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Osiac E, Mitran SI, Manea CN, Cojocaru A, Rosu G, Osiac M, Pirici DN, Bălșeanu AT, Cătălin B. Optical coherence tomography microscopy in experimental traumatic brain injury. Microsc Res Tech 2021; 84:422-431. [PMID: 33009699 PMCID: PMC7891427 DOI: 10.1002/jemt.23599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 12/28/2022]
Abstract
Worldwide elderly traumatic brain injury (TBI) patients tend to become an increasing burden to the society. Thus, a faster and less expensive way of evaluating TBI victims is needed. In the present study we investigated if optical coherence tomography (OCT) could be used as such a method. By using an animal model, we established if OCT can detect cortical changes in the acute phase of a penetrating TBI, in young (5-7 months) and old (20-22 months) rats. Due to the long-term evolution of TBI's, we wanted to investigate to what extent OCT could detect changes within the cortex in the chronic phase. Adult (7-12 months) male rats were used. Surprisingly, OCT imaging of the normal hemisphere was able to discriminate age-related differences in the mean gray values (MGV) of recorded pixels (p = .032). Furthermore, in the acute phase of TBI, OCT images recorded at 24 hr after the injury showed differences between the apparent damaged area of young and aged animals. Changes of MGV and skewness were only recorded 48 hr after injury. Monitoring the chronical evolution of the TBI with OCT revealed changes over time exceeding the normal range recorded for MGV, skewness and kurtosis, 14 and 21 days after TBI. Although in the present study we still used an extremely invasive approach, as technology improves, less invasive and non-harmful ways of recording OCT may allow for an objective way to detect changes within the brain structure after brain injuries.
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Affiliation(s)
- Eugen Osiac
- Experimental Research Center for Normal and Pathological AgingUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
- Department of BiophysicsUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Smaranda Ioana Mitran
- Experimental Research Center for Normal and Pathological AgingUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
- Department of PhysiologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Cătălin Nicolae Manea
- Experimental Research Center for Normal and Pathological AgingUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
- Department of Informatics, Communication and StatisticsUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Alexandru Cojocaru
- Department of PhysiologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Gabriela‐Camelia Rosu
- Department of Research MethodologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Mariana Osiac
- Department of Physics, Faculty of ScienceUniversity of CraiovaCraiovaRomania
| | - Daniel Nicolae Pirici
- Department of Research MethodologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Adrian Tudor Bălșeanu
- Experimental Research Center for Normal and Pathological AgingUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
- Department of PhysiologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
| | - Bogdan Cătălin
- Experimental Research Center for Normal and Pathological AgingUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
- Department of PhysiologyUniversity of Medicine and Pharmacy of CraiovaCraiovaRomania
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Salah M, Saatchi R, Lecky F, Burke D. Traumatic brain injury probability of survival assessment in adults using iterative random comparison classification. Healthc Technol Lett 2020; 7:119-124. [PMID: 33282321 PMCID: PMC7704143 DOI: 10.1049/htl.2019.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 04/22/2020] [Accepted: 07/07/2020] [Indexed: 11/19/2022] Open
Abstract
Trauma brain injury (TBI) is the most common cause of death and disability in young adults. A method to determine the probability of survival (Ps) in trauma called iterative random comparison classification (IRCC) was developed and its performance was evaluated in TBI. IRCC operates by iteratively comparing the test case with randomly chosen subgroups of cases from a database of known outcomes (survivors and not survivors) and determines the overall percentage match. The performance of IRCC to determine Ps in TBI was compared with two existing methods. One was Ps14 that uses regression and the other was predictive statistical diagnosis (PSD) that is based on Bayesian statistic. The TBI database contained 4124 adult cases (mean age 67.9 years, standard deviation 21.6) of which 3553 (86.2%) were survivors and 571 (13.8%) were not survivors. IRCC determined Ps for the survivors and not survivors with an accuracy of 79.0 and 71.4%, respectively, while the corresponding values for Ps14 were 97.4% (survivors) and 40.2% (not survivors) and for PSD were 90.8% (survivors) and 50% (not survivors). IRCC could be valuable for determining Ps in TBI and with a suitable database in other traumas.
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Affiliation(s)
- Mohammed Salah
- Materials and Engineering Research Institute, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Reza Saatchi
- Materials and Engineering Research Institute, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Fiona Lecky
- Centre for Urgent and Emergency Care Research, Health Services Research Section, School of Health and Related Research, University of Sheffield, Sheffield S10 2TH, UK
| | - Derek Burke
- Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK
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Kord Z, Alimohammadi N, Jafari Mianaei S, Riazi A, Zarasvand B. Clinical Guideline for Nursing Care of Children with Head Trauma (HT): Study Protocol for a Sequential Exploratory Mixed-Method Study. Pediatric Health Med Ther 2020; 11:269-275. [PMID: 32848495 PMCID: PMC7429226 DOI: 10.2147/phmt.s260720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/21/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Head trauma is a major health problem. Its primary complications happen at the time of trauma and are inevitable; thus, head trauma management is focused on the prevention and management of secondary complications. A clear clinical guideline for head trauma care can help nurses effectively prevent and manage secondary complications. This study aims to develop the clinical guideline for nursing care of children under 18 years with head trauma hospitalized in emergency departments, critical care units, and neurosurgery wards. METHODS This sequential exploratory mixed-method study will be conducted in three main phases as follows: qualitative, systematic review, and integration phases. In the qualitative phase, semi-structured interviews will be conducted to determine the care-related needs of children with head trauma. In the systematic review phase, a systematic review will be performed to find and then to review the most relevant articles, books, and the appropriate clinical guidelines. The quality of the retrieved guidelines will be assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. In the integration phase, the findings of the qualitative and systematic review phases were integrated, the draft of the guideline will be prepared, which will then be revised and validated through a nationwide Delphi survey. DISCUSSION The guideline for nursing care of children with head trauma can help to more effectively prevent, reduce, and manage the secondary complications of head trauma. Moreover, it reduces disability and mortality rates, improves nursing care quality, decreases healthcare costs, shortens hospital stay, and makes more rational clinical decisions.
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Affiliation(s)
- Zeynab Kord
- School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasrollah Alimohammadi
- Critical Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soheila Jafari Mianaei
- Children Care Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Riazi
- Department of Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran, Department of Pediatric Neurosurgery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Zarasvand
- Department of Neurosurgery, Dezful University of Medical Sciences, Dezful, Iran
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Martin-Jiménez C, Gaitán-Vaca DM, Areiza N, Echeverria V, Ashraf GM, González J, Sahebkar A, Garcia-Segura LM, Barreto GE. Astrocytes Mediate Protective Actions of Estrogenic Compounds after Traumatic Brain Injury. Neuroendocrinology 2019; 108:142-160. [PMID: 30391959 DOI: 10.1159/000495078] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 11/02/2018] [Indexed: 11/19/2022]
Abstract
Traumatic brain injury (TBI) is a serious public health problem. It may result in severe neurological disabilities and in a variety of cellular metabolic alterations for which available therapeutic strategies are limited. In the last decade, the use of estrogenic compounds, which activate protective mechanisms in astrocytes, has been explored as a potential experimental therapeutic approach. Previous works have suggested estradiol (E2) as a neuroprotective hormone that acts in the brain by binding to estrogen receptors (ERs). Several steroidal and nonsteroidal estrogenic compounds can imitate the effects of estradiol on ERs. These include hormonal estrogens, phytoestrogens and synthetic estrogens, such as selective ER modulators or tibolone. Current evidence of the role of astrocytes in mediating protective actions of estrogenic compounds after TBI is reviewed in this paper. We conclude that the use of estrogenic compounds to modulate astrocytic properties is a promising therapeutic approach for the treatment of TBI.
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Affiliation(s)
- Cynthia Martin-Jiménez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Diana Milena Gaitán-Vaca
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Natalia Areiza
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Valentina Echeverria
- Universidad San Sebastián, Fac. Cs de la Salud, Concepción, Chile
- Research and Development Service, Bay Pines VA Healthcare System, Bay Pines, Florida, USA
| | - Ghulam Md Ashraf
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Janneth González
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Amirhossein Sahebkar
- Biotechnology Research Center, Pharmaceutical technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran
- Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Luis Miguel Garcia-Segura
- Instituto Cajal, CSIC, Madrid, Spain
- Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
| | - George E Barreto
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias Pontificia Universidad Javeriana, Bogotá, Colombia,
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Chi FL, Lang TC, Sun SJ, Tang XJ, Xu SY, Zheng HB, Zhao HS. Relationship between different surgical methods, hemorrhage position, hemorrhage volume, surgical timing, and treatment outcome of hypertensive intracerebral hemorrhage. World J Emerg Med 2014; 5:203-8. [PMID: 25225585 DOI: 10.5847/wjem.j.issn.1920-8642.2014.03.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 07/19/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The present study aimed to explore the relationship between surgical methods, hemorrhage position, hemorrhage volume, surgical timing and treatment outcome of hypertensive intracerebral hemorrhage (HICH). METHODS A total of 1 310 patients, who had been admitted to six hospitals from January 2004 to January 2008, were divided into six groups according to different surgical methods: craniotomy through bone flap (group A), craniotomy through a small bone window (group B), stereotactic drilling drainage (group C1 and group C2), neuron-endoscopy operation (group D) and external ventricular drainage (group E) in consideration of hemorrhage position, hemorrhage volume and clinical practice. A retrospective analysis was made of surgical timing and curative effect of the surgical methods. RESULTS The effectiveness rate of the methods was 74.12% for 1 310 patients after one-month follow-up. In this series, the disability rate was 44.82% 3-6 months after the operation. Among the 1 310 patients, 241 (18.40%) patients died after the operation. If hematoma volume was >80 mL and the operation was performed within 3 hours, the mortality rate of group A was significantly lower than that of groups B, C, D, and E (P<0.05). If hematoma volume was 50-80 mL and the operation was performed within 6-12 hours, the mortality rate of groups B and D was lower than that of groups A, C and E (P<0.05). If hematoma volume was 20-50 mL and the operation was performed within 6-24 hours, the mortality rate of group C was lower than that of groups A, B and D (P<0.05). CONCLUSIONS Craniotomy through a bone flap is suitable for patients with a large hematoma and hernia of the brain. Stereotactic drilling drainage is suggested for patients with hematoma volume less than 80 mL. The curative effect of HICH individualized treatment would be improved via the suitable selection of operation time and surgical method according to the position and volume of hemorrhage.
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Affiliation(s)
- Feng-Ling Chi
- Department of Neurosurgery, Shanghai 7th Hospital, Shanghai 200137, China
| | - Tie-Cheng Lang
- Yueyang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Shu-Jie Sun
- Emergency Medicine Department, Dongfang Hospital of Shanghai, Shanghai, China
| | - Xue-Jie Tang
- Second Hospltal of Dalian Medical University, Dlian, China
| | - Shu-Yuan Xu
- Shanghai Pudong New Area Gongli Hospital, Shanghai, China
| | - Hong-Bo Zheng
- First People's Hospital of Qiqihaer City, Heilongjiang Province, China
| | - Hui-Song Zhao
- Third Affiliated Hospital, Qiqihar Medical College, Heilongjiang Province, China
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Zhang JX, Chen YL, Zhou YL, Guo QY, Wang XP. Expression of tissue factor in rabbit pulmonary artery in an acute pulmonary embolism model. World J Emerg Med 2014; 5:144-7. [PMID: 25215165 DOI: 10.5847/wjem.j.issn.1920-8642.2014.02.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 12/27/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tissue factor (TF) is the initiation factor of the extrinsic coagulation pathway, and plays a critical role in the process of thrombosis. This study aimed to investigate the expression of TF and to explore their clinical effect on the pulmonary artery after acute pulmonary thromboembolism. METHODS Thirty-four Japanese white rabbits (Level II animals) supplied by Tianjin Medical University were randomly assigned into: group A, specimens of the pulmonary artery taken 3 hours after pulmonary embolism (n=8); group B, specimens of the pulmonary artery taken 8 hours after pulmonary embolism (n=8); group C, specimens of the pulmonary artery taken 24 hours after pulmonary embolism (n=8); and control group, pseudo-operations performed without injection of autologous blood clots (n=10). The animal model of pulmonary thrombo-embolism was established by injection of autologous blood clots into the jugular vein through a 5F catheter, and was confirmed by digital subtraction angiography. The mRNA expression of TF in different parts of the pulmonary artery was accessed by RT-PCR. The q test was used if there was a significant difference in a given continuous variable among the three groups assessed by ANOVA. The experiment equipment was supplied by the State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, the Chinese Academy of Medical Sciences and Peking Union Medical College. RESULTS The TF expression in the specimen adjacent to emboli was stable at 3, 8 or 24 hours after embolism. The mRNA expression of TF at 3 and 8 hours after embolism was lower in the specimens taken from the distal end of the morbid pulmonary artery than those adjacent to emboli. While at 24 hours after embolism, there were similar mRNA levels in specimens either adjacent or distal to emboli. CONCLUSION The high level of TF expression in pulmonary artery tissue adjacent to emboli could lead to locally increased coagulation activity, indicating the necessity of initiating anti- coagulation treatment as soon as possible after acute pulmonary embolism.
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Affiliation(s)
- Jing-Xia Zhang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, China
| | - Yong-Li Chen
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, China
| | - Yu-Ling Zhou
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, China
| | - Qian-Yu Guo
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, China
| | - Xian-Pei Wang
- Department of Cardiology, Tianjin Chest Hospital, Tianjin 300051, China
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