Frontiers in neurology
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Frontiers in neurology · Jan 2013
The potential for bio-mediators and biomarkers in pediatric traumatic brain injury and neurocritical care.
The use of biomarkers of brain injury in pediatric neurocritical care has been explored for at least 15 years. Two general lines of research on biomarkers in pediatric brain injury have been pursued: (1) studies of "bio-mediators" in cerebrospinal fluid (CSF) of children after traumatic brain injury (TBI) to explore the components of the secondary injury cascades in an attempt to identify potential therapeutic targets and (2) studies of the release of structural proteins into the CSF, serum, or urine in order to diagnose, monitor, and/or prognosticate in patients with TBI or other pediatric neurocritical care conditions. ⋯ Finally, although much of the early work on biomarkers of brain injury in pediatrics has focused on TBI, new applications are emerging across a wide range of conditions specifically for pediatric neurocritical care including abusive head trauma, cardiopulmonary arrest, septic shock, extracorporeal membrane oxygenation, hydrocephalus, and cardiac surgery. The potential scope of the utility of biomarkers in pediatric neurocritical care is thus also discussed.
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Frontiers in neurology · Jan 2013
Altered Low Frequency Oscillations of Cortical Vessels in Patients with Cerebrovascular Occlusive Disease - A NIRS Study.
Analysis of cerebral autoregulation by measuring spontaneous oscillations in the low frequency spectrum of cerebral cortical vessels might be a useful tool for assessing risk and investigating different treatment strategies in carotid artery disease and stroke. Near infrared spectroscopy (NIRS) is a non-invasive optical method to investigate regional changes in oxygenated (oxyHb) and deoxygenated hemoglobin (deoxyHb) in the outermost layers of the cerebral cortex. In the present study we examined oxyHb low frequency oscillations, believed to reflect cortical cerebral autoregulation, in 16 patients with both symptomatic carotid occlusive disease and cerebral hypoperfusion in comparison to healthy controls. ⋯ We found no statistical difference between hemispheres in hypoperfusion patients for phase shift or gain values. There were no differences between the hypoperfusion side and controls for phase shift or gain values. These preliminary results suggest an impairment of autoregulation in hypoperfusion patients at the cortical level detected by NIRS.
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Frontiers in neurology · Jan 2013
Quality of residual neuromuscular control and functional deficits in patients with spinal cord injury.
Prospective cohort study. ⋯ These results supported the hypothesis that clinically relevant function after SCI is related to the degree to which functional organization within the central nervous system is disrupted. Further, due likely to the constraints placed on the expression of functional ability by early post-injury immobilization and hospitalization, neurophysiological assessment of motor function may provide better sensitivity and reliability than can be obtained using the clinical function scales examined here within the early period after injury.
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Frontiers in neurology · Jan 2013
Long-term effects of neonatal single or multiple isoflurane exposures on spatial memory in rats.
General anesthetics are neurotoxic to neonatal rodents and non-human primates. Neonatal exposure to general anesthetics has been associated with long-term cognitive deficits in animal models. Some data from humans are consistent with long-term deleterious effects of anesthetic exposure early in life on cognitive development, with multiple exposures to general anesthetics being particularly damaging. ⋯ Male rats that received a single exposure to isoflurane showed an unexpected facilitation in spatial memory performance. These results support the hypothesis that multiple neonatal exposures to general anesthesia are associated with greater long-term cognitive impairment than a single exposure. The findings are congruent with human epidemiological studies reporting long-term cognitive impairments following multiple but not single general anesthetics early in life.
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Oral therapies and chemodenervation procedures are often unrewarding in the treatment of focal, task-specific hand disorders such as writer's cramp or primary writing tremor (PWT). ⋯ WODs exploiting a muscle-substitution strategy may yield immediate benefits in patients with writer's cramp.