It appears that quality, rather than quantity, might be the

It appears that quality, rather than quantity, might be the

Bucladesine research buy most important factor when comparing genomes.”
“Background: Endovascular aneurysm repair (EVAR) is not generally recommended for patients with hostile neck anatomy. This study analyzed the clinical implications of various clinical features of proximal aortic neck anatomy.

Methods: Prospectively collected data from 258 EVAR patients using modular devices were analyzed. Patients were classified as having favorable neck anatomy (FNA) or hostile neck anatomy (HNA). HNA was defined as any or all of length of < 10 mm, angle of > 60 degrees, diameter of > 28 mm, >= 50% circumferential thrombus, >= 50% calcified neck, and reverse taper. Univariate, multivariate, and Kaplan-Meier analyses were used to compare early and late clinical outcomes.

Results: FNA was present in 37% and HNA was present in 63%. Clinical and demographic characteristics were comparable. Technical success was 99%. Mean follow-up was 22 months (range, 1-78 months). Perioperative complication rates were 3% for FNA vs 16% for HNA (P = .0027). Perioperative deaths were 0% for FNA and 3% for HNA (P = .2997). Proximal type I early

endoleaks (intraoperative) occurred in 9% of FNA vs 22% for HNA (P = .0202). Intraoperative proximal aortic cuffs were used to seal endoleaks in 9% of FNA vs 22% of HNA (P = .0093). At others late MK-1775 chemical structure follow-up, abdominal aortic aneurysm expansion was noted in 6% of FNA vs 7% of HNA (P = .8509).

Rates of freedom from late type I endoleaks at 1, 2, 3, and 4 years were 97%, 97%, 97%, and 90% for FNA vs 89%, 89%, 89%, and 89% for HNA (P = A 224); rates for late interventions were 95%, 90%, 90%, and 90% for FNA vs 95%, 93%, 91%, and 85% for HNA (P = .6902). Graft patency at 1, 2, and 3 years was 99%, 99%, and 99% for FNA vs 97%, 92%, and 90% for HNA (P = .0925). The survival rates were 93%, 84%, 76%, and 76% for FNA vs 88%, 82%, 74%, and 66% for HNA (P = .2631). Reverse taper was a significant predictor for early type I endoleak (odds ratio [OR], 5.25, P < .0001), reverse taper (OR, 5.95; P < .0001) and neck length (OR, 4.15; P = .0146) were for aortic cuff use; circumferential thrombus (OR, 2.44; P = .0448), and neck angle (OR, 3.38; P = .009) were for perioperative complications.

Conclusions: Patients with HNA can be treated with EVAR, but with higher rates of early (intraoperative) type I endoleak and intervention. The midterm outcomes arc similar to FNA. (J Vasc Surg 2011;54:13-21.)”
“Pituitary adenylate-cyclase activating polypeptide (PACAP) has been implicated in the (patho)physiology of stress-adaptation.

Point estimates

Point estimates GSK461364 molecular weight of model parameter values were estimated separately for the two data sets. In the current effort, Bayesian population analysis using Markov chain Monte Carlo simulation was used to recalibrate the model while improving assessments of parameter variability and uncertainty. When model parameters were calibrated simultaneously to the two data sets, agreement between the derived parameters for the two groups was very good, and the central tendency values were similar to those derived from the deterministic approach. These findings are relevant to the proposed update of the ICRP human respiratory tract model with revisions to the alveolar-interstitial region based on this long-term

particle clearance and retention model. (C) 2013 Elsevier Inc. All rights reserved.”
“Background: Human repeated insult patch test (HRIPT)

is regarded as one Nirogacestat cost of the confirmatory test in determining the safety of skin sensitizers. A number of important factors should be considered when conducting and interpreting the results of the HRIPT.

Objective: To investigate for probable critical factors that influence the results of HRIPT with the same protocol in Shanghai and Mumbai.

Methods: Two HRIPTs were carried out in Shanghai and Mumbai in 2011. Six identical products and I% sodium lauryl sulfate were tested. Two Chinese dermatologists performed the grading in the two cities. Climate conditions of Shanghai and Mumbai were also recorded.

Results: For four lower reaction ratio products, cumulative irritation scores in the induction phase were higher in individuals whose C188-9 mouse ethnicity was Indian rather than Chinese. Reaction ratio of the same four products was highly correlated to the climatic parameters. The other two higher reaction ratio products and the positive control had no difference between the two ethnicities.

Conclusion: Greater attention ought to be paid to the impact of climate on the results of HRIPT, especially for the mild irritation cosmetics when giving the interpretation. Greater emphasis also needs to be placed

on the ethnicity of the subjects. Crown Copyright (C) 2013 Published by Elsevier Inc. All rights reserved.”
“The local lymph node assay (LLNA) is the preferred method for classification of sensitizers within REACH. To reduce the number of mice for the identification of sensitizers the reduced LLNA was proposed, which uses only the high dose group of the LLNA. To evaluate the performance of this method for classification, LLNA data from REACH registrations were used and classification based on all dose groups was compared to classification based on the high dose group. We confirmed previous examinations of the reduced LLNA showing that this method is less sensitive compared to the LLNA. The reduced LLNA misclassified 3.

In this study, we evaluated the importance of miR-122 on the repl

In this study, we evaluated the importance of miR-122 on the replication of HCV in nonhepatic cells. Among the nonhepatic cell lines expressing functional HCV entry receptors, Hec1B cells derived this website from human uterus exhibited a low level of replication of

the HCV genome upon infection with HCVcc. Exogenous expression of miR-122 in several cells facilitates efficient viral replication but not production of infectious particles, probably due to the lack of hepatocytic lipid metabolism. Furthermore, expression of mutant miR-122 carrying a substitution in a seed domain was required for efficient replication of mutant HCVcc carrying complementary substitutions in miR-122-binding sites, suggesting that specific interaction between miR-122 and HCV RNA is essential for the enhancement of viral replication. In conclusion, although miR-122 facilitates efficient viral replication in nonhepatic cells, factors other than miR-122, which are most likely specific to hepatocytes, are required for HCV assembly.”
“BACKGROUND: Symptomatic posterior fossa hematoma in the term newborn is rare.

OBJECTIVE: To report on the management and outcome of posterior fossa subdural hematoma (PFSDH) in neonates.

METHODS: A retrospective analysis

of the department database and clinical notes of neonates admitted since 1985 with a PFSDH was performed together with a literature review of similar case series.

RESULTS: Sixteen patients were included. The median gestational age was 40 weeks with a high proportion of primiparous mothers (n = 9) and forceps delivery (n = 9). Nine neonates had symptoms of brainstem dysfunction within the click here first 24 hours of life, whereas the other 7 had a delayed presentation (median 4 days) with signs of raised VE-822 nmr intracranial

pressure due to hydrocephalus. Each patient had a cranial ultrasound followed by computed tomography scan that showed the PFSDH. Eleven neonates required surgical evacuation of the PFSDH, whereas hydrocephalus was managed by transient external ventricular drainage in 2 further patients. Eventually, 2 neonates required a permanent ventriculoperitoneal shunt. Five neonates had no operative intervention. With a mean follow-up of 7.8 years, 2 patients had mild developmental delay and 1 had severe developmental delay. The 13 other patients had a normal development.

CONCLUSION: In neonates with a PFSDH, surgery can be safely performed in those who have clinical and radiological signs of brainstem compression or hydrocephalus. A small number of neonates require a ventriculoperitoneal shunt in the long term. Initial aggressive resuscitation should be performed even in cases of initial severe brainstem dysfunction because of the good long-term neurological outcome.”
“While the role of impaired cognition in accounting for functional outcome in schizophrenia is generally established, the relationship between cognitive and functional change in the context of treatments is far from clear.

LEE presented anti-HSV-1 [EC(50) 142 8 +/- 5 3 mu g ml(-1); selec

LEE presented anti-HSV-1 [EC(50) 142.8 +/- 5.3 mu g ml(-1); selectivity index (SI) 2 0] and anti-DENV-2 activity (EC(50) 9.8 +/- 1.3 mu g ml(-1); SI 1.5). The pectolinarin (1) isolated from LEE was less active against HSV-1 and DENV-2. A mixture of the triterpenoids ursolic, pomolic and oleanolic acids was also obtained. Ursolic and oleanolic acids have

shown antiviral activity against HSV1. A mixture of pectolinarin (1) and acacetin-7-O-rutinoside (2) was isolated from FEE and has presented anti-DENV-2 activity (EC(50) 11.1 +/- 1.6 mu g ml(-1); SI > 45). Besides the antiviral activity, D. elongata has disclosed antioxidant effect.

Conclusions: These data shows that D. elongata selleck chemical has antiviral activity mainly against HSV-1 and DENV-2, besides antioxidant activity. These effects might be principally attributed to flavonoids isolated.

Significance and Impact of the Study: Distictella Cell Cycle inhibitor elongata might be considered a promising source of anti-dengue

fever phytochemicals.”
“The humoral immune system generates immunological memory comprising affinity matured, long-lived memory B cells and plasma cells (PCs), which are generated primarily in germinal centres (GCs). Although many factors are essential in this process, those that specifically govern B cell fate are not fully understood. The provision of T cell help to B cells is key in GC B cell fate determination, and it has become clear recently that this help involves more than direct cell cell interactions. Recently, the cytokine interleukin (IL)-21 has been identified as a key find more factor that can modulate the processes within GCs and directly influence B cell fate.

In this review, we examine the roles of GC cytokines in the context of cell differentiation.”
“This study investigated early androgen influence on the development of human motor and visuomotor characteristics. Participants, ages 12-45 years, were individuals with congenital adrenal hyperplasia (CAH), a disorder causing increased adrenal androgen production before birth (40 females, 29 mates) and their unaffected relatives (29 females, 30 mates). We investigated grip strength and visuomotor targeting tasks on which mates generally outperform females, and fine motor pegboard tasks on which females generally outperform mates. Physical characteristics (height and weight) were measured to explore whether body parameters could explain differences in motor skills. Females with CAH were stronger and showed better targeting than unaffected females and showed reduced fine visuomotor skill on one pegboard measure, with no difference on the other. Mates with CAH were weaker than unaffected mates in grip strength but did not differ on the targeting or pegboard measures.

Together these results demonstrate that within

the DH tra

Together these results demonstrate that within

the DH translational control through the mTOR pathway is important for consolidation as well as the stability of fear memory after retrieval. (C) 2011 IBRO. Published by Elsevier Ltd. All rights reserved.”
“COX-2 has been implicated in Kaposi’s sarcoma-associated herpesvirus (KSHV) latency and pathogenesis (A. George Paul, N. Sharma-Walia, N. Kerur, C. White, and B. Chandran, Cancer Res. 70:3697-3708, 2010; P. P. Naranatt, H. H. Krishnan, S. R. Svojanovsky, C. Bloomer, selleck products S. Mathur, and B. Chandran, Cancer Res. 64:72-84, 2004; N. Sharma-Walia, A. G. Paul, V. Bottero, S. Sadagopan, M. V. Veettil, N. Kerur, and B. Chandran, PLoS Pathog. 6:e1000777, 2010; N. Sharma-Walia, H. Raghu, S. Sadagopan, R. Sivakumar, M. V. Veettil, P. P. Naranatt, M. M. Smith, and B. Chandran, J. Virol. 80:6534-6552, 2006). However, the precise regulatory mechanisms

involved in COX-2 induction during KSHV infection have never been explored. Here, we identified cis-acting elements involved in the transcriptional regulation of COX-2 upon buy I-BET151 KSHV de novo infection. Promoter analysis using human COX-2 promoter deletion and mutation reporter constructs revealed that nuclear factor of activated T cells (NFAT) and the cyclic AMP (cAMP) response element (CRE) modulate KSHV-mediated transcriptional regulation of COX-2. Along with multiple KSHV-induced signaling pathways, infection-induced prostaglandin E(2) (PGE(2)) also augmented COX-2 transcription. Infection of endothelial cells markedly induced COX-2 expression via a cyclosporine A-sensitive, calcineurin/NFAT-dependent pathway. KSHV infection increased intracellular cAMP levels and activated protein kinase A (PKA), which phosphorylated the CRE-binding protein (CREB)

TGF-beta inhibitor at serine 133, which probably led to interaction with CRE in the COX-2 promoter, thereby enhancing COX-2 transcription. PKA selective inhibitor H-89 pretreatment strongly inhibited CREB serine 133, indicating the involvement of a cAMP-PKA-CREB-CRE loop in COX-2 transcriptional regulation. In contrast to phosphatidylinositol 3-kinase and protein kinase C, inhibition of FAK and Src effectively reduced KSHV infection-induced COX-2 transcription and protein levels. Collectively, our study indicates that mediation of COX-2 transcription upon KSHV infection is a paradigm of a complex regulatory milieu involving the interplay of multiple signal cascades and transcription factors. Intervention at each step of COX-2/PGE(2) induction can be used as a potential therapeutic target to treat KSHV-associated neoplasm and control inflammatory sequels of KSHV infection.”
“The ventral hippocampus modulates anxiety-like behavior in rats, and serotonergic transmission within the hippocampus facilitates adaptation to stress.

Initially, it was thought that A beta fibrils, which make up SP,

Initially, it was thought that A beta fibrils, which make up SP, were the root cause of the massive neurodegeneration usual found in AD brains. Over time, the longstanding emphasis on fibrillar A beta deposits and neuronal death slowly gave way to a new paradigm involving soluble oligomeric forms of A beta,

which play a prominent role in triggering the cognitive deficits by specifically targeting synapses and disrupting synaptic signaling pathways. While this paradigm is widely accepted today in the AD field, the molecular details have not been fully elucidated. In this review, we address some of the important evidence, which has led to the A beta oligomer-centric hypothesis as well as some of buy AZD7762 Rigosertib datasheet the key findings concerning the effects of A beta oligomers on synapses at a morphological and functional level. Understanding how A beta oligomers target synapses provides an important framework for ongoing AD research, which can lead to the development of successful therapeutic strategies designed to alter or perhaps reverse the course of the disease.

This article is part

of a Special Issue entitled: Dendritic Spine Plasticity in Brain Disorders. (c) 2012 IBRO. Published by Elsevier Ltd. All rights reserved.”
“The metabolic profiles of Chinese patients either treated with second-generation antipsychotic (SGA) medication and first-generation antipsychotic (FGA) medication were compared. The sample comprised 99 patients treated with SGA (risperidone, olanzapine and ziprasidone) and 99 with FGA (chlorpromazine, haloperidol and trifluoperazine) from the outpatient clinic of a teaching hospital in Hong Kong. The most frequent psychiatric diagnosis was schizophrenia,

followed by affective disorder and other psychiatric diagnoses. Subjects were measured for body weight, body height, fasting lipid and glucose levels. SGA was associated with higher LDL-cholesterol level than FGA. Individual comparison of different antipsychotics showed that patients on olanzapine had the greatest increases in cholesterol and triglycerides among all antipsychotics. The finding suggested SGA, particularly olanzapine, were associated with more metabolic risk factors than first-generation antipsychotics. (C) 2010 Elsevier Ireland Ltd. All rights reserved.”
“Tissue elasticity can be detected using a scanning acoustic microscope (SAM), whereby acoustic images are created from the speed of sound through tissues.

0 mg/kg, i p )

Intra-BLA infusions of

0 mg/kg, i.p.).

Intra-BLA infusions of selleck chemical 2 mu g/side CART 55-102 produced CPP, 4 mu g/side produced CPA, and 1 mu g/side produced neither CPP nor CPA. Intra-BLA infusions of a subrewarding dose of CART 55-102 (1 mu g/side) plus injections of a subrewarding dose of AMPH (0.1 mg/kg, i.p.) produced CPP. Intra-BLA infusions of an aversive dose of CART 55-102 (4 mu g/side) plus injections of a rewarding dose of AMPH (1.0 mg/kg, i.p.) produced neither CPP nor CPA.

Both the affective properties of intra-BLA CART 55-102 and its ability to either facilitate or block AMPH reward are dose dependent.”
“Our study meant to determine, for idiopathic

scoliosis patients, the biomechanical processes involved in postural regulation when self-imposed disturbances occur in seated position in both directions during successive trials. 12 female adolescents with right thoracic scoliosis (SG) and 15 control adolescents (CG) were included in this study. Ground AR-13324 concentration reaction forces were studied using a force platform while the subjects were maintaining their balance in sitting position on a seesaw. Every test is recorded with eyes opened, arms on shoulders and legs free. The force platform data (AP and ML forces data) obtained were processed to determine the following normalized force parameters: delta value (difference between maxima

and minima), maximal and minimal force values (peak and occurrence), and the variability of AP and ML forces. We used a variance analysis (ANOVA test) to analyze and compare 3 trials and groups.

Our results show that, whatever the directions of destabilization (AP versus ML), selleck chemicals SG was always in a learning situation. Indeed, the first test is always less stable than the second and third trials. However, for CG, adaptability between the tests is only highlighted

during ML imbalance. Significant differences of strategies between the groups are only visible for the AP force component.

For all conditions imposed, scoliotic patients perform specific trunk balance strategies. Clinical tests and rehabilitation methods should include the learning effect within the spatio-temporal adaptation to ground reaction forces. (C) 2012 Elsevier Ireland Ltd. All rights reserved.”
“The arenavirus envelope glycoprotein (GPC) retains a stable signal peptide (SSP) as an essential subunit in the mature complex. The 58-amino-acid residue SSP comprises two membrane-spanning hydrophobic regions separated by a short ectodomain loop that interacts with the G2 fusion subunit to promote pH-dependent membrane fusion. Small-molecule compounds that target this unique SSP-G2 interaction prevent arenavirus entry and infection. The interaction between SSP and G2 is sensitive to the phylogenetic distance between New World (Junin) and Old World (Lassa) arenaviruses. For example, heterotypic GPC complexes are unable to support virion entry.

Results: Median patient age was 6 1 years (range 0 4 to 18 8) A

Results: Median patient age was 6.1 years (range 0.4 to 18.8). A total of 218 patients had a median followup of 5.7 months (range 0.2 to 83.4). Seven hernias (3.2%) were diagnosed H 89 research buy at a median of 1.2 months (range 0.1 to 15.1) postoperatively. Patients with hernia were younger than those without hernia, at 1.1 years (range 0.5 to 3.9) vs 6.2 years (0.4 to 18.8, p = 0.04). We analyzed 571 port sites in 187 cases. In 385 ports (67.4%) the fascia was closed. Hernia developed in 4 of 385 ports (1.0%) that were closed and in 3 of 186 (1.6%) that were not closed. No significant relationship was observed between hernia development and port size or location.

Conclusions: The incidence of port site hernia

after pediatric urological

laparoscopy was 3.2%, similar to the reported incidence in adults. While development of hernia after pediatric urological laparoscopy is rare, it is more likely to occur in infants. Due to the low incidence of this complication, it is difficult click here to draw conclusions regarding contributing factors.”
“Purpose: We present the long-term results of simultaneous “”teapot”" ureterocystoplasty and ureteral Mitrofanoff in patients with bilateral megaureters due to neurogenic bladder, and compare urodynamic results before and after the procedure.

Materials and Methods: We treated 13 children (mean age 7.3 years) with end stage neurogenic bladder Olopatadine and refluxing megaureters (mean diameter 5.5 cm) with

simultaneous teapot ureterocystoplasty and Mitrofanoff appendicovesicostomy between April 1995 and May 2001. The larger ureter was used for teapot bladder augmentation while keeping its distal 2 cm tubularized. The Mitrofanoff channel was then created using the opposite ureter.

Results: Followup ranged from 109 to 169 months (median 121). At the end of the followup period all patients were dry with clean intermittent catheterization and/or voiding. No repeat augmentation was needed and there were no bladder calculi during followup. Median postoperative bladder capacity was 430 ml (IQR 380 to 477), which was increased significantly compared to preoperative evaluations (210 ml, IQR 181 to 230, p = 0.001). During followup bladder compliance also improved significantly (p = 0.001) and serum creatinine level decreased (p = 0.021).

Conclusions: Although neurogenic bladder and high grade reflux are poor prognostic factors for ureterocystoplasty, the present modification resulted in enduring bladder augmentation with no calculus formation. Bladders remained compliant with good capacity, presumably because sufficient tissue and blood supply were provided for the augmented flap.”
“Purpose: We studied variables with impact on cessation of congenital high grade vesicoureteral reflux in univariate analyses and provide a multivariate model for prediction of reflux resolution.

Also, VP22 did not significantly affect ICP0 mRNA at any time in

Also, VP22 did not significantly affect ICP0 mRNA at any time in infection. Thus, the protein synthesis and mRNA phenotypes observed with the U(L)49-null virus are separable with regard to both timing during infection and the genes

affected and suggest separate roles for VP22 in enhancing the accumulation of viral proteins and mRNAs. Finally, we show that VP22′s effects on protein synthesis and mRNA accumulation occur independently of mutations in genes encoding the VP22-interacting partners VP16 and vhs.”
“Despite the advent of new pharmacological treatments and the high success rate of many surgical treatments for epilepsy, Ruboxistaurin a substantial number of patients either do not become seizure-free or they experience major adverse events (or both). Neurostimulation-based PCI-32765 molecular weight treatments have gained considerable interest in the last decade. Vagus nerve stimulation (VNS) is an alternative treatment for patients with medically refractory epilepsy, who are unsuitable candidates for conventional epilepsy surgery, or who have had such surgery without optimal outcome. Although responder identification studies are lacking, long-term VNS studies show response rates between 40% and 50% and long-term seizure freedom in 5% to 10% of patients. Surgical complications and perioperative morbidity are low. Research into the mechanism of

action of VNS has revealed a crucial role for the thalamus and cortical areas that are important in the epileptogenic process. Acute deep brain stimulation (DBS) in various thalamic nuclei and medial temporal lobe structures has recently been shown to be efficacious in small pilot studies. There is little evidence-based information on rational targets and stimulation parameters. Amygdalohippocampal DBS has yielded

a significant decrease of seizure counts and interictal EEG abnormalities during long-term follow-up. Data from pilot studies suggest that chronic DBS for epilepsy may be a feasible, effective, and safe procedure. Further trials with larger patient populations and with controlled, randomized, and closed-loop designs should now be initiated. Further progress in understanding the mechanism of action of DBS for epilepsy is a necessary step to find more making this therapy more efficacious and established.”
“The observed association between HLA-B*13 and control of human immunodeficiency virus type 1 (HIV-1) infection has been linked to the number of Gag-specific HLA-B*13-restricted cytotoxic T-cell (CTL) responses identified. To date, the Gag escape mutations described that result in an in vitro fitness cost to the virus have been located within structural protein p24 only. Here we investigated the hypothesis that CTL escape mutations within other regions of HIV Gag may also reduce viral fitness and contribute to immune control.

The methodology and findings of these studies were critically rev

The methodology and findings of these studies were critically reviewed and discussed. Because of the small number of studies, meta-analysis was only conducted for studies that used behavioral PM

this website measures in adults to integrate findings. PM deficits were found to be commonly reported by patients with CHI and their significant others and they could be identified using behavioral measures in adults, children and adolescents with CHI. However, more work is needed to clarify the nature and mechanisms of these deficits. Although some promising results have been reported by studies that evaluated PM treatment, most studies lack tight experimental control and used only a small number of participants. The paper concluded with some suggestions for future research. (C) 2011 Elsevier Ltd. All rights reserved.”
“Purpose: To evaluate results of carotid endarterectomy (CEA) in diabetic patients in a large single-center experience.

Methods: Over a 13-year period ending in December 2008, 4305 consecutive CEAs in 3573 patients were performed. All patients were prospectively enrolled in a dedicated database. Interventions were performed in diabetic patients in 883 cases (20.5%; group 1) and in nondiabetics in the remaining 3422 (79.5%; group 2). Early results in terms of 30-day stroke and death rates were analyzed and compared.

Follow-up results were analyzed with Kaplan-Meier curves and compared with log-rank test.

Results: Diabetic patients were more likely to be females and to have coronary artery disease, peripheral arterial Evofosfamide ic50 disease, hyperlipemia, and arterial hypertension Liproxstatin-1 than nondiabetics. There were no differences between the two groups in terms of preoperative clinical status or degree of carotid stenosis. Interventions were performed under general anesthesia with somatosensory-evoked potentials (SEPs) monitoring in

67% of the patients in both groups, while the remaining interventions were performed under clinical monitoring. Shunt insertion (14% and 11%, respectively) and patch closure rates (79% and 76%, respectively) were similar between the two groups. There were no differences between the two groups in terms of neurological outcomes, while the mortality rate was higher in group 1 than in group 2 (P = .002; odds ratio [OR], 3.5; 95% confidence interval [CI], 1.5-8.3); combined 30-day stroke and death rate was significantly higher in group 1 (2%) than in group 2 (0.9%; P = .006; 95% CI, 1.2-3.9; OR, 2.2). At univariate analysis, perioperative risk of stroke and death in diabetic patients was significantly higher in patients undergoing intervention with SEP cerebral monitoring (95% CI, 0.9-39.9; OR, 5.9; P = .01), and this was also confirmed by multivariate analysis (95% CI, 1.1-23.1; OR, 8.