study had participants write a self-compassionate letter to themselves every day for a week. The participants reported decreased depression levels for three months and increased happiness for six months.

Comfort yourself

Self-touch can release oxytocin and help us feel safe. Neff recommends experimenting with different techniques to see what feels most comforting: Try gently placing both hands over your heart, giving yourself a hug, cradling your face in your hands, or clasping your hands together so you’re holding your own hand.

See also 3 Tips & a Guided Meditation to Expand Your Self-Compassion

[krisiunicornio]

Researchers are studying a myriad of powerful ways compassion practices can improve health and strengthen relationships. Here, we look at the latest findings so you can take a glimpse into what happens in your body and mind when you treat yourself and others with more care.

As a child, James Doty believed the world wasn’t a very kind place. He spent the summer before eighth grade riding his orange Schwinn Sting-Ray bicycle around his hometown of Lancaster, California. He’d saved his money from mowing lawns to buy the freedom to fiercely pedal away from the turbulent apartment he shared with his parents and brother.

His dad was struggling with alcohol addiction and frequently took off for days to weeks at a time, sometimes leaving the family without enough money for food. His mom was chronically depressed and rarely left her bed. When his dad was home, his parents argued constantly, leaving his mom in tears. Doty’s older brother was scrawny and bullied, which meant Doty got into a lot of fights in an effort to defend him. “I felt a lot of anger, despair, and shame,” Doty says. “I never knew what was going to happen next. Worse, I felt like somehow I deserved the situation I was in. ”

Then that summer, Doty met a woman who changed everything. She worked at a magic shop that he’d wandered into without any money. The woman behind the counter, Ruth, was so kind and warm that when she started asking Doty questions about his life, he answered truthfully. “This was rare for me, since I carried so much shame and fear of judgment,” he says.

“Self-compassion is a powerful built-in coping system we all have...”

Ruth told Doty that she could teach him a type of magic different from what the store sold—something that could change his life—if he’d come back to visit. So, he started riding to the shop every day. Ruth brought him lunch, and they’d sit in the shop’s office on metal chairs casually eating and talking. Doty opened up to her about how he perpetually worried about his mom and brother, and was angry with his father. In response, Ruth taught him how to meditate. She asked him to pay attention to what he was feeling in his body when he felt worried or angry or sad. She taught him a head-to-toe body-scanning exercise to help him deeply relax. She introduced him to breathwork, mantra, and self-affirmations such as: I am worthy, I am loved, I love myself, and I love others. And she taught him how to set intentions for the future.

See also 5 Ways To Practice Compassion—and Get Better at It

Most importantly, says Doty, Ruth taught him how to “open his heart” by concentrating on offering unconditional love to people in his life and to himself.

Doty, now 64, says the magic Ruth taught him was better than any card trick he could’ve cracked into his imaginary piggy bank to buy. “Ruth taught me true compassion,” he says, “and it not only changed how I interacted with the world, but also how the world interacted with me.”

It’s poetic to think about the special kind of magic Ruth taught Doty and how it sparked a new trajectory for the sad, scared, anxious little boy who walked into the shop that summer. Yet Doty, now a professor of neurosurgery and founder and director of the Center for Compassion and Altruism Research and Education at Stanford University, says there’s actual science behind the lessons Ruth imparted on him as a kid.

See also How to Cultivate Compassion

How Compassion Improves Your Health

In fact, there’s an emerging field of research that looks at how compassion and compassion training—often via meditation or self-affirmation practices—can improve health and strengthen social bonds. By using heart monitors, brain scans, blood tests, and psychological surveys, scientists are getting a window into what really happens in the human body and mind when we acknowledge suffering (our own or someone else’s) and approach it in a caring and loving way. Recent studies show that when people are compassionate, especially toward themselves, their heart-rate variability—the fluctuations in the timing between heartbeats—increases, which is linked to an improved ability to self-soothe when you’re stressed.

Consider this: A 2015 study published in the Journal of Traumatic Stress found that veterans who served in Iraq and Afghanistan who scored higher on a self-compassion scale were less likely to develop PTSD or commit suicide. Another study, published in 2016 by the American Diabetes Association, found that an eight-week self-compassion training for people with diabetes helped them stabilize their glucose levels. Countless other research has linked self-compassion to lower rates of depression, anxiety, and stress—and higher rates of happiness and improved immune function.

“Self-compassion is the earth into which the seeds of change can be planted...”

Think of self-compassion as a powerful, built-in coping mechanism we all have access to, says Kristin Neff, PhD, associate professor in the department of educational psychology at the University of Texas at Austin and co-author of The Mindful Self-Compassion Workbook. Neff has been studying the topic for more than a decade and developed the Self-Compassion Scale—a survey of questions that identifies whether someone rates high or low for self-compassion—which is commonly used in clinical studies. “There is a ton of research showing that whether you’re in combat or raising a special-needs child, dealing with cancer or going through a divorce, self-compassion gives you the strength to get through it,” she says. That’s because it has an effect on your physiology, says Doty: “When you practice compassion, such as through meditation, you stimulate your vagus nerve—which you can think of like a highway that sends messages to and from your brainstem and major organs, especially your heart.”

See also The Proven Healing Power of Compassion

The Link Between Compassion and Your Nervous System

The vagus nerve activates two key systems in the body that impact how you feel: the parasympathetic nervous system (a.k.a. what’s activated when you’re in rest-and-digest mode) and the sympathetic nervous system (your fight-flight-freeze mechanism). Compassion practices help you more readily turn on your parasympathetic nervous system. You become more calm and relaxed, and your brain functions at its best. Your blood pressure and heart rate go down, and your immune system gets more robust. On the flip side, when the sympathetic nervous system is engaged, blood pressure and heart rate increase. Your brain isn’t as sharp as usual, and stress hormones (like cortisol, epinephrine, and norepinephrine) as well as inflammatory proteins (which are associated with the onset of disease) are released into the bloodstream.

We evolved to toggle quickly between both systems, and high heart-rate variability is a sign that your parasympathetic nervous system is engaged, says Doty, who co-authored a 2017 paper published in Frontiers of Public Health recommending that heart-rate variability be used as a primary measure in studies and trainings in the field of compassion science. The good news, Doty says, is that when that toggling isn’t happening as it should, and you find yourself in fight-or-flight mode more often than not, compassion is one of the best ways to find your way back to health.

See also Compassion in Action

Softening Self-Criticism Can Lead to a Longer Life

While it’s great to know what’s happening physiologically when we show others and ourselves compassion (or don’t), it’s just as important to translate that learning into everyday life, says Neff. Take, for example, someone who is hard on herself. Chronic self-criticism engages the sympathetic nervous system, which isn’t up for the task of near-constant work.

“The sympathetic nervous system was designed to deal with physical threats, but now most of our threats are created in our minds,” says Neff. “It’s things like, ‘I’m not good enough.’ ” But by doing the opposite—by accepting and comforting ourselves, and tapping into the power of self-compassion—we can hold our pain and our brokenness in a kind and loving way, which de-activates the sympathetic nervous system and helps us heal.

Of course, coaching your inner voice to talk to yourself like you would to your best friend can be a tall task. It’s common for people to feel compassion for others yet lack the ability to show kindness to themselves, says Neff. However, here’s some motivation to change that: Improving self-compassion primes you to be more compassionate toward others. That’s because when you engage your parasympathetic nervous system (the one that helps you feel calm, relaxed, and safe) more often and effectively, you’ll be better able to show up in the world more present and kind.

See also These 6 Simple Exercises Can Help You Cultivate More Compassion For Yourself

It’s easier to do this than you might think. Doty and Neff both say the proof of this is in our hard-wired capacity to care and connect. “Mammals are born very immature,” says Neff. “It takes decades for parts of our brains to fully develop, so there had to be a biological system in place to help infants and children feel safe.” This is why we can be easily comforted by a kind, gentle tone of voice and can intuit people’s emotional states by reading their body language. It’s also why we sometimes mirror the behavior of others. “We’re attuned to respond to emotional states through facial expressions, intonation of voices, body language, and smells,” says Doty, “and we learn from and respond to these on a subconscious level.”

We can boost this innate attunement toward compassion and strengthen it within ourselves through practice. Research on how this is happening within the medical community is encouraging for both health-care professionals and their patients. One 2019 review in the journal BMC Medical Education found that medical students who underwent compassion training reported they were better able to manage work stress and had more positive interactions with patients. Another study published in the Journal of Clinical Oncology found that when hospital patients received just 40 seconds of a compassionate message, it lowered their anxiety. And according to a 2010 study in Health Services Research journal, patients who received compassionate care after a heart attack were at lower risk of dying within a year.

Academics studying this field are putting the results of research like this to work in their classrooms, too. Take Scott Plous, a professor of psychology at Wesleyan University, who ends his social psychology courses with what he calls “A Day of Compassion.” Plous challenges his students to focus on being compassionate for an entire day, then write about their experiences. Students commonly report that the exercise helps them to mend rifts with family members or leads them to reach out to neighbors.

See also 4 Ways to Practice Compassion in a Pinch

Regardless of how compassionate you tend to be, your yoga practice is likely to help bolster it. “One of the things that happens with yoga is we focus on the movement of our bodies or the movement of our breath, and we get out of our heads,” says Neff. “For a moment, we leave behind the storyline of our lives and what’s wrong with us. We use our bodies with intention and care and can actually be present with ourselves in a tender way. That’s self-compassion.”

After all, when you’re hypercritical of yourself, it’s easier to judge others. “If I’m not taking care of myself, then my relationships with others are a possible resentment waiting to happen,” says Aruni Nan Futuronsky, a life coach and faculty member at the Kripalu Center for Yoga and Health. “Self-compassion is the earth into which the seeds of change can be planted. Trying to change through force, will, and ego only work to a point. Through compassion, something greater than ourselves comes forth. We have a partner in life—call it grace, call it higher power, call it the wisdom of the body. We’re not alone. And change becomes sustainable.”

When Ruth asked Doty in 1968 what he wanted out of life, one of the first things he said was to be a doctor. She helped him to believe that it was possible for him to attend college and medical school. Today, he says the practices he learned from her are what keeps his breathing slow, his hands steady, and his body relaxed when he’s performing brain surgery. And these same practices are now embedded in the compassion trainings Doty teaches.

“Every day, each one of us has the capacity to change another person’s life through compassion,” Doty says. “When I was a young boy, Ruth told me, ‘Your heart is a compass, and it’s your greatest gift. If you are ever lost, just open it up, and it will steer you in the right direction.’ ” In teaching and studying compassion, Doty is doing his best to do just that—and to show others the magic, too.

See also Don't Be So Hard on Yourself! A Sequence to Practice Compassion

How to Practice Self-Compassion

Experts share their favorite, research-backed ways to cultivate more self-love.

Treat yourself like a friend

When you’re having a tough day or struggling with something, imagine a friend or close family member coming to you with the exact problem you’re dealing with. Ask yourself what you’d say to them. What tone of voice would you use? What would your body posture look like? Now apply your words, tone, and body language to yourself. “It will feel strange at first to say or think to yourself, ‘It’s OK; I’m here for you,’ but it starts to become habitual,” says Neff. “You stop constantly criticizing yourself and putting yourself down.”

Write a letter to your anxiety

When suffering starts to overwhelm you, Kripalu’s Futuronsky recommends that you create a dialogue with your overwhelm. For example, you might write something like, “Dear Aruni, I am your overwhelm. Let me tell you, this is way too much. I can’t do this. I’m terrified. What the hell is going to happen?” Then, write back. Something like, “Dear Overwhelm, Yep, I hear you. This is hard, and we’re going to just do one day at a time.” Research shows that letter writing can be particularly powerful. One study had participants write a self-compassionate letter to themselves every day for a week. The participants reported decreased depression levels for three months and increased happiness for six months.

Comfort yourself

Self-touch can release oxytocin and help us feel safe. Neff recommends experimenting with different techniques to see what feels most comforting: Try gently placing both hands over your heart, giving yourself a hug, cradling your face in your hands, or clasping your hands together so you’re holding your own hand.

See also 3 Tips & a Guided Meditation to Expand Your Self-Compassion

[amyddaniels]

The Science of Compassion

Researchers are studying a myriad of powerful ways compassion practices can improve health and strengthen relationships. Here, we look at the latest findings so you can take a glimpse into what happens in your body and mind when you treat yourself and others with more care.

As a child, James Doty believed the world wasn’t a very kind place. He spent the summer before eighth grade riding his orange Schwinn Sting-Ray bicycle around his hometown of Lancaster, California. He’d saved his money from mowing lawns to buy the freedom to fiercely pedal away from the turbulent apartment he shared with his parents and brother.

His dad was struggling with alcohol addiction and frequently took off for days to weeks at a time, sometimes leaving the family without enough money for food. His mom was chronically depressed and rarely left her bed. When his dad was home, his parents argued constantly, leaving his mom in tears. Doty’s older brother was scrawny and bullied, which meant Doty got into a lot of fights in an effort to defend him. “I felt a lot of anger, despair, and shame,” Doty says. “I never knew what was going to happen next. Worse, I felt like somehow I deserved the situation I was in. ”

Then that summer, Doty met a woman who changed everything. She worked at a magic shop that he’d wandered into without any money. The woman behind the counter, Ruth, was so kind and warm that when she started asking Doty questions about his life, he answered truthfully. “This was rare for me, since I carried so much shame and fear of judgment,” he says.

“Self-compassion is a powerful built-in coping system we all have...”

Ruth told Doty that she could teach him a type of magic different from what the store sold—something that could change his life—if he’d come back to visit. So, he started riding to the shop every day. Ruth brought him lunch, and they’d sit in the shop’s office on metal chairs casually eating and talking. Doty opened up to her about how he perpetually worried about his mom and brother, and was angry with his father. In response, Ruth taught him how to meditate. She asked him to pay attention to what he was feeling in his body when he felt worried or angry or sad. She taught him a head-to-toe body-scanning exercise to help him deeply relax. She introduced him to breathwork, mantra, and self-affirmations such as: I am worthy, I am loved, I love myself, and I love others. And she taught him how to set intentions for the future.

See also 5 Ways To Practice Compassion—and Get Better at It

Most importantly, says Doty, Ruth taught him how to “open his heart” by concentrating on offering unconditional love to people in his life and to himself.

Doty, now 64, says the magic Ruth taught him was better than any card trick he could’ve cracked into his imaginary piggy bank to buy. “Ruth taught me true compassion,” he says, “and it not only changed how I interacted with the world, but also how the world interacted with me.”

It’s poetic to think about the special kind of magic Ruth taught Doty and how it sparked a new trajectory for the sad, scared, anxious little boy who walked into the shop that summer. Yet Doty, now a professor of neurosurgery and founder and director of the Center for Compassion and Altruism Research and Education at Stanford University, says there’s actual science behind the lessons Ruth imparted on him as a kid.

See also How to Cultivate Compassion

How Compassion Improves Your Health

In fact, there’s an emerging field of research that looks at how compassion and compassion training—often via meditation or self-affirmation practices—can improve health and strengthen social bonds. By using heart monitors, brain scans, blood tests, and psychological surveys, scientists are getting a window into what really happens in the human body and mind when we acknowledge suffering (our own or someone else’s) and approach it in a caring and loving way. Recent studies show that when people are compassionate, especially toward themselves, their heart-rate variability—the fluctuations in the timing between heartbeats—increases, which is linked to an improved ability to self-soothe when you’re stressed.

Consider this: A 2015 study published in the Journal of Traumatic Stress found that veterans who served in Iraq and Afghanistan who scored higher on a self-compassion scale were less likely to develop PTSD or commit suicide. Another study, published in 2016 by the American Diabetes Association, found that an eight-week self-compassion training for people with diabetes helped them stabilize their glucose levels. Countless other research has linked self-compassion to lower rates of depression, anxiety, and stress—and higher rates of happiness and improved immune function.

“Self-compassion is the earth into which the seeds of change can be planted...”

Think of self-compassion as a powerful, built-in coping mechanism we all have access to, says Kristin Neff, PhD, associate professor in the department of educational psychology at the University of Texas at Austin and co-author of The Mindful Self-Compassion Workbook. Neff has been studying the topic for more than a decade and developed the Self-Compassion Scale—a survey of questions that identifies whether someone rates high or low for self-compassion—which is commonly used in clinical studies. “There is a ton of research showing that whether you’re in combat or raising a special-needs child, dealing with cancer or going through a divorce, self-compassion gives you the strength to get through it,” she says. That’s because it has an effect on your physiology, says Doty: “When you practice compassion, such as through meditation, you stimulate your vagus nerve—which you can think of like a highway that sends messages to and from your brainstem and major organs, especially your heart.”

See also The Proven Healing Power of Compassion

The Link Between Compassion and Your Nervous System

The vagus nerve activates two key systems in the body that impact how you feel: the parasympathetic nervous system (a.k.a. what’s activated when you’re in rest-and-digest mode) and the sympathetic nervous system (your fight-flight-freeze mechanism). Compassion practices help you more readily turn on your parasympathetic nervous system. You become more calm and relaxed, and your brain functions at its best. Your blood pressure and heart rate go down, and your immune system gets more robust. On the flip side, when the sympathetic nervous system is engaged, blood pressure and heart rate increase. Your brain isn’t as sharp as usual, and stress hormones (like cortisol, epinephrine, and norepinephrine) as well as inflammatory proteins (which are associated with the onset of disease) are released into the bloodstream.

We evolved to toggle quickly between both systems, and high heart-rate variability is a sign that your parasympathetic nervous system is engaged, says Doty, who co-authored a 2017 paper published in Frontiers of Public Health recommending that heart-rate variability be used as a primary measure in studies and trainings in the field of compassion science. The good news, Doty says, is that when that toggling isn’t happening as it should, and you find yourself in fight-or-flight mode more often than not, compassion is one of the best ways to find your way back to health.

See also Compassion in Action

Softening Self-Criticism Can Lead to a Longer Life

While it’s great to know what’s happening physiologically when we show others and ourselves compassion (or don’t), it’s just as important to translate that learning into everyday life, says Neff. Take, for example, someone who is hard on herself. Chronic self-criticism engages the sympathetic nervous system, which isn’t up for the task of near-constant work.

“The sympathetic nervous system was designed to deal with physical threats, but now most of our threats are created in our minds,” says Neff. “It’s things like, ‘I’m not good enough.’ ” But by doing the opposite—by accepting and comforting ourselves, and tapping into the power of self-compassion—we can hold our pain and our brokenness in a kind and loving way, which de-activates the sympathetic nervous system and helps us heal.

Of course, coaching your inner voice to talk to yourself like you would to your best friend can be a tall task. It’s common for people to feel compassion for others yet lack the ability to show kindness to themselves, says Neff. However, here’s some motivation to change that: Improving self-compassion primes you to be more compassionate toward others. That’s because when you engage your parasympathetic nervous system (the one that helps you feel calm, relaxed, and safe) more often and effectively, you’ll be better able to show up in the world more present and kind.

See also These 6 Simple Exercises Can Help You Cultivate More Compassion For Yourself

It’s easier to do this than you might think. Doty and Neff both say the proof of this is in our hard-wired capacity to care and connect. “Mammals are born very immature,” says Neff. “It takes decades for parts of our brains to fully develop, so there had to be a biological system in place to help infants and children feel safe.” This is why we can be easily comforted by a kind, gentle tone of voice and can intuit people’s emotional states by reading their body language. It’s also why we sometimes mirror the behavior of others. “We’re attuned to respond to emotional states through facial expressions, intonation of voices, body language, and smells,” says Doty, “and we learn from and respond to these on a subconscious level.”

We can boost this innate attunement toward compassion and strengthen it within ourselves through practice. Research on how this is happening within the medical community is encouraging for both health-care professionals and their patients. One 2019 review in the journal BMC Medical Education found that medical students who underwent compassion training reported they were better able to manage work stress and had more positive interactions with patients. Another study published in the Journal of Clinical Oncology found that when hospital patients received just 40 seconds of a compassionate message, it lowered their anxiety. And according to a 2010 study in Health Services Research journal, patients who received compassionate care after a heart attack were at lower risk of dying within a year.

Academics studying this field are putting the results of research like this to work in their classrooms, too. Take Scott Plous, a professor of psychology at Wesleyan University, who ends his social psychology courses with what he calls “A Day of Compassion.” Plous challenges his students to focus on being compassionate for an entire day, then write about their experiences. Students commonly report that the exercise helps them to mend rifts with family members or leads them to reach out to neighbors.

See also 4 Ways to Practice Compassion in a Pinch

Regardless of how compassionate you tend to be, your yoga practice is likely to help bolster it. “One of the things that happens with yoga is we focus on the movement of our bodies or the movement of our breath, and we get out of our heads,” says Neff. “For a moment, we leave behind the storyline of our lives and what’s wrong with us. We use our bodies with intention and care and can actually be present with ourselves in a tender way. That’s self-compassion.”

After all, when you’re hypercritical of yourself, it’s easier to judge others. “If I’m not taking care of myself, then my relationships with others are a possible resentment waiting to happen,” says Aruni Nan Futuronsky, a life coach and faculty member at the Kripalu Center for Yoga and Health. “Self-compassion is the earth into which the seeds of change can be planted. Trying to change through force, will, and ego only work to a point. Through compassion, something greater than ourselves comes forth. We have a partner in life—call it grace, call it higher power, call it the wisdom of the body. We’re not alone. And change becomes sustainable.”

When Ruth asked Doty in 1968 what he wanted out of life, one of the first things he said was to be a doctor. She helped him to believe that it was possible for him to attend college and medical school. Today, he says the practices he learned from her are what keeps his breathing slow, his hands steady, and his body relaxed when he’s performing brain surgery. And these same practices are now embedded in the compassion trainings Doty teaches.

“Every day, each one of us has the capacity to change another person’s life through compassion,” Doty says. “When I was a young boy, Ruth told me, ‘Your heart is a compass, and it’s your greatest gift. If you are ever lost, just open it up, and it will steer you in the right direction.’ ” In teaching and studying compassion, Doty is doing his best to do just that—and to show others the magic, too.

See also Don't Be So Hard on Yourself! A Sequence to Practice Compassion

How to Practice Self-Compassion

Experts share their favorite, research-backed ways to cultivate more self-love.

Treat yourself like a friend

When you’re having a tough day or struggling with something, imagine a friend or close family member coming to you with the exact problem you’re dealing with. Ask yourself what you’d say to them. What tone of voice would you use? What would your body posture look like? Now apply your words, tone, and body language to yourself. “It will feel strange at first to say or think to yourself, ‘It’s OK; I’m here for you,’ but it starts to become habitual,” says Neff. “You stop constantly criticizing yourself and putting yourself down.”

Write a letter to your anxiety

When suffering starts to overwhelm you, Kripalu’s Futuronsky recommends that you create a dialogue with your overwhelm. For example, you might write something like, “Dear Aruni, I am your overwhelm. Let me tell you, this is way too much. I can’t do this. I’m terrified. What the hell is going to happen?” Then, write back. Something like, “Dear Overwhelm, Yep, I hear you. This is hard, and we’re going to just do one day at a time.” Research shows that letter writing can be particularly powerful. One study had participants write a self-compassionate letter to themselves every day for a week. The participants reported decreased depression levels for three months and increased happiness for six months.

Comfort yourself

Self-touch can release oxytocin and help us feel safe. Neff recommends experimenting with different techniques to see what feels most comforting: Try gently placing both hands over your heart, giving yourself a hug, cradling your face in your hands, or clasping your hands together so you’re holding your own hand.

See also 3 Tips & a Guided Meditation to Expand Your Self-Compassion

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To Protect From Paralysis Associated With Spinal Cord Injuries Can Oriented On Genes Therapy

To Protect From Paralysis Associated With Spinal Cord Injuries Can Oriented On Genes Therapy. A lessons in rats is raising remodelled assumption for a treatment that might help spare people with injured spines from the paralysis that often follows such trauma. Researchers found that by instanter giving injured rats a drug that acts on a specific gene, they could halt the menacing bleeding that occurs at the site of spinal damage as example. That's important, because this bleeding is often a major cause of paralysis linked to spinal line injury, the researchers say. In spinal cord injury, fractured or dislocated bone can disgrace or damage axons, the long branches of nerve cells that transmit messages from the body to the brain libido impotence. But post-injury bleeding at the site, called gradual hemorrhagic necrosis, can prepare these injuries worse, explained study author Dr J Marc Simard, a professor of neurosurgery, pathology and physiology at University of Maryland School of Medicine in Baltimore. Researchers have prolonged been searching for ways to deal with this non-critical injury. In the study, Simard and his colleagues gave a drug called antisense oligodeoxynucleotide (ODN) to rodents with spinal rope injuries for 24 hours after the injury occurred. ODN is a exact single strand of DNA that temporarily blocks genes from being activated sizegenetics knockoff. In this case, the painkiller suppresses the Sur1 protein, which is activated by the Abcc8 gene after injury. After programmed injuries, Sur1 is usually a beneficial part of the body's defense mechanism, preventing chamber death due to an influx of calcium, the researchers explained. However, in the case of spinal cord injury, this defense identity theory goes awry. As Sur1 attempts to prevent an influx of calcium into cells, it allows sodium in and too much sodium can cause the cells to swell, puff up and die. In that sense, "the 'protective' monism is a two-edged sword. What is a very good thing under conditions of moderate injury, under tough injury becomes a maladaptive mechanism and allows unchecked sodium to come in, causing the stall to literally explode". However, the new gene-targeted therapy might put a stop to that. Injured rats given the hallucinogen had lesions that were one-fourth to one-third the size of lesions in animals not given the drug. The animals also recovered from their injuries much better. So "The results in rats were indubitably dramatic. The rats did a entire lot better. In some, it was hard to tell that they were injured at all". The study, which received funding from the Veterans' Administration, the US National Institutes of Health and the Christopher & Dana Reeve Foundation, is published in the April 21 pour of Science Translational Medicine. Importantly, researchers also found animated Sur1 and sodium in kindly spinal tissue taken from people who had died testily after suffering a spinal cord injury. That strongly suggests that a similar process occurs in folk and could be treated the same way. Antisense oligodeoxynucleotide is currently used in the treatment of some cancers and diabetes, although there are concerns about opinion effects from its long term use. Challenges also remain in terms of getting the drug to butt the right tissue or cells. However, in spinal cord injury, the treatment, which is given intravenously, is short-term and poses few risks of facet effects. In the injured rats, the ODN went into the bloodstream and targeted the endothelial cells of the capillaries, where the bleeding around the spinal twine was coming from. After just 24 hours, rats were removed from the IV and the bleeding did not continue, according to Simard. The researchers are seeking FDA sanction to begin Phase 1 or 2 clinical trials using either oligodeoxynucleotide or nearly the same drugs that work on the same pathways. "It is powerfully effective, the side effects are nil and this is something that could be given quite early, even in the field or in the ambulance on the detail to the hospital if it is proven to be safe, which I believe it is". Dr Robert Grossman, chairman of neurosurgery and head of the Methodist Neurological Institute in Houston, said the findings were promising. So "A great deal is known about these drugs and they are on the whole quite safe. People have been looking for a long take of blunting the secondary injury. There are multiple ways of attacking the same process, but this is a very promising way". Such treatments may also one daylight be used to help staunch bleeding in brain injury discover more here. Every year, about 11000 settle in the United States suffer spinal cord injury, according to breeding information in the study.