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Treatment of severe traumatic brain injury with human bone marrow mesenchymal stem cell extracellular vesicles: a case report. 人骨髓间充质干细胞胞外囊泡治疗重型颅脑外伤1例。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2025-01-01 DOI: 10.1080/02699052.2024.2432967
Thomas S Nabity, John T Ransom

Objective: Extracellular vesicles (EVs) derived from regenerative mesenchymal stem cells might safely treat traumatic brain injury (TBI). We evaluated the safety and efficacy of a human bone marrow derived mesenchymal stem cell EVs (hBM-MSC EV) investigational product (IP) in a patient with severe TBI.

Design: A single case study employing an IP with a strong safety profile in over 200 patients.

Method: The patient was dosed intravenously three times/week in the first week of six successive months. Functional Independence Measure (FIM) and Functional Assessment Measure (FAM) were performed to quantify effects. Safety monitoring was performed every week for nine months.

Results: No adverse events occurred. Within eight weeks FIM and FAM scores improved by 48-55% and were sustained for the entire 36 weeks. All specific outcome items assessed by FIM and FAM that were initially low showed sustained improvements ranging from 41% to 233%, with the greatest improvements seen in locomotion, mobility and cognitive function.

Conclusion: After moderate improvement with conventional therapy, the substantial improvement observed following introduction of the IP suggests that hBM-MSC EVs may offer a novel and safe means to improve TBI patient outcomes. Appropriate randomized, controlled clinical trials to conclusively evaluate this therapeutic option are indicated.

目的:再生间充质干细胞衍生的细胞外囊泡(EVs)可安全治疗创伤性脑损伤(TBI)。我们评估了人类骨髓来源间充质干细胞EV (hBM-MSC EV)研究产品(IP)在严重TBI患者中的安全性和有效性。设计:在200多名患者中使用具有强安全性的IP进行单一案例研究。方法:连续6个月,第1周静脉滴注3次/周。采用功能独立性测量(FIM)和功能评估测量(FAM)来量化效果。每周进行安全监测,为期9个月。结果:无不良事件发生。在8周内,FIM和FAM评分提高了48-55%,并持续了整个36周。所有由FIM和FAM评估的最初较低的具体结果项目都显示出持续的改善,从41%到233%不等,其中运动、机动性和认知功能的改善最大。结论:在常规治疗的中度改善后,引入IP后观察到的实质性改善表明hBM-MSC EVs可能提供一种新的安全方法来改善TBI患者的预后。建议进行适当的随机对照临床试验,以最终评估这种治疗方案。
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引用次数: 0
"Gender matters": the development of infographics to raise awareness and promote gender-transformative care in traumatic brain injury. "性别问题":制作信息图表,以提高对脑外伤的认识,并促进性别转变护理。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-21 DOI: 10.1080/02699052.2024.2429698
Thaisa Tylinski Sant'Ana, Alina Rodrigues, Farrah Schwartz, Angela Colantonio, Tatyana Mollayeva

Purpose: To develop a series of infographics providing persons with traumatic brain injury (TBI) and their circle of care with evidence-based information on sex and gender topics in TBI.

Materials and methods: We employed an iterative participatory design engaging knowledge users, scientists, and experts in brain injury and patient education. To inform infographic content, we conducted an information needs assessment with knowledge users through semi-structured interviews and referred to our previously published evidence syntheses on TBI topics. We followed principles of graphic design and science communication to create materials reflecting lived experiences of knowledge users.

Results: We created a series of infographics with actionable messages and visual representations of evidence-based information. We achieved a Flesch Reading-Ease score of 60.1, corresponding to a Grade 7/8 reading level. The infographics met the color contrast criteria of the Web Content Accessibility Guidelines. Knowledge users found the material useful, visually appealing, and helpful in understanding complex topics.

Conclusions: There is value in merging art and science to develop educational materials that meet the unique information needs of knowledge users. Iterative participatory design engaging diverse stakeholders is essential for co-creating knowledge translation tools to improve access to health information and quality of care after TBI.

目的:开发一系列信息图表,为创伤性脑损伤(TBI)患者及其护理圈提供有关 TBI 中性与性别主题的循证信息:我们采用了迭代参与式设计,让知识使用者、科学家以及脑损伤和患者教育方面的专家参与其中。为了充实信息图表的内容,我们通过半结构式访谈对知识用户进行了信息需求评估,并参考了我们之前发布的有关创伤性脑损伤主题的证据综述。我们遵循平面设计和科学传播的原则,制作了反映知识用户生活经验的材料:我们制作了一系列信息图表,其中包含可操作的信息和基于证据的信息的可视化表达。我们获得了 60.1 分的 Flesch 阅读容易度,相当于 7/8 年级的阅读水平。信息图表符合《网络内容可访问性指南》的色彩对比标准。知识用户认为这些材料有用、具有视觉吸引力并有助于理解复杂的主题:将艺术与科学相结合,开发出满足知识用户独特信息需求的教育材料是有价值的。让不同的利益相关者参与到迭代参与式设计中,对于共同创造知识转化工具以改善健康信息的获取和创伤性脑损伤后的护理质量至关重要。
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引用次数: 0
Medical complications and advance medical decision-making in the minimally conscious state. 微意识状态下的医疗并发症和预先医疗决策。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-12 DOI: 10.1080/02699052.2024.2425737
Berno U H Overbeek, Willemijn S van Erp, Henk J Eilander, Raymond T C M Koopmans, Jan C M Lavrijsen

Objectives: Medical complications occur frequently in MCS and influence advance medical decision-making. This study aimed to report on medical complications and advance medical decision-making in a nationwide group of MCS patients.

Methods: In this descriptive cross-sectional study, clinical and advance medical decision-making characteristics were collected in a survey, completed by the treating physician.

Results: The MCS population consisted of 32 patients: 65.6% traumatic etiology, 68.8% male. Patients had a median of five complications: hypertonia/spasticity (81.3%) and pneumonia (50.0%) occurred most frequently. Most patients had curative goals: three patients had a fully curative treatment scenarios, 29 a curative scenario with ≥ 1 treatment restrictions, two a palliative and two a symptomatic scenario. Conversations about advance medical decision-making were complicated by disputes with next of kin, inability to evaluate medical treatment because of medical instability, next of kin not being ready to discuss medical treatment, or a treatment scenario explicitly based on requests of next of kin.

Conclusion: Medical complications are common in MCS patients and advance medical decision making was complicated. This legitimates realization of specialized care across acute, post-acute and long-term care. Further longitudinal research into advance medical decision-making is recommended.

目的:医疗并发症经常出现在 MCS 中,并影响预先医疗决策。本研究旨在报告全国范围内一组 MCS 患者的医疗并发症和预先医疗决策情况:在这项描述性横断面研究中,由主治医生填写调查问卷,收集临床和预先医疗决策特征:结果:MCS 群体由 32 名患者组成:结果:MCS 患者共 32 人:65.6% 为创伤性病因,68.8% 为男性。患者并发症的中位数为五种:高张力/痉挛(81.3%)和肺炎(50.0%)最为常见。大多数患者的目标是治愈:3 名患者的治疗方案是完全治愈,29 名患者的治疗方案是治愈,但治疗限制≥ 1 项,2 名患者的治疗方案是缓解,2 名患者的治疗方案是对症。与近亲发生争执、因病情不稳定而无法评估治疗方案、近亲尚未准备好讨论治疗方案或治疗方案明确基于近亲的要求,这些都使有关预先医疗决策的对话变得复杂:结论:医疗并发症在慢性病患者中很常见,预先医疗决策也很复杂。这就需要在急性期、急性期后和长期护理中实现专业护理。建议对预先医疗决策进行进一步的纵向研究。
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引用次数: 0
Understanding 'quality' in adult traumatic brain injury rehabilitation from the perspectives of different stakeholders: a participatory mixed methods study. 从不同利益相关者的角度理解成人脑外伤康复的 "质量":一项参与式混合方法研究。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-16 DOI: 10.1080/02699052.2024.2425743
Carolyn Murray, Anthea Worley, Julie Luker, Susan Hillier

Primary objective: The purpose of this study was to explore how 'quality' is understood for traumatic brain injury (TBI) rehabilitation from the perspectives of the rehabilitation recipients, their families and the providing clinicians.

Research design: A participatory study using a mixed-methods, triangulation design.

Methods: The study involved 1. a systematic literature search; 2. Individual semi-structured interviews with people with TBI and/or their caregivers and TBI rehabilitation clinicians, and 3. an online consensus process.

Outcomes and results: 22 participants (7 people with TBI, 8 caregivers, 7 clinicians) participated in individual interviews. Their transcribed data were coded into broad categories via in-depth reflexive, thematic analysis; these categories were then mapped to 13 quality domains extracted from the literature. The emergent themes were then presented to the individuals, via an electronic consensus tool in two rounds. This resulted in 12 prioritized domains of quality that encompass service features, staff qualities and effectiveness.

Conclusion: These evidence-informed and consensus-agreed indicators for quality may help guide both the provision and evaluation of TBI rehabilitation, that is valued and meaningful.

主要目的本研究旨在从康复对象、其家人和提供康复服务的临床医生的角度,探讨如何理解创伤性脑损伤(TBI)康复的 "质量":研究设计:参与式研究,采用混合方法和三角测量设计:研究内容包括:1.系统性文献检索;2.对创伤性脑损伤患者和/或其照顾者以及创伤性脑损伤康复临床医生进行个人半结构化访谈;3.在线共识过程。结果和成果:22 名参与者(7 名创伤性脑损伤患者、8 名照顾者、7 名临床医生)参加了个人访谈。通过深入的反思性主题分析,将他们转录的数据编码成大类;然后将这些类别与从文献中提取的 13 个质量领域进行映射。然后,通过电子共识工具分两轮向个人展示了新出现的主题。最终确定了 12 个优先质量领域,其中包括服务特点、员工素质和有效性:结论:这些以证据为依据、并得到共识的质量指标有助于指导提供和评估有价值、有意义的创伤性脑损伤康复服务。
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引用次数: 0
Responding to the ongoing pandemic-related challenges of individuals with brain injury through the perspective of community-service in Canada: A qualitative study. 通过加拿大社区服务的视角应对脑损伤患者当前面临的与大流行病相关的挑战:定性研究。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-16 DOI: 10.1080/02699052.2024.2426683
Ana Paula Salazar, Sophie Lecours, Lisa Engel, Monique A M Gignac, Shlomit Rotenberg, Sareh Zarshenas, Michelle McDonald, Emily Nalder, Carolina Bottari

Objective: To investigate brain injury (BI) associations' perspectives regarding the impacts of the second year of the COVID-19 pandemic on individuals with BI and BI associations services across Canada.

Methods: This qualitative descriptive study included 26 representatives of Canadian BI associations that participated in six online focus groups to discuss the effects of the second year of the pandemic on clients living with BI and on the provision of community services.

Results: Findings revealed three main themes: 1) ongoing pandemic-related challenges faced by clients living with BI, including worsening mental health and basic needs insecurities, difficulties faced by clients in adhering to safety measures, and ongoing technological issues; 2) ongoing adaptations to accommodate clients' needs, including offering tailored services, ensuring consistent and transparent safety measures, and providing hybrid services; and 3) developing a sustainable 'new normal' aligned with association mandates and resources by expanding networks and building resilience.

Conclusion: The unfolding of the pandemic has brought increased challenges for people with BI and reinforced the need for adapted, clear, and accessible public health information to ensure the safety of vulnerable populations in times of crisis. It is essential to bolster community-based associations that provide direct care to people with BI.

目的调查脑损伤(BI)协会对 COVID-19 大流行第二年对加拿大各地脑损伤患者和脑损伤协会服务的影响的看法:这项定性描述研究包括加拿大脑损伤协会的 26 名代表,他们参加了六个在线焦点小组,讨论大流行第二年对脑损伤患者和社区服务的影响:研究结果揭示了三大主题:1)感染 BI 的患者持续面临与大流行相关的挑战,包括心理健康和基本需求不安全状况的恶化、患者在遵守安全措施方面面临的困难以及持续存在的技术问题;2)为满足患者需求而持续进行的调整,包括提供量身定制的服务、确保一致且透明的安全措施以及提供混合服务;以及 3)通过扩大网络和建设复原力,根据协会的任务和资源发展可持续的 "新常态":大流行病的发展给生物多样性感染者带来了更多的挑战,并加强了对经过调整的、清晰的和可获取的公共卫生信息的需求,以确保弱势群体在危机时期的安全。必须加强以社区为基础的协会,为生物感染者提供直接护理。
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引用次数: 0
Analysis of influencing factors for postoperative brain injury in patients with cardiac surgery. 心脏手术患者术后脑损伤影响因素分析。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-12-06 DOI: 10.1080/02699052.2024.2430386
Weifang Xu, Xiaolan Ma, Chen Zhang

Objective: To identify risk factors in people with heart disease prior to undergoing cardiac surgery and to provide a prediction model.

Methods: 106 patients who underwent cardiac surgery were selected by convenience sampling method. Case-control study design was used to divide them into control and observation groups according to whether there was postoperative brain injury. General demographic data, perioperative surgery, postoperative recovery, past medical history and preoperative conditions, laboratory test indicators were collected. Univariate and multivariate Logistic regression analyses were performed to select influencing factors. A nomogram model for predicting postoperative brain injury was established.

Results: Univariate Logistic regression analysis showed that age, female, stroke, diabetes mellitus, perioperative administration of dexmedetomidine, intraoperative use of cardiopulmonary bypass were related factors for postoperative brain injury(p < 0.05). Multivariate Logistic regression analysis showed that females, history of stroke, and intraoperative use of cardiopulmonary bypass were risk factors, and perioperative administration of dexmedetomidine was protective factor(p < 0.05). Nomogram model was established with an AUC of 0.847 and accuracy of 84.7%.

Conclusion: Preoperative stroke history and females are risk factors for brain injury after coronary artery bypass grafting under cardiopulmonary bypass, and perioperative use of dexmedetomidine is protective factor.

目的:确定心脏手术前心脏病患者的危险因素并提供预测模型。方法:采用方便抽样法对106例心脏手术患者进行抽样调查。采用病例对照研究设计,根据术后有无脑损伤分为对照组和观察组。收集一般人口统计资料、围手术期手术情况、术后恢复情况、既往病史及术前情况、实验室检查指标。采用单因素和多因素Logistic回归分析筛选影响因素。建立了预测术后脑损伤的nomogram模型。结果:单因素Logistic回归分析显示,年龄、女性、卒中、糖尿病、围手术期给予右美托咪定、术中使用体外循环是术后脑损伤的相关因素(p p)。结论:术前卒中史和女性是体外循环下冠状动脉旁路移植术后脑损伤的危险因素,围手术期使用右美托咪定是保护因素。
{"title":"Analysis of influencing factors for postoperative brain injury in patients with cardiac surgery.","authors":"Weifang Xu, Xiaolan Ma, Chen Zhang","doi":"10.1080/02699052.2024.2430386","DOIUrl":"10.1080/02699052.2024.2430386","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors in people with heart disease prior to undergoing cardiac surgery and to provide a prediction model.</p><p><strong>Methods: </strong>106 patients who underwent cardiac surgery were selected by convenience sampling method. Case-control study design was used to divide them into control and observation groups according to whether there was postoperative brain injury. General demographic data, perioperative surgery, postoperative recovery, past medical history and preoperative conditions, laboratory test indicators were collected. Univariate and multivariate Logistic regression analyses were performed to select influencing factors. A nomogram model for predicting postoperative brain injury was established.</p><p><strong>Results: </strong>Univariate Logistic regression analysis showed that age, female, stroke, diabetes mellitus, perioperative administration of dexmedetomidine, intraoperative use of cardiopulmonary bypass were related factors for postoperative brain injury(<i>p</i> < 0.05). Multivariate Logistic regression analysis showed that females, history of stroke, and intraoperative use of cardiopulmonary bypass were risk factors, and perioperative administration of dexmedetomidine was protective factor(<i>p</i> < 0.05). Nomogram model was established with an AUC of 0.847 and accuracy of 84.7%.</p><p><strong>Conclusion: </strong>Preoperative stroke history and females are risk factors for brain injury after coronary artery bypass grafting under cardiopulmonary bypass, and perioperative use of dexmedetomidine is protective factor.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"320-329"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A cross-season analysis of S100B as a potential marker of concussion in professional rugby players. S100B作为职业橄榄球运动员脑震荡潜在标志的跨赛季分析。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-12-02 DOI: 10.1080/02699052.2024.2429700
Áine M Kelly, Clíodhna McHugh, James Hale, Joice Cunningham, Noreen Boyle, Oisín Joyce, Brendan O'Connell, Gareth Farrell, Fiona Wilson

Objectives: To investigate the effect of multiple seasons of play on serum S100B concentration in male professional rugby players, while also assessing the acute effects following a season of play and concussion.

Methods: A prospective study of professional male rugby players over three seasons (2016/17 to 2018/19) was conducted. Serum sampling was carried out during pre-season, post-season and following a concussion; sustained during match play at a home game (between 2-24hrs), during each season. Serum S100B concentrations were determined by ELISA assay.

Results: Fourteen players sustained 24 concussions over three seasons, of which 13 samples (54%) were collected. Pre- and post-season serum S100B remained stable across multiple seasons. S100B concentration increased significantly following concussion compared with pre-season (p = 0.002) and post-season (p = 0.009), reflective in a 3.23-fold-change post-concussion, with no difference found between pre- and post-season values. S100B concentration measured at post-season was not significantly different for players who had a concussion during a season and players who did not.

Conclusion: S100B remains stable across multiple seasons of play in professional rugby players. As concussion results in a temporary increase in S100B concentration, returning to pre-season values by post-season, S100B may be a useful diagnostic marker for improving existing management protocols for sports-related concussions.

目的:探讨多赛季比赛对男性职业橄榄球运动员血清S100B浓度的影响,同时评估一个赛季比赛和脑震荡后的急性影响。方法:对2016/17 - 2018/19三个赛季的职业男子橄榄球运动员进行前瞻性研究。在赛季前、赛季后和脑震荡后进行血清取样;在每个赛季的主场比赛中持续(2-24小时)。ELISA法测定血清S100B浓度。结果:14名球员在3个赛季中发生24次脑震荡,其中13例(54%)被采集。季前和季后血清S100B在多个季节保持稳定。与赛季前(p = 0.002)和赛季后(p = 0.009)相比,脑震荡后S100B浓度显著增加,反映出脑震荡后的3.23倍变化,而赛季前和赛季后的值没有差异。在赛季中有脑震荡的球员和没有脑震荡的球员在赛季后测量的S100B浓度没有显著差异。结论:S100B在职业橄榄球运动员的多个赛季中保持稳定。由于脑震荡导致S100B浓度暂时升高,在赛季结束后恢复到赛季前的值,因此S100B可能是一个有用的诊断指标,可用于改进现有的运动相关脑震荡管理方案。
{"title":"A cross-season analysis of S100B as a potential marker of concussion in professional rugby players.","authors":"Áine M Kelly, Clíodhna McHugh, James Hale, Joice Cunningham, Noreen Boyle, Oisín Joyce, Brendan O'Connell, Gareth Farrell, Fiona Wilson","doi":"10.1080/02699052.2024.2429700","DOIUrl":"10.1080/02699052.2024.2429700","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of multiple seasons of play on serum S100B concentration in male professional rugby players, while also assessing the acute effects following a season of play and concussion.</p><p><strong>Methods: </strong>A prospective study of professional male rugby players over three seasons (2016/17 to 2018/19) was conducted. Serum sampling was carried out during pre-season, post-season and following a concussion; sustained during match play at a home game (between 2-24hrs), during each season. Serum S100B concentrations were determined by ELISA assay.</p><p><strong>Results: </strong>Fourteen players sustained 24 concussions over three seasons, of which 13 samples (54%) were collected. Pre- and post-season serum S100B remained stable across multiple seasons. S100B concentration increased significantly following concussion compared with pre-season (<i>p</i> = 0.002) and post-season (<i>p</i> = 0.009), reflective in a 3.23-fold-change post-concussion, with no difference found between pre- and post-season values. S100B concentration measured at post-season was not significantly different for players who had a concussion during a season and players who did not.</p><p><strong>Conclusion: </strong>S100B remains stable across multiple seasons of play in professional rugby players. As concussion results in a temporary increase in S100B concentration, returning to pre-season values by post-season, S100B may be a useful diagnostic marker for improving existing management protocols for sports-related concussions.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"312-319"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dodecafluoropentane improves neuro-behavioral outcomes and return of spontaneous circulation rate in a swine model of cardiac arrest. 十二氟戊烷可改善猪心脏骤停模型的神经行为结果和自发性循环恢复率。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-21 DOI: 10.1080/02699052.2024.2427803
Travis W Murphy, Robert J Cueto, Jiepei Zhu, Jacob Milling, Justin Sauter, Muna Oli, Ian T Griffin, Gagan Midathala, J Adrian Tyndall, Bruce Spiess, Kevin K W Wang, Firas H Kobeissy, Torben K Becker

Introduction: Dodecafluoropentane emulsion (DDFPe) administration has previously demonstrated improved gas exchange in single-organ perfusion models. This could translate to prevention of brain injury in cardiac arrest.

Methods: We induced cardiac arrest in 12 pigs, performing CPR after 5-minute downtime. Pigs were randomly assigned to DDFPe (n = 7) or saline placebo (n = 5) groups. Neurologic injury biomarkers were measured at baseline, after return of spontaneous circulation (ROSC), and every 24 hours in survivors. Blinded Neurological Alertness Score, Neurological Dysfunction Score, and Overall Performance Score was performed in addition to histopathological scoring of parietal and hippocampal sections.

Results: One placebo and four DDFPe pigs survived the 96-hour observation period. The odds ratio for ROSC was 7.2 (p = 0.22). Survival odds ratio was 4.6 (p = 0.29). All surviving animals had impaired motor responses that recovered by 72 hours. DDFPe animals showed better neuro-behavioral scores than placebo.

Conclusion: The findings of this novel study provide a proof of concept and early signal toward efficacy of intravenous DDFPe in cardiac arrest. The trend toward improved ROSC and functional survival may reflect improved microcirculatory gas exchange in DDFPe animals. Improving gas exchange in brain microcirculation during resuscitation from cardiac arrest may provide a significant therapeutic benefit.

简介:十二氟戊烷乳剂(DDFPe)用药曾在单器官灌注模型中改善了气体交换。这可用于预防心脏骤停时的脑损伤:方法:我们诱导 12 头猪心脏骤停,停机 5 分钟后进行心肺复苏。猪被随机分配到 DDFPe 组(n = 7)或生理盐水安慰剂组(n = 5)。在基线、自发循环恢复(ROSC)后以及幸存者每 24 小时测量一次神经损伤生物标志物。除了顶叶和海马切片的组织病理学评分外,还进行了盲法神经系统警觉性评分、神经系统功能障碍评分和总体表现评分:结果:1 头安慰剂猪和 4 头 DDFPe 猪在 96 小时观察期内存活。ROSC 的几率为 7.2(p = 0.22)。存活几率为 4.6(p = 0.29)。所有存活动物的运动反应均受损,但在 72 小时内均已恢复。DDFPe 动物的神经行为评分优于安慰剂:这项新研究的结果证明了静脉注射 DDFPe 治疗心脏骤停的概念和早期疗效。改善 ROSC 和功能存活率的趋势可能反映了 DDFPe 动物微循环气体交换的改善。在心脏骤停复苏期间改善脑微循环的气体交换可能会带来显著的治疗效果。
{"title":"Dodecafluoropentane improves neuro-behavioral outcomes and return of spontaneous circulation rate in a swine model of cardiac arrest.","authors":"Travis W Murphy, Robert J Cueto, Jiepei Zhu, Jacob Milling, Justin Sauter, Muna Oli, Ian T Griffin, Gagan Midathala, J Adrian Tyndall, Bruce Spiess, Kevin K W Wang, Firas H Kobeissy, Torben K Becker","doi":"10.1080/02699052.2024.2427803","DOIUrl":"10.1080/02699052.2024.2427803","url":null,"abstract":"<p><strong>Introduction: </strong>Dodecafluoropentane emulsion (DDFPe) administration has previously demonstrated improved gas exchange in single-organ perfusion models. This could translate to prevention of brain injury in cardiac arrest.</p><p><strong>Methods: </strong>We induced cardiac arrest in 12 pigs, performing CPR after 5-minute downtime. Pigs were randomly assigned to DDFPe (<i>n</i> = 7) or saline placebo (<i>n</i> = 5) groups. Neurologic injury biomarkers were measured at baseline, after return of spontaneous circulation (ROSC), and every 24 hours in survivors. Blinded Neurological Alertness Score, Neurological Dysfunction Score, and Overall Performance Score was performed in addition to histopathological scoring of parietal and hippocampal sections.</p><p><strong>Results: </strong>One placebo and four DDFPe pigs survived the 96-hour observation period. The odds ratio for ROSC was 7.2 (<i>p</i> = 0.22). Survival odds ratio was 4.6 (<i>p</i> = 0.29). All surviving animals had impaired motor responses that recovered by 72 hours. DDFPe animals showed better neuro-behavioral scores than placebo.</p><p><strong>Conclusion: </strong>The findings of this novel study provide a proof of concept and early signal toward efficacy of intravenous DDFPe in cardiac arrest. The trend toward improved ROSC and functional survival may reflect improved microcirculatory gas exchange in DDFPe animals. Improving gas exchange in brain microcirculation during resuscitation from cardiac arrest may provide a significant therapeutic benefit.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"277-285"},"PeriodicalIF":1.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142680833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Understanding factors influencing exercise program adherence for youth with persistent post-concussive symptoms (PPCS). 了解影响有持续性脑震荡后症状(PPCS)的青少年坚持运动计划的因素。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-03-21 Epub Date: 2024-11-19 DOI: 10.1080/02699052.2024.2428404
Beth J Bollinger, Sara Pd Chrisman, Jordan Sahlberg, Jason A Mendoza, Tonya M Palermo, Chuan Zhou, M Alison Brooks, Frederick P Rivara, Payton Pedersen, Emily Prentice, Colby Hansen

Background: A significant portion of youth sustain a concussion every year, with around 30% experiencing persistent post-concussion symptoms (PPCS). Research has shown exercising just below the exertion level that provokes symptoms can lead to more rapid recovery. However, youth often struggle to adhere to exercise recommendations following concussion.

Methods: We conducted structured qualitative interviews (n = 32) with concussed youth and their parents to examine factors influencing motivation to engage in exercise post-concussion. Questions were framed through the lens of Self-Determination Theory (SDT) and Thematic Analysis was used to code and analyze transcripts.

Results: Four primary factors appeared to motivate youth to exercise after receiving a concussion: 1) social support, 2) accountability, 3) goal setting, and 4) structure. Utilizing the lens of SDT, one could theorize that including social support and accountability helped fulfill the need of relatedness, setting goals helped fulfill the need of autonomy, and providing program structure helped fulfill the need for competence.

Conclusions: Our results suggest that Self-Determination Theory may be a useful frame for examining exercise adherence post-concussion. Incorporating social support, accountability, goal setting and structure could increase the effectiveness of exercise prescription post-concussion and should be the focus of further study.

背景:每年都有相当一部分青少年遭受脑震荡,其中约有 30% 会出现持续性脑震荡后症状 (PPCS)。研究表明,运动量略低于引发症状的运动量,可使患者更快康复。然而,青少年在脑震荡后往往很难坚持运动建议:我们对脑震荡青少年及其家长进行了结构化定性访谈(n = 32),以研究影响脑震荡后运动动机的因素。我们从自我决定理论(SDT)的角度提出问题,并采用主题分析法对访谈记录进行编码和分析:结果:有四个主要因素似乎能够激励青少年在脑震荡后进行锻炼:1)社会支持;2)责任感;3)目标设定;4)结构。利用 SDT 的视角,我们可以从理论上认为,社会支持和问责制有助于满足相关性需求,设定目标有助于满足自主性需求,而提供项目结构则有助于满足能力需求:我们的研究结果表明,自我决定理论可能是研究脑震荡后坚持锻炼的有用框架。结合社会支持、责任感、目标设定和结构可以提高脑震荡后运动处方的有效性,应该成为进一步研究的重点。
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引用次数: 0
Methamphetamine and traumatic brain injury outcomes: an analysis of 29,416 patients from the national trauma data bank.
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2025-02-27 DOI: 10.1080/02699052.2025.2469705
Nicholas W Sheets, Yan Shen, Jeneva M Garland, David S Plurad, Lori F Harbour, Alessandro Orlando, Samir M Fakhry

Background: Methamphetamine (Meth) use is rising in the US. Most research focuses on severe TBI, neglecting milder cases. We evaluated Meth's impact on patient outcomes and hospital resource use across all TBI severities.

Methods: This study included National Trauma Data Bank (NTDB) patients from 2017-2019, aged 18-54, with near-isolated TBI, a drug screen, and negative blood alcohol. Meth+ patients were compared to Meth- patients on demographics, injury severity, and outcomes using χ² and Wilcoxon rank-sum tests.

Results: Of 29,416 patients with TBI patients, 337 (1%) were Meth+. Meth+ patients had significantly higher ICU admissions (61% vs. 50%, p < 0.001), mechanical ventilation (32% vs. 22%, p < 0.001), and tracheostomy (7% vs. 4%, p < 0.008). Meth+ had longer hospital stays (median 4 vs. 3 days, p < 0.001) and higher cerebral monitor use (8% vs. 5%, p < 0.05). Mortality rates were similar (5% vs. 5%, p = 0.46). Meth+ patients had more preexisting mental health/personality (20% vs. 12%, p < 0.001) and substance use disorders (44% vs. 6%, p < 0.001).

Conclusions: Meth use in patients with near-isolated TBI patients is linked to greater injury severity, increased resource use, and longer hospital stays but does not significantly impact mortality. Targeted interventions are needed to manage clinical challenges and optimize resource utilization.

{"title":"Methamphetamine and traumatic brain injury outcomes: an analysis of 29,416 patients from the national trauma data bank.","authors":"Nicholas W Sheets, Yan Shen, Jeneva M Garland, David S Plurad, Lori F Harbour, Alessandro Orlando, Samir M Fakhry","doi":"10.1080/02699052.2025.2469705","DOIUrl":"https://doi.org/10.1080/02699052.2025.2469705","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine (Meth) use is rising in the US. Most research focuses on severe TBI, neglecting milder cases. We evaluated Meth's impact on patient outcomes and hospital resource use across all TBI severities.</p><p><strong>Methods: </strong>This study included National Trauma Data Bank (NTDB) patients from 2017-2019, aged 18-54, with near-isolated TBI, a drug screen, and negative blood alcohol. Meth+ patients were compared to Meth- patients on demographics, injury severity, and outcomes using χ² and Wilcoxon rank-sum tests.</p><p><strong>Results: </strong>Of 29,416 patients with TBI patients, 337 (1%) were Meth+. Meth+ patients had significantly higher ICU admissions (61% vs. 50%, <i>p</i> < 0.001), mechanical ventilation (32% vs. 22%, <i>p</i> < 0.001), and tracheostomy (7% vs. 4%, <i>p</i> < 0.008). Meth+ had longer hospital stays (median 4 vs. 3 days, <i>p</i> < 0.001) and higher cerebral monitor use (8% vs. 5%, <i>p</i> < 0.05). Mortality rates were similar (5% vs. 5%, <i>p</i> = 0.46). Meth+ patients had more preexisting mental health/personality (20% vs. 12%, <i>p</i> < 0.001) and substance use disorders (44% vs. 6%, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Meth use in patients with near-isolated TBI patients is linked to greater injury severity, increased resource use, and longer hospital stays but does not significantly impact mortality. Targeted interventions are needed to manage clinical challenges and optimize resource utilization.</p>","PeriodicalId":9082,"journal":{"name":"Brain injury","volume":" ","pages":"1-8"},"PeriodicalIF":1.5,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Brain injury
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