Current Issue : April - June Volume : 2014 Issue Number : 2 Articles : 7 Articles
Background. Many critically ill patients with a traumatic brain injury (TBI) are unable to communicate. While observation of\r\nbehaviors is recommended for pain assessment in nonverbal populations, they are undetectable in TBI patients who are under the\r\neffects of neuroblocking agents. Aim.This study aimed to validate the use of vital signs for pain detection in critically ill TBI patients.\r\nMethods. Using a repeated measure within subject design, participants (N = 45) were observed for 1 minute before (baseline),\r\nduring, and 15 minutes after two procedures: noninvasive blood pressure: NIBP (nonnociceptive) and turning (nociceptive). At\r\neach assessment, vital signs (e.g., systolic, diastolic, mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), capillary\r\nsaturation (SpO2), end-tidal CO2, and intracranial pressure (ICP)) were recorded. Results. Significant fluctuations (P < 0.05) in\r\ndiastolic (F = 6.087), HR (F = 3.566), SpO2 (F = 5.740), and ICP (?? = 3.776) were found across assessments, but they were similar\r\nduring both procedures. In contrast, RR was found to increase exclusively during turning (t = 3.933; P < 0.001) andwas correlated\r\nto participants� self-report. Conclusions. Findings from this study support previous ones that vital signs are not specific for pain\r\ndetection.While RR could be a potential pain indicator in critical care, further research is warranted to support its validity in TBI\r\npatients with different LOC....
The molecular chaperone heat shock protein 90 alpha (Hsp90??) has been recognized in various tumours including glioma.\r\nThis pilot study using a proteomic approach analyses the downstream effects of Hsp90 inhibition using 17-allylamino-17-\r\ndemethoxygeldanamycin (17AAG) and a short hairpin RNA (shRNA) oligonucleotide targeting hsp90?? (shhsp90??) in theU87-MG\r\nglioma cell line. Preliminary data coupled with bioinformatic analysis identified several known and unknownHsp90 client proteins\r\nthat demonstrated a change in their protein expression after Hsp90 inhibition, signifying an alteration in the canonical pathways of\r\ncell cycle progression, apoptosis, cell invasion, angiogenesis, and metastasis. Members of the glycolysis pathway were upregulated,\r\ndemonstrating increased dependency on glycolysis for energy source by the treated glioma cells. Upregulated proteins also include\r\nHsp70 and members of its family such as Hsp27 and gp96, thereby suggesting the role of Hsp90 co-chaperones in compensating\r\nfor Hsp90 function after Hsp90 inhibition. Considering Hsp70�s role in antiapoptosis, it was postulated that a combination therapy\r\ninvolving a multitarget approach could be carried out. Consequently inhibition of both Hsp90 and Hsp70 in U87-MG glioma cells\r\nresulted in 60% cell death indicating the importance of combination therapy for glioma therapeutics....
The ultimate goal of epilepsy treatment is to become seizure free and live a healthy life without the need to take antiepileptic drugs may cause several tricky and sometimes serious side-effects. There is no class I evidence that is based on randomized double-blind trials for withdrawal of antiepileptic’s in adults who become seizure-free while taking such drugs. Whether or not antiepileptic drugs should be withdrawn after a patient has been seizure-free is a challenging concern for several years. Certain studies advise that the total risk of seizure recurrence is approximately 30%, if treatment is withdrawn. The clinical factors associated with a greater chance of successful withdrawal include childhood onset epilepsy, monotherapy, being seizure-free for more than two years, a normal electroencephalogram prior to drug withdrawal, normal neuroimaging and normal intellect. Withdrawal should be gradual and take place over roughly 6 months. Several useful review articles, guidelines and meta-analyses have been published on the subject of antiepileptic drug withdrawal. Tapering the dose play an essential role in withdrawal of an antiepileptic drug....
Background. Development of non-deqi control is still a challenge.This study aims to set up a potential approach to non-deqi control\r\nby using lidocaine anesthesia at ST36. Methods. Forty healthy volunteers were recruited and they received two fMRI scans. One was\r\naccompanied with manual acupuncture at ST36 (DQ group), and another was associated with both local anesthesia and manual\r\nacupuncture at the same acupoint (LAgroup). Results.Comparing toDQgroup,more than90 percent deqi sensations were reduced\r\nby local anesthesia in LA group. The mainly activated regions in DQ group were bilateral IFG, S1, primary motor cortex, IPL,\r\nthalamus, insula, claustrum, cingulate gyrus, putamen, superior temporal gyrus, and cerebellum. Surprisingly only cerebellum\r\nshowed significant activation in LA group. Compared to the two groups, bilateral S1, insula, ipsilateral IFG, IPL, claustrum, and\r\ncontralateral ACC were remarkably activated. Conclusions. Local anesthesia at ST36 is able to block most of the deqi feelings and\r\ninhibit brain responses to deqi, which would be developed into a potential approach for non-deqi control. Bilateral S1, insula,\r\nipsilateral IFG, IPL, claustrum, and contralateral ACC might be the key brain regions responding to deqi....
Stressful events can have both short- and long-term effects on the brain. Our recent investigation identified short-term white\r\nmatter integrity (WMI) changes in 30 subjects soon after the Japanese earthquake. Our findings suggested that lower WMI in\r\nthe right anterior cingulum (Cg) was a pre-existing vulnerability factor and increased WMI in the left anterior Cg and uncinate\r\nfasciculus (Uf) after the earthquake was an acquired sign of postearthquake distress. However, the long-term effects on WMI\r\nremained unclear. Here, we examined the 1-year WMI changes in 25 subjects to clarify long-term effects on the WMI. We found\r\ndifferential FAs in the right anterior Cg, bilateral Uf, left superior longitudinal fasciculus (SLF), and left thalamus, suggesting that\r\nsynaptic enhancement and shrinkage were long-term effects. Additionally, the correlation between psychological measures related\r\nto postearthquake distress and the degree ofWMIalternation in the right anterior Cg and the leftUf led us to speculate that temporal\r\nWMI changes in some subjects with emotional distress occurred soon after the disaster. We hypothesized that dynamic WMI\r\nchanges predict a better prognosis, whereas persistently lowerWMIis amarker of cognitive dysfunction, implying the development\r\nof anxiety disorders....
Theextracellular protein Reelin was initially identified as an essential factor in the control of neuronal migration and layer formation\r\nin the developing mammalian brain. In the years following its discovery, however, it became clear that Reelin is a multifunctional\r\nprotein that controls not only the positioning of neurons in the developing brain, but also their growth, maturation, and synaptic\r\nactivity in the adult brain. In this review, we will highlight the major discoveries of the biological activities of Reelin and the\r\nunderlying molecular mechanisms that affect the development and function of the mammalian brain, from embryonic ages to\r\nadulthood....
This paper reports the discovery of a geometrical algorithm that provides a coherent step by step mechanical account of the\r\nstructure of the nervous system, including the vertebrate brain, the spinal cord, the vertebral column, and the spinal nerves. The\r\nmorphology of these organs and the observed steps of neural development are well described, consequent of centuries of study. But\r\nmorphogenesis, the origin and cause of these forms, has not been studied since the last half of the nineteenth century. Neurology\r\ndoes not teach how the brain gained its shape, nor have any causative theories of brain formation been published in recent times.\r\nThis paper proposes a hypothetical construction based on the discovery of a simple algorithm which generates topologically the\r\nform of the brain, the spinal cord, and the vertebral column by the deformation of a gridded segmented sphere by the inversion of\r\nits surface.The hypothetical model is in close analogy with nature: the blastula is a segmented gridded sphere which results from\r\nthe subdivision of the egg. The first step of embryogenesis is gastrulation, where blastula is pressed to enter its own interior, pulling\r\nthe surface inside out, forming the embryo....
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