All participants were aged between 25 and 55 and met inclusion criteria for either PSY-I, PARA-I or GS. Interventions: N/A Measurements and results: Results showed no between group differences on REM sleep macrostructure. As for REM sleep microstructure, PSY-I had an increased number of wake intrusions compared to PARA-I (p = .03). Subjective
SE, TST and TWT were significantly correlated with the duration of REM sleep (REMD; p smaller than = .002) and with the proportion of REM sleep for PARA-I (p smaller than = .06). Conclusions: REM sleep macrostructure does not seem to be an adequate indicator selleck compound of hyperarousal in insomnia. However, the number of wake intrusions in REM could be used to differentiate PSY-I from PARA-I and could reflect the heightened arousal of the former group. Relationships between REM sleep duration and proportion could be linked to dream imagery activity, especially in PARA-I. Further investigations are
needed to identify variables that could reflect hyperarousal and differentiate insomnia types. (C) 2015 Elsevier B.V. All rights reserved.”
“BACKGROUND: Transforaminal epidural injection (TEI) is commonly used in the treatment of radicular pain. However, there have been many published cases of serious complications after a TEI, occurring most often in cervical levels. One of the presumptive reasons for this complication is inadvertent intravascular injection. We sought to identify the incidence of intravascular injections see more in cervical and lumbar spinal segments during TEI.\n\nMETHODS: All patients with radicular symptoms or herpes zoster-associated pain underwent cervical and lumbar TEIs (LTEIs) prospectively by one of the authors. After an ideal needle position was confirmed by biplanar fluoroscopy, 3 mL of a mixture containing nonionic contrast and normal saline was continuously injected at the rate of 0.3-0.5 PCI-34051 inhibitor mL/s with real-time fluoroscopic visualization.\n\nRESULTS: One hundred eighty-two TEIs were performed. Fifty-six cases (30.8%) showed intravascular spreading
patterns, 45 cases occurring during a cervical TEI (CTEI) and 11 during a LTEI. The incidences of simultaneous perineural and vascular injection in cervical and LTEIs were 52.1%, and 9%, respectively, and pure vascular flow pattern rates in cervical and LTEIs were 11.3% and 0.9%, respectively.\n\nCONCLUSION: The incidence of vascular injection in CTEIs is significantly higher than in LTEIs, Suggesting that CTEIs should be performed more cautiously. Furthermore, the vascular injection rate of CTEIs is much higher than that previously reported. This finding suggests the need for a proper volume of contrast injection (3 mL) to detect vascular flow, especially in simultaneous perineural and vascular injections.
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