Journal of the neurological sciences
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Traumatic brain injury (TBI) causes deleterious critical-illness-related-corticosteroid-insufficiency (CIRCI), leading to high mortality and morbidity. However, the incidence of CIRCI following different TBI severities is not fully defined. This study was designed to investigate mechanistically the effects of injury severity on corticosteroid response and the development of CIRCI in a rat model of experimentally controlled TBI. ⋯ Second, TBI-induced CIRCI is closely correlated with injury severity. As the injury severity rises both the incidence of CIRCI and mortality surge; Third, increased level of injury severity reduces the expression of endothelial tight junction protein, aggravate BBB permeability and exacerbate the ensuing neural apoptosis in the PVN of hypothalamus. These findings indicate that increased severity of TBI aggravate the incidence of CIRCI by causing damage to tight junctions of vascular endothelial cells and increasing neuronal apoptosis in the PVN of hypothalamus.
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Randomized Controlled Trial Comparative Study
An open labeled randomized controlled trial of pregabalin versus amitriptyline in chronic low backache.
There is no head on comparison of amitriptyline (AMT) and pregabalin (PG) in relieving pain and disability in chronic low backache (CLBA). This randomized controlled trial reports the efficacy and safety of AMT and PG in CLBA. ⋯ AMT and PG are effective in CLBA but AMT reduced pain and disability significantly compared to PG.
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Letter Case Reports
New IDH1 I113T mutation associated with BRAF V600E mutation: new driver of gliomagenesis?
IDH mutations and BRAF mutations are classically mutually exclusive and usually associated with infiltrative or circumscribed gliomas and glioneuronal tumors respectively. ⋯ We report a new IDH1 mutation associated with BRAF mutation in a very unusual glial tumor.
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Therapeutic targets for intracranial pressure (ICP) in patients with severe intracerebral hemorrhage (ICH) are approximated from data of traumatic brain injury. However, specific data for ICH are lacking. Here, we aimed to investigate the association between ICP, mortality and functional outcome following severe ICH. ⋯ Our data suggest that in the context of other predictors as age, admission clinical status, hemorrhage volume and intraventricular hemorrhage, average ICP, ICP variability and the frequency of ICP values >20 mm Hg are independently associated with mortality and poor outcome after ICH. Further studies and prospective validations of ICP thresholds for ICH patients are highly warranted.
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Early brain injury (EBI), following subarachnoid hemorrhage (SAH), comprises blood-brain barrier (BBB) disruption and consequent edema formation. Peripheral leukocytes can infiltrate the injured brain, thereby aggravating BBB leakage and neuroinflammation. Thus, anti-inflammatory pharmacotherapies may ameliorate EBI and provide neuroprotection after SAH. ⋯ Furthermore, JWH133 treatment significantly increased TGF-β1 expression and prevented an SAH-induced increase in E-selectin and myeloperoxidase. Lastly, SAH resulted in a decreased expression of the tight junction protein zonula occludens-1 (ZO-1); however, JWH133 treatment increased the ZO-1 expression. We suggest that CB2R stimulation attenuates neurological outcome and brain edema, by suppressing leukocyte infiltration into the brain through TGF-β1 up-regulation and E-selectin reduction, resulting in protection of the BBB after SAH.