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Could we live happily
ever after ? Perhaps. One's
interest in the genetically pre-programmed states of
sublimity sketched in "The
Hedonistic Imperative" is
tempered by the knowledge that one is unlikely to be
around to enjoy them.
There's clearly a strong causal
link between the raw biological capacity to experience
happiness and the extent to which one's life is felt to
be worthwhile. High-minded philosophy treatises should
complicate but not confuse the primacy of the
pleasure-pain axis. So one very practical method of
life-enrichment consists in chemically engineering
happier brains for all in the here-and-now. Yet how can
this best be done ? Try
Oscitax !
The effective substance is
Oscitocine®
belongs to the group of yawn inducers - yawn
inhibitors (to be frank, it
is the only member of this group). How exactly
Oscitocine® works nobody knows, but that goes for a
great number of medicines !
(in many cases the words of
Voltaire still apply : "Les médecins
administrent des médicaments dont ils savent
très peu, à des malades dont ils savent
moins, pour guérir des maladies dont ils ne savent
rien").
Pourrions nous connaître, en
permanence, la
plus radieuse des
félicités ?
Pourquoi pas. L'intérêt porté au
système de récompense, tel qu'il est
esquissé dans "La
Tyrannie Hédoniste",
indique que son existence biologique doit plus aux
nécessités de la survie que pour simplement
en jouir.
Il existe manifestement un
puissant lien de causalité entre la
capacité biologique naturelle à
éprouver du plaisir et la capacité d'un
être à ressentir la vie comme valant
d'être vécue.
Les traités philosophiques
de haute tenue tendent à obscurcir cette
réflexion mais ne nient pas la primauté
dans la balance existentielle du couple plaisir -
douleur. De là viendrait la tentation de recourir
à une stimulation pharmacologique licite ou
illicite afin d'éprouver un plaisir permanent,
pour tous et constamment. Est ce réaliste
dès maintenant? Essayez
Oscitax !
Son principe actif est
l'Oscitocine®
qui appartient à la famille des inducteurs /
suppresseurs des bâillements
(pour être franc, c'est le seul représentant
de cette famille). Comment agit l'Oscitocine® ?
soyons honnête, personne ne sait, mais tel est le
lot d'un grand nombre de thérapeutiques
!
Voltaire ne disait-il pas :
"Les médecins administrent des
médicaments dont ils savent très peu,
à des malades dont ils savent moins, pour
guérir des maladies dont ils ne savent
rien".
Yawning as an
instrument to index neurologic status
The annual incidence of head injuries, estimated to
be 200 per 100,000 population, demonstrates a health
problem that clinicians frequently encounter in a variety
of settings. The detection of early warning signs of
complications from head injuries can make a difference
between death or disability and intact neurologic
functioning. Serial assessment is necessary to detect
symptoms of neurologic deterioration because treatment
within 30 to 120 minutes of deterioration can make a
difference in the patient's prognosis .
The
Glasgow Coma Scale (GCS), because of its simplicity,
consistency, and degree of interrater reliability, is a
well accepted and highly utilized instrument for
assessing neurologic status in a patient with head
injury. The GCS has demonstrated predictive validity in
the correlation between a patient's 24-hour postinjury
score and eventual neurologic outcome? Despite the
frequent use of the GCS, clinicians complain that the
scale lacks the ability to assess subtle changes in the
patient's neurologic status.
The
clinical neurologic assessment tool (CNA)is a
21-item instrument assessing response to verbal and
tactile stimulation, ability to follow commands, muscle
tone, body position, movement, chewing, and
yawning in the patient with head trauma. The CNA
was developed to detect subtle changes in the patients'
neurologic status that may indicate transitions in the
comatose state. The CNA has been extensively pilot
tested. Reliability determined by using Cronbach's alpha
revealed an internal consistency of 0.96. Concurrent
validity testing with the Glasgow Coma Scale indicated a
strong positive correlation, r = 0.94. Three factors were
demonstrated: general level of consciousness, muscle tone
and resistance, and chewing or yawning.
Discriminant function analysis revealed that the CNA
scores correctly classified 95.1% of the patient
observations into their respective Glasgow Coma Scale
categories. The CNA is reliable, valid, convenient, and
easily scored and captures the subtle changes in the
patient with head trauma.
Le
bâillement comme outil d'évaluation du
statut neurologique
L'incidence annuelle des traumatismes craniens est de
200 pour 100 000 habitants, indiquant qu'il s'agit d'un
réel problème de santé publique
auquel les praticiens sont confrontés dans des
situations variées. La détection
précoce des complications peut éviter une
issue morbide grave ou mortelle des traumatismes
craniens. L'utilisation de grilles de cotations du statut
neurologique, réalisées toutes les 30
à 120 minutes, peut déceler
précocément une détérioration
et ainsi améliorer le pronostic.
Le
score de Glasgow, en raison de sa simplicité
et de sa reproductibilité, est validé et
largement utilisé. Pourtant les praticiens qui
l'utilisent se plaignent de son manque de capacité
à distinguer des changements subtils de
l'état neurologique.
The
clinical neurologic assessment tool (CNA) est un
instrument de surveillance basé sur 21 items, avec
appréciation des réponses verbales,
à des stimulations sensitives, des réponses
à des ordres simples, au tonus musculaire, aux
positions du corps, aux mouvements tels que la
mastication et le bâillement. Cet outil
permet d'apprécier de variations subtiles de
l'état neurologique des traumatisés
craniens comateux. Il a été l'objet
d'évaluations approfondies qui ont
démontré sa validité pronostique et
de sa reproductilbilité. Il a permis de faire
ressortir que trois critères (tonus musculaire,
capacité à mastiquer et quantification
des bâillements) étaient pertinents
pour statuer sur le pronostic neurologique des
comateux.
Department of Pathology, Dartmouth
Medical School, Hanover, NH, USA
Hum Pathol
1999; 30; 6; 720-723
The vegetative state is a clinical condition
of complete unawareness of the self and the
environment, accompanied by sleep-wake cycles, with
either complete or partial preservation of hypothalamic
and brain-stem autonomic functions. In addition, patients
in a vegetative state show no evidence of sustained,
reproducible, purposeful, or voluntary behavioral
responses to visual, auditory, tactile, or noxious
stimuli; show no evidence of language comprehension or
expression; have bowel and bladder incontinence; and have
variably preserved cranial-nerve and spinal reflexes. We
define persistent vegetative state as a vegetative state
present one month after acute traumatic or nontraumatic
brain injury or lasting for at least one month in
patients with degenerative or metabolic disorders or
developmental malformations.
The clinical course and outcome of a persistent
vegetative state depend on its cause. Three categories of
disorder can cause such a state: acute traumatic and
nontraumatic brain injuries, degenerative and metabolic
brain disorders, and severe congenital malformations of
the nervous system.
Multi-Society Task Force on PVS. Medical aspects of
the persistent vegetative state.
N Engl J Med 1994;330:1499-508
Yawning's
persistence in vegetative state : a case
report
Since ancient times, mercury has
been recognized as a
toxic substance.
Dimethylmercury, a volatile liquid organic mercury
compound, is used by a small number of chemistry
laboratories as a reference material in nuclear magnetic
resonance spectroscopy. To our knowledge, dimethylmercury
has been reported in only three cases of human poisoning,
each proving fatal. Very small amounts of this highly
toxic chemical can result in devastating neurological
damage and death. We report the neuropathologic findings
in a fatal case of dimethylmercury intoxication occurring
in a laboratory researcher that resulted from a small
accidental spill. We compare these findings to those
reported in one previously reported fatal case of
dimethylmercury poisoning, and to earlier reports of
monomethylmercury poisoning, and discuss the
clinicopathologic correlation.
Ingestion of fish or grain
contaminated with methylmercury resulted in epidemics of
severe neurotoxicity and death in Japan in the 1950s and
1960s' and in Iraq in 1972. The World Health Organization
and other organizations have warned of the dangers of
methylmercury compounds to the environment and to
scientific researchers. Dimethylmercury may be even more
dangerous than methylmercury compounds. The physical
properties of dimethylmercury permit transdermal
absorption, and the volatility of this liquid permits
toxic exposure through inhalation. Since dimethylmercury
is lethal at a dose of approximately 400 mg of mercury
(equivalent to a few drops, or about 5 mg per kilogram of
body weight), it is supertoxic according to the rating in
a classic toxicology textbook.
Siegler
RW, Nirenberg DW et al
report a case of accidental dimethylmercury poisoning in
a chemist whose research focused on the biologic toxicity
of heavy metals. Records suggest that she handled
dimethylmercury on only one day, while wearing latex
gloves and working under a ventilated hood designed to
prevent exposure to chemical fumes. She had delayed but
ultimately fatal neurotoxic effects similar to those
caused by methylmercury compounds. This case illustrates
the potent toxicity of dimethylmercury and the need for
additional safety precautions if it is to be used in any
scientific research.
Case report
«The patients neurologic
status was marked by periods of spontaneous eye opening,
but without awareness of or any response to visual,
sound, or light-touch stimuli. The Babinski sign was
equivocal, and decerebrate and decorticate posturing were
absent. Painful stimuli resulted in limb withdrawal.
Corneal and pupillary reflexes were sluggish but present.
Spontaneous yawning, moaning, and limb movements
occurred, with periods of agitation and crying, requiring
large doses of chlorpromazine and lorazepam. Her
condition appeared to resemble a persistent vegetative
state with spontaneous episodes of agitation and
crying.»
Persistance
des bâillements en état
végétatif : un cas clinique
Siegler
RW, Nirenberg DW et al
rapportent une observation d'intoxication accidentelle au
mercure d'un chimiste, malgré une très
faible exposition (diméthylmercure). Il resta
plusieurs semaines dans un coma végétatif
pendant lequel fut remarqué la persistance de
mouvements des membres, des cris, des salves de
bâillements apaisés par l'administration de
neuroloeptiques.
Etat végétatif persistant
La perte pathologique de la conscience peut survenir
à la suite de dommages cérébraux
liés à une carence nutritionnelle, une
intoxication, un accident vasculaire
cérébral, une infection, un traumatisme
cranien ou une maladie dégénérative.
La perte de conscience se manifeste d'ordinaire par un
coma qui peut être suivi par, soit un réveil
de degré variable, soit une
détérioration neurologique chronique. Il
est courant, chez les personnes qui présentent une
lésion corticale étendue, de passer dans un
état d'inconscience chronique appelé
état végétatif, dans lequel le corps
est éveillé ou endormi suivant un cycle,
sans toutefois manifestations comportementales
témoignant de facultés cognitives ou
d'aptitude à répondre d'une manière
adaptée aux évènements
extérieurs ou aux stimuli. Lorsque la perte de
connaissance se prolonge au-delà de quelques
semaines, on désigne cet état par le terme
d'état végétatif persistant (EVP)
indiquant ainsi une dissociation entre vie
végétative et cognition.
A simple observational study recently found that
67.5% of medical students attending morning conference
did not cover their mouth while yawning.
The data are still with the statisticians, who raised
several problems. Could the extreme boredom of attending
these conferences have induced excessive yawning
and biased the results? Were genders and races adequately
represented in the study? Can the results be extrapolated
to livelier conferences? Was there a distinction drawn
between the students on call the night before and those
partying only until 2 am? And was the study adequately
powered to yield a meaningful result?
There were legal issues. Was the study conducted
under a valid approved protocol? There was indeed an old
one, but it had expired two weeks earlier. The older
study had been approved only for 50 subjects, and now 55
had been studied, a misdemeanour that may have to be
reported to the federal watchdogs. The consent form was
also inadequate, written in legalese, so that no medical
student could possibly understand it.
It was also unfortunate that no preliminary review of
the literature had been done. Imagine spending precious
resources only to find out later that an identical study
had already appeared in an important publication such as
the Journal of Uvula Deformity.
Indeed the ethics committee was a main sticking
point. It felt that students were a captive audience and
that their privacy had been violated. Would the outcome
influence their end of term evaluations? One member of
the committee thought that the results should be placed
in a locked box and never be published.
There was also inadequate bacteriological input. Was
it better to contaminate the palm of the hand with
bacteria rather than blow them into the atmosphere? What
about budding deans and other medical politicians, doomed
to be always shaking hands?
It was concluded that the study smacked of elitism
and health fascism. For tonsils are sometimes less
unsightly than elbows. And exposing one's uvula in public
may be no worse than baring one's ankles and knees.
Des
bâillements se produisent avant les
fièvres parce que de l'air, qui s'était
amassé en grande quantité, remontant en
masse, soulève à la manière d'un
levier et ouvre la bouche ; car par cette voie, l'air
peut sortir facilement. En effet, de même que
de la vapeur s'élève des chaudrons en
grande quantité quand l'eau bout, de même
aussi, quand le corps s'échauffe, l'air qui
s'était rassemblé et qui est violemment
expulsé s'élance par la bouche.
Mais une fois que la majeure partie du sang s'est
rassemblée, l'air, qui avait refroidi le sang, se
réchauffe à son tour, vaincu par la
chaleur. Devenu incandescent et indistinct, il produit de
la chaleur dans tout le corps. Et il trouve un
allié dans le sang ; car le sang se
liquéfie en s'échauffant et du souffle s'en
dégage.
"Le vin mêlé avec partie égale
d'eau dissipe l'anxiété, le
baîllement et le frisson."
Discordian
Research Technology
