Restor Neurol Neuros
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Restor Neurol Neuros · Jan 2003
ReviewMolecular markers of brain damage--clinical and ethical implications with particular focus on cardiac arrest.
Although 25-50% of patients suffering from cardiac arrest can be stabilised haemodynamically, the hospital discharge rate is only 2-14%. One of the major causes of this discrepancy is persistent brain damage. Studies to assess the prognostic value of early prediction of neurologic and overall outcome in patients with cardiac arrest have not yet produced precise and generally accepted diagnostic rules. ⋯ Although it cannot be absolutely determined whether cerebral or cardiac release of S100 is predominant in this clinical setting, recent studies have revealed that S100 serum levels are a useful diagnostic tool for outcome prediction. In contrast, after cardiac arrest serum levels of protein S100 did not reach a 100% specificity and sensitivity in clinical studies, and, therefore, elevated S100 in these patients has to be interpreted with caution. Nonetheless, low S100 serum levels have been correlated with good outcome and, therefore, even if all other diagnostic tests indicate poor outcome, all therapeutic efforts must be undertaken, as no single study has shown that normal S100 serum levels were associated with poor prognosis.
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Restor Neurol Neuros · Jan 2002
ReviewQuality of life in patients with traumatic brain injury-basic issues, assessment and recommendations.
Traumatic brain injuries (TBI) are one of the most common consequences of traffic accidents. Patients with mild, moderate or severe brain injuries suffer from physical, cognitive, behavioral, emotional and social problems. Most of these problems have been a long standing focus amongst practitioners and researchers. Only recently a development has started that took interest in the quality of life outcome of TBI patients. The international members of this consensus meeting reviewed the literature on Quality of Life assessment after TBI and discussed the applicability of different measurements to this specific patient group. ⋯ The family's and relatives' view of the patient's QoL should not be used as a proxy but provides an additional source of information in the acute phase. At T2 and T3, assessment of the patient's quality of life should include a generic as well as a disease specific instrument. Among the generic instruments the SF-36, the EuroQol and the WHO-QoL should be considered. The literature about specific instruments for patients with TBI like the EBIC is scarce. Therefore, the group could hardly give an empirically based recommendation. The need for further investigation on QoL instruments in TBI patients is strongly emphasized.
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Restor Neurol Neuros · Jan 2002
ReviewQuality of life in patients with multiple injuries--basic issues, assessment, and recommendations.
While the primary goal of trauma care continues to be the preservation of life, interest has begun to focus on disability and quality of life of those who survive. Numerous instruments have been developed to measure personal well-being, impairment, or subjective life-satisfaction. But there is no consensus regarding which instruments are most appropriate to use in multiply injured patients, and comparison of results are difficult. ⋯ While most selected measures are psychometrically sound, many have had limited use in the setting of multiple injuries. Researchers and clinicians may use these suggestions as a source of information when developing a measurement strategy.
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Restor Neurol Neuros · Jan 2001
Effects of chronic, post-injury Cyclosporin A administration on motor and sensorimotor function following severe, experimental traumatic brain injury.
Cyclosporin A (CsA) is widely used in clinical situations to attenuate graft rejection following organ and central nervous system transplantation. Previous studies demonstrated that CsA administration is neuroprotective in models of traumatic brain injury (TBI). However, no studies, to date, have evaluated the influence of post-injury CsA administration on behavioral recovery after TBI. ⋯ These data suggest that daily post-injury treatment with CsA improves certain aspects of motor and sensorimotor function following experimental TBI.
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Restor Neurol Neuros · Jan 2001
Selective fascicular stimulation of the rat sciatic nerve with multipolar polyimide cuff electrodes.
To assess a new flexible, multicontact spiral-cuff electrode made of polyimide with integrated platinum contacts for selective stimulation of nerve fascicles. ⋯ Despite the relative small size of the rat sciatic nerve and the close apposition of tibial and peroneal fascicles, we proved the feasibility of using multipolar polyimide cuff electrodes to produce selective fascicular nerve stimulation.