Neurological research
-
Neurological research · Dec 2008
ReviewThe application of viral vectors to enhance regeneration after peripheral nerve repair.
Despite great advancements in surgical repair techniques, a considerable degree of functional impairment remains in the majority of patients after peripheral nerve reconstruction. New concepts to promote regeneration of the peripheral nerve are needed since it is generally held that surgery has reached an optimal technical refinement. Several neurotrophic factors stimulate regeneration of the peripheral nerve, but the effects of the exogenous application of these factors have so far been limited, possibly as the result of their fast degradation and unwanted side effects after systemic application. These problems can be resolved with the recent development of non-toxic, non-immunogenic viral vectors that drive local, long-term transgene expression. ⋯ In the near future, viral vectors will increasingly be used to study a wide range of neurotrophic factors and other potentially therapeutic proteins for their effect on peripheral nerve regeneration in animal models. If this approach leads to beneficial effects on regeneration and functional recovery, the safety and clinical applicability of these viral vectors will allow the rapid translation of basic research to clinical trials. This makes the use of viral vectors a highly attractive concept that holds great promise as a novel adjuvant therapy to peripheral nerve reconstruction.
-
Neurological research · Dec 2008
Clinical TrialTemperature disturbances in traumatic brain injury: relationship to secondary insults, barbiturate treatment and outcome.
To describe the occurrence of spontaneous hyper- and hypothermia in patients with traumatic brain injury using a computerized data collecting system, to show how temperature correlates with other secondary insults, to describe how temperature affects outcome and to show how barbiturate treatment influences those analyses. ⋯ Patients with hyperthermia, hypertension, high CPP and tachycardia may suffer from a hyperdynamic state. This may worsen outcome and hence clinical awareness is important. Barbiturate treatment confounds several analyses which have not been shown before. We recommend those patients to be analysed separately in future studies.