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Kavand A, Noverraz F, Gerber-Lemaire S. Recent Advances in Alginate-Based Hydrogels for Cell Transplantation Applications. Pharmaceutics 2024; 16:469. [PMID: 38675129 PMCID: PMC11053880 DOI: 10.3390/pharmaceutics16040469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/28/2024] Open
Abstract
With its exceptional biocompatibility, alginate emerged as a highly promising biomaterial for a large range of applications in regenerative medicine. Whether in the form of microparticles, injectable hydrogels, rigid scaffolds, or bioinks, alginate provides a versatile platform for encapsulating cells and fostering an optimal environment to enhance cell viability. This review aims to highlight recent studies utilizing alginate in diverse formulations for cell transplantation, offering insights into its efficacy in treating various diseases and injuries within the field of regenerative medicine.
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Affiliation(s)
| | | | - Sandrine Gerber-Lemaire
- Group for Functionalized Biomaterials, Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne, 1015 Lausanne, Switzerland; (A.K.); (F.N.)
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Huang JS, Huang SY, Liao HZ, Cai RZ, Zeng Q, Xiang XT, Chen SX, Liu D, Yang ZK. Point-of-care ultrasound diagnosis of skull fracture in Chinese children 0–6 years old with scalp hematoma from minor head trauma: A preliminary prospective observational study. Heliyon 2023; 9:e15255. [PMID: 37096000 PMCID: PMC10121451 DOI: 10.1016/j.heliyon.2023.e15255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 04/09/2023] Open
Abstract
Background Previous studies have suggested that point-of-care ultrasound could help to evaluate and diagnose pediatric skull fracture for the closed scalp hematoma from blunt trauma. However, relevant data in Chinese children are missing, especially in children 0-6 years old. Objectives Our study aimed to evaluate the efficacy of point-of-care ultrasound to diagnose skull fracture in children 0-6 years old with scalp hematoma in China. Methods We performed a prospective observational study and screened children 0-6 years old with closed scalp hematoma and a Glasgow coma scale of 14-15 at Hospital in China. Enrolled children (N = 152) were first evaluated for skull fracture with point-of-care ultrasound by the emergency physician and then received a head computed tomography scan. Results The point-of-care ultrasound examination and computed tomography scan revealed skull fracture in 13 (8.6%) and 12 (7.9%) children, respectively. The kappa test showed a satisfactory agreement between two examinations (P < 0.0001), with kappa = 0.87 (95% confidence interval, i.e., 95% CI, [0.69, 1.00]) and area under the curve = 0.95 (95% CI [0.86, 1], P < 0.0001). The point-of-care ultrasound examination had the sensitivity of 91.7% (95% CI [62.5%, 100%]), specificity of 98.6% (95% CI [94.6%, 100%]), positive predictive value of 84.6% (95% CI [56.5%, 96.9%]), negative predictive value of 99.2% (95% CI [95.6%, 100%]), and accuracy of 98.0% (95% CI [94.1%, 99.6%]). Conclusions While our study is preliminary in nature, our findings may guide future larger studies in assessing the utility of point-of-care ultrasound examination in diagnosing skull fractures in children with scalp hematoma from minor head trauma.
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Ismail II, Salama S. Depiction of nervous system disorders in television medical drama: A content analysis of 18 seasons of Grey's Anatomy. Clin Neurol Neurosurg 2022; 224:107569. [PMID: 36584584 DOI: 10.1016/j.clineuro.2022.107569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Television medical dramas enjoy great popularity among the general public, and can be a source of information and misinformation about medical disorders. Nervous system disorders have always received attention in popular media, yet no studies have been performed to analyze their depiction and accuracy, to our knowledge. OBJECTIVE To investigate the representation of neurological and neurosurgical diseases in Grey's Anatomy, one of most popular and longest running primetime medical melodramas in American television. METHODS We performed a quantitative and qualitative content analysis of depictions of nervous system disorders in all 18 seasons of Grey's Anatomy, in addition to investigating the medical accuracy and the global quality of the portrayed medical content. RESULTS A total of 285 depictions were identified in 314 out of 400 episodes (78.5%) of Grey's Anatomy. Most of portrayed characters were males (59.2%), Caucasians (72.6%), and adults (76.4%), with a mean age of 32.6 ± 19.7 years for those mentioned. Most of the portrayals were of acute nature (65.5%), with neurosurgical diseases constituting the majority; 85.6%, while 31.6% depicted neurological diseases, and 19.3% had both. The most common clinical presentations were altered level of consciousness (16.5%) and seizures (14.4%). Traumatic brain injury was the most common portrayed diagnosis (39.3%), followed by brain tumors (13.7%), stroke (8.4%), and spinal injury (8.1%). Management was surgical for the majority of cases (79.6%), while only 17.9% received pharmacotherapy. The prognosis of portrayed cases was generally favorable, as 79.5% showed good/full recovery, while mortality rate was 18.6%. Forty cases (14.0%) were depictions of rare to very rare diseases. As regards to medical accuracy, 74.3% of depictions were deemed accurate within reason, with a mean GQS score of 4.38 ± 1.4. Four clinical trials involving the nervous system have been depicted throughout the show. CONCLUSIONS Neurosurgical and neurological diseases were portrayed in most episodes of Grey's Anatomy, with a good quality of its scientific content within reason. This study demonstrated that Grey's Anatomy had a good amount of medical information that could be able to improve the public perception of the specialty. However, there is still a room for significant improvement to acknowledge certain inaccuracies and misrepresentations in future episodes.
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Affiliation(s)
| | - Sara Salama
- Department of Neurology and Psychiatry, University of Alexandria, Alexandria, Egypt
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4
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Apostol CR, Bernard K, Tanguturi P, Molnar G, Bartlett MJ, Szabò L, Liu C, Ortiz JB, Saber M, Giordano KR, Green TRF, Melvin J, Morrison HW, Madhavan L, Rowe RK, Streicher JM, Heien ML, Falk T, Polt R. Design and Synthesis of Brain Penetrant Glycopeptide Analogues of PACAP With Neuroprotective Potential for Traumatic Brain Injury and Parkinsonism. FRONTIERS IN DRUG DISCOVERY 2022; 1. [PMID: 35237767 PMCID: PMC8887546 DOI: 10.3389/fddsv.2021.818003] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
There is an unmet clinical need for curative therapies to treat neurodegenerative disorders. Most mainstay treatments currently on the market only alleviate specific symptoms and do not reverse disease progression. The Pituitary adenylate cyclase-activating polypeptide (PACAP), an endogenous neuropeptide hormone, has been extensively studied as a potential regenerative therapeutic. PACAP is widely distributed in the central nervous system (CNS) and exerts its neuroprotective and neurotrophic effects via the related Class B GPCRs PAC1, VPAC1, and VPAC2, at which the hormone shows roughly equal activity. Vasoactive intestinal peptide (VIP) also activates these receptors, and this close analogue of PACAP has also shown to promote neuronal survival in various animal models of acute and progressive neurodegenerative diseases. However, PACAP's poor pharmacokinetic profile (non-linear PK/PD), and more importantly its limited blood-brain barrier (BBB) permeability has hampered development of this peptide as a therapeutic. We have demonstrated that glycosylation of PACAP and related peptides promotes penetration of the BBB and improves PK properties while retaining efficacy and potency in the low nanomolar range at its target receptors. Furthermore, judicious structure-activity relationship (SAR) studies revealed key motifs that can be modulated to afford compounds with diverse selectivity profiles. Most importantly, we have demonstrated that select PACAP glycopeptide analogues (2LS80Mel and 2LS98Lac) exert potent neuroprotective effects and anti-inflammatory activity in animal models of traumatic brain injury and in a mild-toxin lesion model of Parkinson's disease, highlighting glycosylation as a viable strategy for converting endogenous peptides into robust and efficacious drug candidates.
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Affiliation(s)
- Christopher R Apostol
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, Tucson, AZ, United States
| | - Kelsey Bernard
- Graduate Interdisciplinary Program in Physiological Sciences, The University of Arizona, Tucson, AZ, United States
| | | | - Gabriella Molnar
- Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Mitchell J Bartlett
- Department of Neurology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Lajos Szabò
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, Tucson, AZ, United States
| | - Chenxi Liu
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, Tucson, AZ, United States
| | - J Bryce Ortiz
- Barrow Neurological Institute at Phoenix Children's Hospital, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Phoenix Veteran Affairs Health Care System, Phoenix, AZ, United States
| | - Maha Saber
- Barrow Neurological Institute at Phoenix Children's Hospital, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States
| | - Katherine R Giordano
- Barrow Neurological Institute at Phoenix Children's Hospital, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Phoenix Veteran Affairs Health Care System, Phoenix, AZ, United States
| | - Tabitha R F Green
- Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States
| | - James Melvin
- Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Biological Sciences, University of Bath, Bath, United Kingdom
| | - Helena W Morrison
- College of Nursing, University of Arizona, Tucson, AZ, United States
| | - Lalitha Madhavan
- Graduate Interdisciplinary Program in Physiological Sciences, The University of Arizona, Tucson, AZ, United States.,Department of Neurology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Rachel K Rowe
- Barrow Neurological Institute at Phoenix Children's Hospital, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Child Health, The University of Arizona College of Medicine-Phoenix, Phoenix, AZ, United States.,Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - John M Streicher
- Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Michael L Heien
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, Tucson, AZ, United States
| | - Torsten Falk
- Graduate Interdisciplinary Program in Physiological Sciences, The University of Arizona, Tucson, AZ, United States.,Department of Pharmacology, College of Medicine, The University of Arizona, Tucson, AZ, United States.,Department of Neurology, College of Medicine, The University of Arizona, Tucson, AZ, United States
| | - Robin Polt
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, Tucson, AZ, United States
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Apostol CR, Tanguturi P, Szabò LZ, Varela D, Gilmartin T, Streicher JM, Polt R. Synthesis and In Vitro Characterization of Glycopeptide Drug Candidates Related to PACAP 1-23. Molecules 2021; 26:4932. [PMID: 34443519 PMCID: PMC8401035 DOI: 10.3390/molecules26164932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 01/05/2023] Open
Abstract
The search for efficacious treatment of neurodegenerative and progressive neuroinflammatory diseases continues, as current therapies are unable to halt or reverse disease progression. PACAP represents one potential therapeutic that provides neuroprotection effects on neurons, and also modulates inflammatory responses and circulation within the brain. However, PACAP is a relatively long peptide hormone that is not trivial to synthesize. Based on previous observations that the shortened isoform PACAP1-23 is capable of inducing neuroprotection in vitro, we were inspired to synthesize shortened glycopeptide analogues of PACAP1-23. Herein, we report the synthesis and in vitro characterization of glycosylated PACAP1-23 analogues that interact strongly with the PAC1 and VPAC1 receptors, while showing reduced activity at the VPAC2 receptor.
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Affiliation(s)
- Christopher R. Apostol
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, 1306 E. University Blvd, Tucson, AZ 85721, USA; (C.R.A.); (L.Z.S.)
| | - Parthasaradhireddy Tanguturi
- Department of Pharmacology, College of Medicine, The University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85724, USA; (P.T.); (J.M.S.)
| | - Lajos Z. Szabò
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, 1306 E. University Blvd, Tucson, AZ 85721, USA; (C.R.A.); (L.Z.S.)
| | - Daniel Varela
- Facultat de Quìmica Tarragona, Universitat Rovera I Virgili, 43007 Barcelona, Spain; (D.V.); (T.G.)
| | - Thiago Gilmartin
- Facultat de Quìmica Tarragona, Universitat Rovera I Virgili, 43007 Barcelona, Spain; (D.V.); (T.G.)
| | - John M. Streicher
- Department of Pharmacology, College of Medicine, The University of Arizona, 1501 N. Campbell Ave, Tucson, AZ 85724, USA; (P.T.); (J.M.S.)
| | - Robin Polt
- Department of Chemistry and Biochemistry, BIO5, The University of Arizona, 1306 E. University Blvd, Tucson, AZ 85721, USA; (C.R.A.); (L.Z.S.)
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de Souza MR, Fagundes CF, Solla DJF, da Silva GCL, Barreto RB, Teixeira MJ, Oliveira de Amorim RL, Kolias AG, Godoy D, Paiva WS. Mismatch between midline shift and hematoma thickness as a prognostic factor of mortality in patients sustaining acute subdural hematoma. Trauma Surg Acute Care Open 2021; 6:e000707. [PMID: 34104799 PMCID: PMC8144027 DOI: 10.1136/tsaco-2021-000707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/05/2021] [Accepted: 04/11/2021] [Indexed: 11/08/2022] Open
Abstract
Background Acute subdural hematoma (ASDH) is a traumatic lesion commonly found secondary to traumatic brain injury. Radiological findings on CT, such as hematoma thickness (HT) and structures midline shift (MLS), have an important prognostic role in this disease. The relationship between HT and MLS has been rarely studied in the literature. Thus, this study aimed to assess the prognostic accuracy of the difference between MLS and HT for acute outcomes in patients with ASDH in a low-income to middle-income country. Methods This was a post-hoc analysis of a prospective cohort study conducted in a university-associated tertiary-level hospital in Brazil. The TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis or Diagnosis) statement guidelines were followed. The difference values between MLS and HT (Zumkeller index, ZI) were divided into three categories (<0.00, 0.01–3, and >3). Logistic regression analyses were performed to reveal the OR of categorized ZI in predicting primary outcome measures. A Cox regression was also performed and the results were presented through HR. The discriminative ability of three multivariate models including clinical and radiological variables (ZI, Rotterdam score, and Helsinki score) was demonstrated. Results A total of 114 patients were included. Logistic regression demonstrated an OR value equal to 8.12 for the ZI >3 category (OR 8.12, 95% CI 1.16 to 40.01; p=0.01), which proved to be an independent predictor of mortality in the adjusted model for surgical intervention, age, and Glasgow Coma Scale (GCS) score. Cox regression analysis demonstrated that this category was associated with 14-day survival (HR 2.92, 95% CI 1.38 to 6.16; p=0.005). A multivariate analysis performed for three models including age and GCS with categorized ZI or Helsinki or Rotterdam score demonstrated area under the receiver operating characteristic curve values of 0.745, 0.767, and 0.808, respectively. Conclusions The present study highlights the potential usefulness of the difference between MLS and HT as a prognostic variable in patients with ASDH. Level of evidence Level III, epidemiological study.
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Affiliation(s)
| | | | - Davi Jorge Fontoura Solla
- Department of Neurology, University of São Paulo, São Paulo, Brazil.,Department of Neurology, University of Cambridge, Cambridge, UK
| | | | | | | | | | - Angelos G Kolias
- Department of Clinical Neuroscience - Division of Neurosurgery, Addenbrooke's Hospital, Cambridge, UK
| | - Daniel Godoy
- Intensive Care Unit, San Juan Bautista Hospital, San Fernando del Valle de Catamarca, Argentina
| | - Wellingson Silva Paiva
- Department of Neurology, University of São Paulo, São Paulo, Brazil.,Department of Neurology, University of Cambridge, Cambridge, UK
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Pietzka S, Kämmerer PW, Pietzka S, Schramm A, Lampl L, Lefering R, Bieler D, Kulla M. Maxillofacial injuries in severely injured patients after road traffic accidents-a retrospective evaluation of the TraumaRegister DGU® 1993-2014. Clin Oral Investig 2019; 24:503-513. [PMID: 31377860 PMCID: PMC7223802 DOI: 10.1007/s00784-019-03024-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 07/11/2019] [Indexed: 12/20/2022]
Abstract
Objectives It was the aim of the study to analyse the prevalence of maxillofacial trauma (MFT) in severely injured patients after road traffic accidence (RTA) and to investigate associated factors. Materials and methods In a retrospective study, data from patients after RTA by the TraumaRegister DGU® from 1993 to 2014 were evaluated for demographical and injury characteristics. The predictor variable was mechanism of injury and the outcome variables were type of injury, severity and hospital resources utilization. Results During the investigation period, n = 62,196 patients were enclosed with a prevalence of maxillofacial injuries of 20.3% (MFT positive). The injury severity score of MFT-positive patients was higher than in the MTF-negative subgroup (27 ± 12.8 vs. 23.0 ± 12.7). If MFT positive, 39.8% show minor, 37.1% moderate, 21.5% serious and 1.6% severe maxillofacial injuries. Injuries of the midface occurred in 60.3% of MTF-positive patients. A relevant blood loss (> 20% of total blood volume) occurred in 1.9%. MFT-positive patients had a higher coincidence with cervical spine fractures (11.3% vs. 7.8%) and traumatic brain injuries (62.6% vs. 34.8%) than MFT-negative patients. There was a noticeable decrease in the incidence of facial injuries in car/truck drivers during the study period. Conclusions Every 5th patient after RTA shows a MFT and the whole trauma team must be aware that this indicates a high prevalence of traumatic brain and cervical spine injuries. Clinical relevance Even if sole injuries of the face are seldom life threatening, maxillofacial expertise in interdisciplinary trauma centres is strongly recommended.
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Affiliation(s)
- Sebastian Pietzka
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
| | - Peer W. Kämmerer
- Department of Cranio-Maxillo-Facial-Surgery, University Medical Centre Mainz, Mainz, Germany
| | - Silke Pietzka
- Department of Dental Care and Centre for Dental Specialties, German Armed Forces Hospital Ulm, Ulm, Germany
| | - Alexander Schramm
- Department of Cranio-Maxillo-Facial-Surgery, German Armed Forces Hospital Ulm, Ulm, Germany
- Department of Cranio-Maxillo-Facial-Surgery, University Hospital Ulm, Ulm, Germany
| | - Lorenz Lampl
- Department of Anaesthesiology and Intensive Care Medicine, German Armed Forces Hospital of Ulm, Ulm, Germany
| | - Rolf Lefering
- Institute for Research in Operative Medicine (IFOM), Witten/Herdecke University, Witten, Germany
| | - Dan Bieler
- Department of Trauma Surgery and Orthopaedics, Reconstructive Surgery, Hand Surgery and Burn Medicine, German Armed Forces Central Hospital Koblenz, Ruebenacher Strasse 170, 56072 Koblenz, Germany
| | - Martin Kulla
- Department of Anaesthesiology and Intensive Care Medicine, Emergency Medicine Section, HEMS Christoph 22, German Armed Forces Hospital of Ulm, Oberer Eselsberg 40, 89081 Ulm, Germany
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Management and outcome of moderate head trauma: our experience. ROMANIAN NEUROSURGERY 2018. [DOI: 10.2478/romneu-2018-0016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractObjective: The aim of this study is to follow up patients with moderate head trauma who were admitted to Mansoura University Hospital in the period from 1 Dec. 2015 to 30 Jul. 2016 until discharge and determine the outcome of head trauma.Material and Methods:This prospective study were conducted on all patients with moderate head trauma admitted to Mansoura Emergency Hospital during the period from 1 Dec. 2015 to 30 Jul. 2016 with exclude Polytrauma, bleeding disorders, severe liver and kidney disease patients.Results: In this study, we correlated different risk factors with management and with outcome. Management may be surgical or conservative and outcome may be alive or dead. We have 60 patients with 17 cases (28.3%) were treated surgically and 43 cases (71.6%) were treated conservatively. According to outcome 36 cases (60%) were alive and 24 cases (40%) died, all cases managed in ICU. According to sex, 10 cases (17%) were female and 50 cases were male (83%) with statistically nonsignificant effect on outcome (P = 0.7) and management (P =0.7). road traffic accidents is most common cause of injury with 33 cases (55%), and Cause of injury had statistically significant effect on management (P = 0.02) and statistically non-significant effect on outcome (p = 0.4). GCS on admission had no statistically significant effect on management (P=0.8) and outcome (P=0.1) with mean of 10.1±1.2 and GCS on discharge had no statistically significant effect on management (P=0.6).Conclusion: There were significant effect of age of patients, systemic diseases (such as DM, HTN, chronic kidney diseases, and chronic liver diseases), type of lesions (especially SDH, SAH), and serum electrolytes (especially serum Sodium) on outcome which determined by GCS at discharge, length of hospital stay, and the state of the patient at discharge.
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Zhang K, Shi Z, Zhou J, Xing Q, Ma S, Li Q, Zhang Y, Yao M, Wang X, Li Q, Li J, Guan F. Potential application of an injectable hydrogel scaffold loaded with mesenchymal stem cells for treating traumatic brain injury. J Mater Chem B 2018; 6:2982-2992. [DOI: 10.1039/c7tb03213g] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
In this contribution, we developed an injectable hydrogel composed of sodium alginate and hyaluronic acid that acts as a tissue scaffold to create a more optimal microenvironment for the stem cells for potential application of traumatic brain injury implantation.
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10
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Moussa WMM, Khedr WM, Elwany AH. Prognostic significance of hematoma thickness to midline shift ratio in patients with acute intracranial subdural hematoma: a retrospective study. Neurosurg Rev 2017; 41:483-488. [DOI: 10.1007/s10143-017-0873-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
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Venegoni W, Shen Q, Thimmesch AR, Bell M, Hiebert JB, Pierce JD. The use of antioxidants in the treatment of traumatic brain injury. J Adv Nurs 2017; 73:1331-1338. [PMID: 28103389 DOI: 10.1111/jan.13259] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2017] [Indexed: 11/26/2022]
Abstract
AIMS The aim of this study was to discuss secondary traumatic brain injury, the mitochondria and the use of antioxidants as a treatment. BACKGROUND One of the leading causes of death globally is traumatic brain injury, affecting individuals in all demographics. Traumatic brain injury is produced by an external blunt force or penetration resulting in alterations in brain function or pathology. Often, with a traumatic brain injury, secondary injury causes additional damage to the brain tissue that can have further impact on recovery and the quality of life. Secondary injury occurs when metabolic and physiologic processes alter after initial injury and includes increased release of toxic free radicals that cause damage to adjacent tissues and can eventually lead to neuronal necrosis. Although antioxidants in the tissues can reduce free radical damage, the magnitude of increased free radicals overwhelms the body's reduced defence mechanisms. Supplementing the body's natural supply of antioxidants, such as coenzyme Q10, can attenuate oxidative damage caused by reactive oxygen species. DESIGN Discussion paper. DATA SOURCES Research literature published from 2011-2016 in PubMed, CINAHL and Cochrane. IMPLICATIONS FOR NURSING Prompt and accurate assessment of patients with traumatic brain injury by nurses is important to ensure optimal recovery and reduced lasting disability. Thus, it is imperative that nurses be knowledgeable about the secondary injury that occurs after a traumatic brain injury and aware of possible antioxidant treatments. CONCLUSION The use of antioxidants has potential to reduce the magnitude of secondary injury in patients who experience a traumatic brain injury.
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Affiliation(s)
| | - Qiuhua Shen
- School of Nursing, University of Kansas, Kansas, USA
| | | | - Meredith Bell
- School of Nursing, University of Kansas, Kansas, USA
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13
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Veeramuthu V, Narayanan V, Ramli N, Hernowo A, Waran V, Bondi MW, Delano-Wood L, Ganesan D. Neuropsychological Outcomes in Patients with Complicated Versus Uncomplicated Mild Traumatic Brain Injury: 6-Month Follow-Up. World Neurosurg 2016; 97:416-423. [PMID: 27751922 DOI: 10.1016/j.wneu.2016.10.041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the extent of persistent neuropsychological impairment in patients with complicated mild traumatic brain injury (mTBI) and those with uncomplicated mTBI. METHODS Sixty-one patients with mTBI (Glasgow Coma Scale score 13-15) were recruited prospectively, categorized according to baseline computed tomography findings, and subjected to neuropsychological assessment at initial admission (n = 61) as well as at a 6-month follow-up (n = 30). The paired t test, Cohen's d effect size calculation, and repeated-measures analysis of variance were used to establish the differences between the 2 groups in terms of neuropsychological performance. RESULTS A trend toward poorer neuropsychological performance among the patients with complicated mTBI was observed during admission; however, performance in this group improved over time. In contrast, the uncomplicated mTBI group showed slower recovery, especially in tasks of memory, visuospatial processing, and executive functions, at follow-up. CONCLUSIONS Our findings suggest that despite the broad umbrella designation of mTBI, the current classification schemes of injury severity for mild neurotrauma should be revisited. They also raise questions about the clinical relevance of both traumatic focal lesions and the absence of visible traumatic lesions on brain imaging studies in patients with milder forms of head trauma.
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Affiliation(s)
- Vigneswaran Veeramuthu
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vairavan Narayanan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Norlisah Ramli
- Research Imaging Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Aditya Hernowo
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Vicknes Waran
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mark W Bondi
- VA San Diego Healthcare System, San Diego, California, USA; Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Lisa Delano-Wood
- VA San Diego Healthcare System, San Diego, California, USA; Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Dharmendra Ganesan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Bragge P, Synnot A, Maas AI, Menon DK, Cooper DJ, Rosenfeld JV, Gruen RL. A State-of-the-Science Overview of Randomized Controlled Trials Evaluating Acute Management of Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2016; 33:1461-78. [PMID: 26711675 PMCID: PMC5003006 DOI: 10.1089/neu.2015.4233] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Moderate-to-severe traumatic brain injury (TBI) remains a major global challenge, with rising incidence, unchanging mortality and lifelong impairments. State-of-the-science reviews are important for research planning and clinical decision support. This review aimed to identify randomized controlled trials (RCTs) evaluating interventions for acute management of moderate/severe TBI, synthesize key RCT characteristics and findings, and determine their implications on clinical practice and future research. RCTs were identified through comprehensive database and other searches. Key characteristics, outcomes, risk of bias, and analysis approach were extracted. Data were narratively synthesized, with a focus on robust (multi-center, low risk of bias, n > 100) RCTs, and three-dimensional graphical figures also were used to explore relationships between RCT characteristics and findings. A total of 207 RCTs were identified. The 191 completed RCTs enrolled 35,340 participants (median, 66). Most (72%) were single center and enrolled less than 100 participants (69%). There were 26 robust RCTs across 18 different interventions. For 74% of 392 comparisons across all included RCTs, there was no significant difference between groups. Positive findings were broadly distributed with respect to RCT characteristics. Less than one-third of RCTs demonstrated low risk of bias for random sequence generation or allocation concealment, less than one-quarter used covariate adjustment, and only 7% employed an ordinal analysis approach. Considerable investment of resources in producing 191 completed RCTs for acute TBI management has resulted in very little translatable evidence. This may result from broad distribution of research effort, small samples, preponderance of single-center RCTs, and methodological shortcomings. More sophisticated RCT design, large multi-center RCTs in priority areas, increased focus on pre-clinical research, and alternatives to RCTs, such as comparative effectiveness research and precision medicine, are needed to fully realize the potential of acute TBI research to benefit patients.
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Affiliation(s)
- Peter Bragge
- Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Monash University and The Alfred Hospital, Victoria, Australia
- BehaviourWorks Australia, Monash Sustainability Institute, Monash University, Victoria, Australia
| | - Anneliese Synnot
- Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Monash University and The Alfred Hospital, Victoria, Australia
- Cochrane Consumers and Communication Review Group, Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Andrew I. Maas
- Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium
| | - David K. Menon
- Division of Anaesthesia, University of Cambridge; Neurosciences Critical Care Unit, Addenbrooke's Hospital; Queens' College, Cambridge, United Kingdom
| | - D. James Cooper
- Department of Intensive Care, Alfred Hospital, Victoria, Australia; Department of Epidemiology and Preventive Medicine, Monash University, Victoria, Australia
| | - Jeffrey V. Rosenfeld
- Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Monash University and The Alfred Hospital, Victoria, Australia
- Monash Institute of Medical Engineering (MIME); Division of Clinical Sciences and Department of Surgery, Central Clinical School, Monash University, Victoria, Australia; Department of Neurosurgery, Alfred Hospital, Victoria, Australia; F. Edward Hébert School of Medicine, Uniformed Services University of The Health Sciences (USUHS), Bethesda, Maryland
| | - Russell L. Gruen
- Centre of Excellence in Traumatic Brain Injury Research, National Trauma Research Institute, Monash University and The Alfred Hospital, Victoria, Australia
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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15
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Choonthar MM, Raghothaman A, Prasad R, Pradeep S, Pandya K. Head Injury- A Maxillofacial Surgeon's Perspective. J Clin Diagn Res 2016; 10:ZE01-6. [PMID: 26894193 DOI: 10.7860/jcdr/2016/16112.7122] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 11/19/2015] [Indexed: 11/24/2022]
Abstract
Injuries and violence are one of the leading causes of mortality worldwide. A substantial portion of these injuries involve the maxillofacial region. Among the concomitant injuries, injuries to the head and cervical spine are amongst those that demand due consideration on account of their life threatening behaviour. Studies have shown that facial fractures have a strong association with traumatic brain injury. Knowledge of the types and mechanisms of traumatic brain injury is crucial for their treatment. Many a times, facial fractures tend to distract our attention from more severe and often life threatening injuries. Early diagnosis of these intracranial haemorrhage leads to prompt treatment which is essential to improve the outcome of these patients. An oral and maxillofacial surgeon should be able to suspect and diagnose head injury and also provide adequate initial management.
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Affiliation(s)
- Muralee Mohan Choonthar
- Professor, Department of Oral And Maxillofacial Surgery, A.B.Shetty Memorial Institute of Dental Sciences , Mangalore, India
| | - Ananthan Raghothaman
- Consultant Neurosurgeon, Justice K.S.Hegde Charitable Hospital , Mangalore, India
| | - Rajendra Prasad
- Professor, Director of Pg Studies, Department of Oral And Maxillofacial Surgery, A.B.Shetty Memorial Institute of Dental Sciences , Mangalore, India
| | - S Pradeep
- Post Graduate, Department of Oral And Maxillofacial Surgery, A.B.Shetty Memorial Institute of Dental Sciences , Mangalore, India
| | - Kalpa Pandya
- Post Graduate, Department of Oral And Maxillofacial Surgery, A.B.Shetty Memorial Institute of Dental Sciences , Mangalore, India
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16
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Recent advances in the management of oral and maxillofacial trauma. Br J Oral Maxillofac Surg 2015; 53:913-21. [DOI: 10.1016/j.bjoms.2015.08.261] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 08/20/2015] [Indexed: 11/17/2022]
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17
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Lourens A, Botha JC. Hypertonic saline (HTS) versus standard (isotonic) fluid therapy for traumatic brain injuries: a systematic review. Afr J Emerg Med 2014. [DOI: 10.1016/j.afjem.2014.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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18
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Rajandram RK, Syed Omar SN, Rashdi MFN, Abdul Jabar MN. Maxillofacial injuries and traumatic brain injury - a pilot study. Dent Traumatol 2013; 30:128-32. [DOI: 10.1111/edt.12052] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Rama Krsna Rajandram
- Department of Oral and Maxillofacial Surgery; National University of Malaysia; Kuala Lumpur Malaysia
| | - Syed Nabil Syed Omar
- Department of Oral and Maxillofacial Surgery; National University of Malaysia; Kuala Lumpur Malaysia
| | - Muhd Fazly Nizam Rashdi
- Department of Oral and Maxillofacial Surgery; National University of Malaysia; Kuala Lumpur Malaysia
| | - Mohd Nazimi Abdul Jabar
- Department of Oral and Maxillofacial Surgery; National University of Malaysia; Kuala Lumpur Malaysia
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19
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DiFazio J, Fletcher DJ. Updates in the management of the small animal patient with neurologic trauma. Vet Clin North Am Small Anim Pract 2013; 43:915-40. [PMID: 23747266 DOI: 10.1016/j.cvsm.2013.03.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Neurologic trauma, encompassing traumatic brain injury (TBI) and acute spinal cord injury (SCI), is a cause of significant morbidity and mortality in veterinary patients. Acute SCIs occurring secondary to trauma are also common. Essential to the management of TBI and SCI is a thorough understanding of the pathophysiology of the primary and secondary injury that occurs following trauma. This article reviews the pathophysiology of this primary and secondary injury, as well as recommendations regarding clinical assessment, diagnostics, pharmacologic and nonpharmacologic therapy, and prognosis.
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Affiliation(s)
- Jillian DiFazio
- Section of Emergency and Critical Care, Cornell University Hospital for Animals, Upper Tower Road, Ithaca, NY 14853, USA
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20
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Arbour RB. Traumatic brain injury: pathophysiology, monitoring, and mechanism-based care. Crit Care Nurs Clin North Am 2013; 25:297-319. [PMID: 23692946 DOI: 10.1016/j.ccell.2013.02.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Traumatic brain injury, which may be blunt or penetrating, begins altering intracranial physiology at the moment of impact as primary brain trauma. This article differentiates blunt versus penetrating brain trauma, primary versus secondary brain injury, and subsequent intracranial pathophysiology. Discussion and case study correlate intracranial pathophysiology and multisystem influences on evolving brain injury with mechanism-based interventions to modulate brain components (brain, blood, and cerebrospinal fluid volumes). The discussion also explores the effects of controlled ventilation, cardiopulmonary physiology, and global physiologic state on secondary injury, control of intracranial pressure, and recovery.
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21
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Farhad K, Khan HM, Ji AB, Yacoub HA, Qureshi AI, Souayah N. Trends in Outcomes and Hospitalization Costs for Traumatic Brain Injury in Adult Patients in the United States. J Neurotrauma 2013; 30:84-90. [DOI: 10.1089/neu.2011.2283] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Khosro Farhad
- Department of Neurology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - Hafiz M.R. Khan
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Andrew B. Ji
- Department of Neurology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - Hussam A. Yacoub
- Department of Neurology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
| | - Adnan I. Qureshi
- Zeenat Qureshi Stroke Research Center, University of Minnesota, Minneapolis, Minnesota
| | - Nizar Souayah
- Department of Neurology, University of Medicine and Dentistry of New Jersey, Newark, New Jersey
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Abstract
The aim of this article was to provide a resource for critical care nurses wishing to further their understanding of inotropic drugs used in critical care. The physiology of cardiac output and blood pressure is examined along with an explanation of adrenergic receptors acted on by inotropes. Some common indications for inotropic therapy are discussed, along with essential patient monitoring and dose calculations to ensure safe therapeutic ranges are observed. Some of the most commonly used positive inotropes used in critical care environments are individually explored, providing indications and some of the latest research relating to their uses. Frequently, observed side effects of individual inotropes are also offered, enabling the nurse to maintain patient safety when administering these potent drugs. Some major nursing and professional issues related to inotrope therapy and medicine administration are discussed, as well as some recommended practices in renewing infusions.
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Affiliation(s)
- Andrew Parry
- Faculty of Health, Sport and Science, Lower Glyntaf Campus, University of Glamorgan, Pontypridd, UK.
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