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Leaving on a Jet Plane: reflections on working with a patient with complex acquired brain injury secondary to attempted suicide. 乘坐喷气式飞机离开:与一名继发于自杀未遂的复杂后天性脑损伤患者共事的反思。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-07-24 DOI: 10.1080/02699052.2024.2378847
Amanda Thorpe

Objective: Despite indications that patients with Acquired Brain Injury (ABI) as a result of deliberate self-harm have more complex presentations and lower rehabilitation outcomes (Brenner, 2009)1, there is nominal published literature that considers adjustments to care for these individuals. A multifaceted and emotionally triggering subject, laced with clinical and ethical considerations, the lack of published articles may indicate the complexities surrounding this topic.

Method: This case study reflects on the care of a young man on a specialist brain injury unit who had devastating physical and cognitive disabilities after a significant drug overdose. Because the patient was unable to make informed treatment choices, all medical care was delivered in the patient's best interest amidst questions and doubts about the value of continuing life-saving treatments and escalation plans.

Results: This article is not to defend or challenge the decisions made during this patient's care, but reflects on the complexity and impact of these situations on the patient, the family, and the care team. The patient's father gave permission for this case review publication.

Conclusion: Further investigation is needed to better understand the challenges faced by this population and to determine if bespoke pathways and therapy considerations are necessary to address these specific circumstances.

目的:尽管有迹象表明,因蓄意自残而导致后天性脑损伤(ABI)的患者表现更为复杂,康复效果也更差(Brenner,2009 年)1,但却没有公开发表的文献考虑如何调整对这些患者的护理。这是一个多层面和情绪化的话题,掺杂着临床和伦理方面的考虑,缺乏公开发表的文章可能表明围绕这一话题的复杂性:本案例研究反映了脑损伤专科病房对一名年轻男子的护理情况,这名男子在服用过量药物后出现了严重的身体和认知障碍。由于患者无法做出知情的治疗选择,所有医疗护理都是在患者对继续挽救生命的治疗和升级计划的价值存在疑问和疑虑的情况下,以患者的最佳利益为出发点进行的:本文并非要为该患者在治疗过程中做出的决定辩护或提出质疑,而是要反映这些情况的复杂性及其对患者、家属和医疗团队的影响。患者的父亲同意发表这篇病例评论:需要进一步调查,以更好地了解这类人群所面临的挑战,并确定是否有必要针对这些特殊情况制定专门的治疗路径和治疗注意事项。
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引用次数: 0
A systematic literature review of the impact of impaired self-awareness on the process of rehabilitation in acquired brain injury. 关于自我意识受损对后天性脑损伤康复过程的影响的系统性文献综述。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-08-19 DOI: 10.1080/02699052.2024.2392161
Rebecca Di Somma, Peter Fleming

Background: Impaired self-awareness (ISA) is common in individuals with an acquired brain injury (ABI) and can lead to reduced awareness of one's difficulties. Previous reviews have found that ISA impacts on functional outcomes in rehabilitation. However, to date there has not been a systematic literature review which examines how ISA impacts on the process of rehabilitation in ABI populations.

Method: A literature search was conducted using several databases in May 2024, including Academic Search Premier, CINAHL, MEDLINE, APA PsycARTICLES and APA PsycINFO. Seventeen articles were selected for the review and were analyzed using Narrative Synthesis.

Results: Four themes arose from the findings, including goal setting, treatment adherence, engagement and willingness to change and time spent in hospital. ISA was found to impact on the value adult ABI participants placed in rehabilitation, which decreased treatment compliance, motivation, and engagement. ISA also impacted on goal setting and behavior and resulted in a longer length of time spent in hospital.

Conclusion: This review emphasizes the impact of ISA on various aspects/processes of rehabilitation in ABI and provides considerations of how clinicians might adapt interventions to manage these difficulties.

背景:自我意识受损(ISA)在后天性脑损伤(ABI)患者中很常见,可导致对自身困难的认识不足。以往的综述发现,自我意识障碍会影响康复的功能结果。然而,迄今为止还没有系统性的文献综述来研究 ISA 如何影响 ABI 患者的康复过程:2024 年 5 月,我们使用多个数据库进行了文献检索,包括 Academic Search Premier、CINAHL、MEDLINE、APA PsycARTICLES 和 APA PsycINFO。研究选取了 17 篇文章进行综述,并采用叙事综合法进行了分析:结果:研究结果提出了四个主题,包括目标设定、治疗依从性、参与和改变意愿以及住院时间。研究发现,ISA 会影响成年 ABI 参与者对康复的重视程度,从而降低治疗依从性、积极性和参与度。综合服务评估还对目标设定和行为产生影响,并导致住院时间延长:本综述强调了ISA对ABI康复的各个方面/过程的影响,并就临床医生如何调整干预措施以应对这些困难提供了思考。
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引用次数: 0
Cluster-based analysis of PTSD-Checklist for DSM-5 (PCL-5) in civilians with post-concussive cognitive changes. 基于聚类分析的 PTSD-Checklist for DSM-5(PCL-5)在有震荡后认知变化的平民中的应用。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-07-31 DOI: 10.1080/02699052.2024.2381065
Erik A Fraunberger, Alison J Wilson, Adam Idriss, Christina Campbell, Regan King, Meng Wang, Chantel T Debert

Objective: This study explores the relationship between PTSD symptoms and cognition in patients with persistent post-concussive symptoms (PPCS).

Methods: Adults with PPCS presenting to a specialized brain injury clinic provided demographic and injury information and completed the PTSD checklist for DSM-5, Generalized Anxiety Disorder Scale-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). The Montreal Cognitive Assessment (MoCA) was used to screen for possible cognitive concerns. Multiple regression analysis (MLR) adjusting for age, sex, mechanism of injury, psychiatric history, number of previous concussions, months since most recent injury, and mental health questionnaire scores was used to determine associations between PTSD and cognition. Binomial logistic regression explored the relationship between domains of the MoCA and PCL-5 scores.

Results: We found a negative correlation between MoCA scores, PCL-5 (ρ=-0.211, p = 0.009) and PHQ-9 (ρ=-0.187, p = 0.021) in patients with PPCS and collinearity of PCL-5 and PHQ-9 scores. Significantly higher Arousal and Reactivity cluster scores within the PCL-5 were associated with poorer scores on naming and abstract tasks on the MoCA.

Conclusion: The association between specific PCL-5 clusters and lower MoCA scores may represent a viable target for psychotherapeutic and psychopharmacologic intervention in patients with cognitive changes associated with PPCS.

目的:本研究探讨了持续性震后症状(PPCS)患者的创伤后应激障碍症状与认知之间的关系:本研究探讨了持续性脑震荡后症状(PPCS)患者的创伤后应激障碍症状与认知之间的关系:在脑损伤专科门诊就诊的 PPCS 患者提供了人口统计学和损伤信息,并填写了 DSM-5 的创伤后应激障碍清单、广泛性焦虑症量表-7(GAD-7)和患者健康问卷-9(PHQ-9)。蒙特利尔认知评估(MoCA)用于筛查可能存在的认知问题。多元回归分析(MLR)调整了年龄、性别、受伤机制、精神病史、既往脑震荡次数、最近一次受伤后的月份以及心理健康问卷分数,用于确定创伤后应激障碍与认知之间的关联。二项式逻辑回归探讨了MoCA和PCL-5得分之间的关系:我们发现,PPCS 患者的 MoCA 分数、PCL-5(ρ=-0.211,p = 0.009)和 PHQ-9 (ρ=-0.187,p = 0.021)之间存在负相关,PCL-5 和 PHQ-9 分数之间存在共线性。PCL-5中 "唤醒 "和 "反应 "群组得分明显较高与MoCA中命名和抽象任务得分较低有关:结论:特定的 PCL-5 群组与较低的 MoCA 分数之间的关联可能是对与 PPCS 相关的认知改变患者进行心理治疗和精神药物干预的可行目标。
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引用次数: 0
Comparison of concordance and predictive validity of head injuries from parental reports and medical records. 比较父母报告和医疗记录中头部损伤的一致性和预测有效性。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-07-23 DOI: 10.1080/02699052.2024.2381046
Olivia E Gunther, Mathilde Garneau, Marie-Claude Geoffroy, Alexa Martin-Storey, Eric Latimer, Michèle Déry, Caroline E Temcheff

Objective: To examine agreement between parental reports of head injury and evidence of head injury in medical records and to compare these two measures in predicting early conduct disorder (CD).

Design and setting: Parent survey data was compared with records of child head injury from the National Health Services Register (Régie de l'assurance maladie du Québec, RAMQ) administrative database.

Participants: Children (N = 685) ages 6-9 with and without CD. There were 147 children with RAMQ recorded head injury and 39 children with parent-reported head injury.

Main measures: Indication of one or more head injury before 6 years of age as reported by parents and/or as noted in medical data. Early CD (present by age 9) according to parents and/or teachers.

Results: Results indicated poor agreement between the two forms of reporting κ = .161 (95% CI, .083 to .239), p < 0.001. Medical data significantly predicted the presence of CD in children, with a RAMQ coded head injury suggesting a child was 1.88 times more likely to have CD. Parent reports of head injuries did not significantly predict CD. Conclusion: Medical data should be prioritized in research addressing pediatric head injury, given that parent reports may fail to capture incidence of injury and therefore may be less predictive of other known correlates of head injury.

目的研究父母关于头部受伤的报告与医疗记录中头部受伤证据之间的一致性,并比较这两种方法在预测早期行为障碍(CD)方面的作用:将家长调查数据与国家卫生服务登记处(Régie de l'assurance maladie du Québec,RAMQ)行政数据库中的儿童头部受伤记录进行比较:6-9岁患有和未患有CD的儿童(N = 685)。其中147名儿童有RAMQ记录的头部损伤,39名儿童有家长报告的头部损伤:主要测量指标:家长报告和/或医疗数据显示的 6 岁前一次或多次头部损伤。根据家长和/或教师的报告,早期 CD(9 岁前):结果显示,两种报告形式之间的一致性较差 κ = .161 (95% CI, .083 to .239),p
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引用次数: 0
Evaluating performance of a near-infrared-spectroscopy-based and machine-learning-powered bio-optical sensitivity parameters in identifying intracranial hemorrhages in TBI across different age-groups. 评估基于近红外光谱和机器学习驱动的生物光学灵敏度参数在识别不同年龄组创伤性脑损伤颅内出血方面的性能。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-07-31 DOI: 10.1080/02699052.2024.2381056
Jaimin Shah, Shailendra Solanki, Abhishek Chandra, Mangukiya Laljibhai Shivabhai, Pooja Gwalani

Primary objective: To evaluate the accuracy of an innovative machine-learning-powered near-infrared spectroscopy (mNIRS)-based bio-optical sensitivity parameters, namely specific tissue optical index (STOI) and intracranial tissue optical index (ITOI) for effective triaging of patients with suspected traumatic brain injury (TBI) across different age-groups to facilitate timely intervention and curtail the silent epidemic.

Research design: Prospective, observational, double-blinded, cross-sectional single-center.

Methods: A total of 240 subjects suspected with TBI and recommended for head CT scan were enrolled. Findings of CT were compared with the bio-optical sensitivity parameters (STOI+ITOI) generated by the mNIRS system to detect intracranial hemorrhages (ICHs).

Statistical software used: spss (ibm version 21.0) results: Bio-optical sensitivity parameters (STOI+ITOI) analysis of 1288 scanned lobes showed high specificity of 97% (CI 95-98%), sensitivity of 96% (CI 92-99%), and accuracy of 97% (CI 96-98%) across all ages, maintaining robust performance for detecting subdural, epidural, subarachnoid hemorrhages, and contusions. Also, the reliability in the diagnosis of ICH was evidenced by Youden's index of 0.93 and positive and negative likelihood ratios of 29.13 and 0.04, respectively.

Conclusion: The mNIRS-based STOI+ITOI proves to be an effective triage tool for TBI, exhibiting superior diagnostic performance across all age-groups.

主要目的评估基于机器学习的创新型近红外光谱(mNIRS)生物光学灵敏度参数(即特定组织光学指数(STOI)和颅内组织光学指数(ITOI))的准确性,以有效分流不同年龄组的疑似创伤性脑损伤(TBI)患者,促进及时干预并遏制无声流行病:研究设计:前瞻性、观察性、双盲、横断面单中心研究:方法:共招募了 240 名怀疑患有创伤性脑损伤并建议进行头部 CT 扫描的受试者。将CT结果与mNIRS系统生成的生物光学灵敏度参数(STOI+ITOI)进行比较,以检测颅内出血(ICHs):对 1288 个扫描脑叶进行的生物光学灵敏度参数(STOI+ITOI)分析表明,在所有年龄段,特异性高达 97%(CI 95-98%),灵敏度高达 96%(CI 92-99%),准确性高达 97%(CI 96-98%),在检测硬膜下、硬膜外、蛛网膜下腔出血和挫伤方面保持了强劲的性能。此外,ICH 诊断的可靠性还体现在尤登指数(Youden's index)为 0.93,阳性和阴性似然比(positive and negative likelihood ratios)分别为 29.13 和 0.04:结论:基于 mNIRS 的 STOI+ITOI 被证明是治疗创伤性脑损伤的有效分诊工具,在所有年龄组中均表现出卓越的诊断性能。
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引用次数: 0
Barriers and enablers to physical activity for individuals living with traumatic brain injury: a mixed methods systematic review. 脑外伤患者参加体育活动的障碍和促进因素:混合方法系统综述。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-07-24 DOI: 10.1080/02699052.2024.2381053
Chloe Burgess, Esther Jie Tian, Elizabeth Tyack, Saravana Kumar

Background: Despite well-documented benefits of physical activity (PA), people with brain injury face numerous PA barriers. This mixed methods systematic review aimed to summarize barriers and enablers that individuals with traumatic brain injury (TBI) experience when participating in PA.

Methods: Primary studies investigating barriers and/or enablers to PA in adults living with TBI were included. Literature search in MEDLINE, EmCare, Embase, PsychINFO, PEDro, and OTSeeker was initially conducted in December 2021 and January 2022, and updated in June 2022. Methodological quality of the included studies was assessed using Joanna Briggs Institute critical appraisal tools. A customized data extraction form was utilized. Descriptive synthesis was used to summarize the findings.

Results: Twelve studies of various methodological qualities were identified. Barriers to PA included personal issues, changing health status, external factors, lack of support, and lack of knowledge. Identified enablers included personal drivers, social support, professional support, accessibility, and education.

Conclusions: The shared similarities between barriers and enablers across several themes suggest that multiple barriers may be amenable to change. Given the diverse barriers to PA, health professionals should use person-centered, holistic approach with ongoing review and monitoring, when engaging with individuals with TBI.

背景:尽管体力活动(PA)的益处已得到充分证实,但脑损伤患者在参加体力活动时仍面临诸多障碍。本混合方法系统综述旨在总结脑外伤(TBI)患者在参加体育锻炼时遇到的障碍和促进因素:方法:纳入调查成年 TBI 患者参与 PA 的障碍和/或促进因素的主要研究。最初于 2021 年 12 月和 2022 年 1 月在 MEDLINE、EmCare、Embase、PsychINFO、PEDro 和 OTSeeker 中进行了文献检索,并于 2022 年 6 月进行了更新。采用乔安娜-布里格斯研究所(Joanna Briggs Institute)的关键评估工具对纳入研究的方法学质量进行评估。使用了定制的数据提取表。采用描述性综合方法对研究结果进行总结:结果:共确定了 12 项方法质量各异的研究。个人防护的障碍包括个人问题、不断变化的健康状况、外部因素、缺乏支持以及缺乏知识。确定的促进因素包括个人驱动力、社会支持、专业支持、可及性和教育:多个主题中的障碍和促进因素之间的相似之处表明,多种障碍可能是可以改变的。鉴于锻炼的障碍多种多样,医护人员在与创伤性脑损伤患者接触时,应采用以人为本的整体方法,并进行持续审查和监测。
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引用次数: 0
Effects of preinjury oral anticoagulants on the outcomes of traumatic brain injury in elderly patients: a systematic review and meta-analysis. 受伤前口服抗凝剂对老年脑外伤结果的影响:系统回顾和荟萃分析。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-05 Epub Date: 2024-08-14 DOI: 10.1080/02699052.2024.2392163
Armin Karamian, Ali Seifi, Brandon Lucke-Wold

Background: With the increasing cases of TBI cases in the elderly population taking anticoagulants for comorbidities, there is a need to better understand the safety of new anticoagulants and how to manage anticoagulated TBI patients.

Methods: A meta-analysis using a random-effect model was conducted to compare the effect of preinjury use of DOACs and VKAs on the outcomes following TBI.

Results: From 1951 studies, 49 studies with a total sample size of 15,180 met our inclusion criteria. Our meta-analysis showed no difference between preinjury use of DOACs or VKAs on ICH progression, in-hospital delayed ICH, delayed ICH at follow-up, and in-hospital mortality, but using DOACs was associated with a lower risk of immediate ICH (OR = 0.58; 95% CI = [0.42; 0.79]; p < 0.01) and neurosurgical interventions (OR = 0.59; 95% CI = [0.42; 0.82]; p < 0.01) compared to VKAs. Moreover, patients on DOACs experienced shorter length of stay in the hospital than those on VKAs (OR = -0.42; 95% CI = [-0.78; -0.07]; p = 0.02).

Conclusion: We found a lower risk of immediate ICH and surgical interventions as well as a shorter hospital stay in patients receiving DOACs compared to VKA users before the head injury.

背景:随着因合并症而服用抗凝药物的老年人群中创伤性脑损伤病例的增加,有必要更好地了解新型抗凝药物的安全性以及如何管理抗凝创伤性脑损伤患者:采用随机效应模型进行荟萃分析,比较受伤前使用 DOACs 和 VKAs 对创伤性脑损伤后预后的影响:在 1951 项研究中,有 49 项研究符合我们的纳入标准,样本量共计 15,180 份。我们的荟萃分析表明,伤前使用 DOACs 或 VKAs 对 ICH 进展、院内延迟 ICH、随访时延迟 ICH 和院内死亡率没有影响,但使用 DOACs 与较低的即刻 ICH 风险相关(OR = 0.58;95% CI = [0.42;0.79];p p = 0.02):我们发现,与 VKA 使用者相比,在头部受伤前接受 DOACs 治疗的患者发生即刻 ICH 和手术干预的风险更低,住院时间更短。
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引用次数: 0
Post-concussion changes in the N200 and P300 ERPs are associated with cognitive symptoms and performance. 脑震荡后N200和P300 erp的变化与认知症状和表现有关。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-04 DOI: 10.1080/02699052.2024.2435947
Patrick S Ledwidge, Lindsey C Hartland, Chloe A Huston, Christa M Jones, Erin Neff, Elizabeth Castro, John P Abt

Purpose: To examine how post-concussion changes to the N200 and P300 event-related potentials (ERPs) are associated with cognitive symptoms and neurocognitive performance.

Methods: High-density electroencephalography (EEG) was recorded during a Go/No-Go task from 16 young adults within one month after their concussion and 16 matched controls. Participants were also administered the Cognitive-Linguistic Quick Test (CLQT) and self-reported concussion-like symptoms. Mixed analysis of variance models compared the N200/P300 ERPs between concussion and control groups. Nested linear regressions examined associations between the N200/P300 ERPs and CLQT cognitive domains, cognitive symptom clusters, and total concussion symptoms, with particular interest in within-task changes in the N200/P300 ERPs (e.g. habituation).

Results: N200 and P300 ERP amplitudes were associated with individual differences in cognitive outcomes after concussion. For concussion participants only, smaller P300 amplitudes were significantly associated with greater cognitive symptoms. When considering within-task changes in ERPs over repeated trial presentations, reduced habituation of N200 amplitudes was significantly associated with poorer attention and memory CLQT domain scores. Reduced habituation of P300 amplitudes was also associated with greater cognitive symptoms and total symptoms for concussion participants.

Conclusion: Within-task changes in ERP dynamics supporting attention and executive control are associated with individual differences in cognitive outcomes after concussion.

目的:研究脑震荡后N200和P300事件相关电位(ERPs)的变化与认知症状和神经认知表现的关系。方法:记录16名年轻成人脑震荡后1个月内进行Go/No-Go任务时的高密度脑电图(EEG)。参与者还接受了认知语言快速测试(CLQT)和自我报告的脑震荡样症状。混合方差分析比较了脑震荡组和对照组的N200/P300 erp。嵌套线性回归检验了N200/P300 erp与CLQT认知域、认知症状集群和总体脑震荡症状之间的关联,特别关注了N200/P300 erp在任务内的变化(如习惯化)。结果:N200和P300 ERP振幅与脑震荡后认知结果的个体差异有关。仅对于脑震荡参与者,较小的P300振幅与较大的认知症状显著相关。当考虑到在重复的试验演示中erp的任务内变化时,N200振幅的习惯化降低与较差的注意力和记忆CLQT域得分显著相关。对于脑震荡参与者来说,P300振幅的习惯化程度降低也与认知症状和总症状的加重有关。结论:支持注意和执行控制的任务内ERP动态变化与脑震荡后认知结果的个体差异有关。
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引用次数: 0
What are the views of those participating in a trial investigating acute post-traumatic benign paroxysmal positional vertigo? A qualitative study. 参与一项调查急性创伤后良性阵发性位置性眩晕的试验的人有什么看法?定性研究。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-12-03 DOI: 10.1080/02699052.2024.2435952
Rebecca M Smith, Bithi Sahu, Caroline Burgess, Jenna Beattie, Abby Newdick, Vassilios Tahtis, Jonathan Marsden, Barry M Seemungal

Objective: The purpose of this study was to explore the experiences of patients and healthcare professionals participating in a randomized feasibility trial exploring the management of acute post-traumatic benign paroxysmal positional vertigo (BPPV), and to establish the acceptability and tolerability of BPPV assessment and treatment procedures.

Methods: This was a multi-center qualitative study nested within a wider randomized feasibility trial. Purposive sampling was used to gather a cohort of healthcare professionals and patients from three major trauma centres in London, UK. Data were gathered using semi-structured interviews and were analyzed using Framework analysis.

Results: Fifteen healthcare professionals and 26 patients participated. Patients and healthcare professionals reported acute BPPV diagnosis was acceptable and practicable. However, divergence was noted regarding views of randomization. Participants proposed several research delivery and protocol modifications for a future trial, including changes to study design and outcome measures.

Conclusions: Healthcare professionals and patients participating in a multi-center qualitative study felt post-traumatic BPPV was feasible and acceptable to diagnose and treat acutely. Findings from this study will enhance the content and delivery of a future trial and may assist in influencing the development of clinical practice guidelines.

目的:本研究旨在探讨急性创伤后良性阵发性体位性眩晕(BPPV)治疗的随机可行性试验的患者和医护人员的经验,并建立BPPV评估和治疗程序的可接受性和耐受性。方法:这是一项多中心定性研究,嵌套在更广泛的随机可行性试验中。有目的的抽样是用来收集一个队列的医疗保健专业人员和患者从三个主要的创伤中心在伦敦,英国。使用半结构化访谈收集数据,并使用框架分析进行分析。结果:15名医护人员和26名患者参与。患者和卫生保健专业人员报告急性BPPV诊断是可接受和可行的。然而,关于随机化的观点存在分歧。参与者为未来的试验提出了几项研究交付和方案修改,包括研究设计和结果测量的变化。结论:参与多中心定性研究的医护人员和患者认为创伤后BPPV的急性诊断和治疗是可行和可接受的。这项研究的发现将增强未来试验的内容和交付,并可能有助于影响临床实践指南的制定。
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引用次数: 0
Protective effects of puerarin combined with bone marrow mesenchymal stem cells on nerve injury in rats with ischemic stroke. 葛根素联合骨髓间充质干细胞对缺血性脑卒中大鼠神经损伤的保护作用。
IF 1.5 4区 医学 Q4 NEUROSCIENCES Pub Date : 2024-11-28 DOI: 10.1080/02699052.2024.2433667
Jiane Chen, Xiaoli Wu, Dongliang Nie, Zhimin Yu

Background: Bone marrow mesenchymal stem cells (BM-MSCs) transplantation shows promise for treating ischemic stroke, but the ischemic environment that follows cerebral infarction hinders the survival of transplanted cells. We aimed to study the effects of puerarin (Pue) in combination with BM-MSCs on cerebral ischemic injury.

Methods: After middle cerebral artery occlusion (MCAO) models were prepared by suture-occluded method, rats were randomly allocated to the sham, MCAO, Pue (50 mg/kg), BM-MSCs (2×106), and BM-MSCs+Pue groups. The neurological function, infarct area, levels of inflammation-related factors, brain tissue damage, apoptosis, BrdU, Beclin1, and LC3 levels were then assessed.

Results: Pue and BM-MSCs reduced the modified neurological severity score, cerebral infarction area, and serum inflammation-related factor levels for MCAO rats. Furthermore, Pue and BM-MSCs interventions ameliorated brain tissue damage, and repressed apoptosis of brain tissues in MCAO rats. Moreover, Pue or BM-MSCs enhanced BrdU expression, restrained LC3II/LC3I ratio and Beclin 1 expression in MCAO rats' brain tissues. Importantly, the combination of Pue and BM-MSCs exhibited more pronounced effects on aforementioned outcomes.

Conclusion: The combination of Pue and BM-MSCs facilitated the recovery of neurological function in rats after cerebral ischemic damage, and the mechanisms may correlate with the repression of neuronal apoptosis, inflammation, and autophagy.

背景:骨髓间充质干细胞(BM-MSCs)移植有望治疗缺血性卒中,但脑梗死后的缺血环境阻碍了移植细胞的存活。我们旨在研究葛根素(Pue)联合骨髓间充质干细胞对脑缺血损伤的影响。方法:采用缝合法制备大脑中动脉闭塞(MCAO)模型后,将大鼠随机分为假手术组、MCAO组、Pue组(50 mg/kg)、BM-MSCs组(2×106)和BM-MSCs+Pue组。然后评估神经功能、梗死面积、炎症相关因子水平、脑组织损伤、细胞凋亡、BrdU、Beclin1和LC3水平。结果:Pue和BM-MSCs降低了MCAO大鼠的改良神经系统严重程度评分、脑梗死面积和血清炎症相关因子水平。此外,Pue和BM-MSCs干预可以改善MCAO大鼠的脑组织损伤,抑制脑组织凋亡。此外,Pue或BM-MSCs增强了MCAO大鼠脑组织中BrdU的表达,抑制了LC3II/LC3I比值和Beclin 1的表达。重要的是,Pue和BM-MSCs联合使用对上述结果的影响更为明显。结论:Pue联合BM-MSCs可促进大鼠脑缺血损伤后神经功能的恢复,其机制可能与抑制神经元凋亡、炎症和自噬有关。
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引用次数: 0
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Brain injury
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