Decompressive Craniectomy for Traumatic Brain Injury: Postoperative Cerebral Hemodynamic Evaluation

Conclusion: There is a wide heterogeneity of postoperative cerebral hemodynamic findings among TBI patients who underwent DC, including hemodynamic heterogeneity between their cerebral hemispheres. DC was proved to be effective for the treatment of cerebral oligoemia. Our data support the concept of heterogeneous nature of the pathophysiology of the TBI and suggest that DC as the sole treatment modality is insufficient. Introduction Decompressive craniectomy (DC) may effectively decrease intracranial pressure (ICP) and increase cerebral perfusion pressure (CPP) in traumatic brain injury (TBI) patients with refractory elevated ICP (1, 2). However, randomized controlled trials failed to disclose the efficacy of this procedure for improving these patients' neurological outcome (3, 4). This means that ICP control to ensure CPP, as the sole treatment strategy, is not sufficient to achieve satisfactory therapeutic results in most cases. New research should focus on different pathophysiological mechanisms of posttraumatic brain swelling. Transcranial Doppler (TCD) ultrasonography is a non-invasive and bedside method for real-time assessment of cerebral blood circulation. This technique is routinely used in clinical and scientific scenario (5–8). To date, few studies have addressed the cerebral hemodynamic and metabolic effects of DC for uncontrolled elevation of ICP (2, 9–15). To our knowledge, there are no studies describing the different cerebral hemo...
Source: Frontiers in Neurology - Category: Neurology Source Type: research

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Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
In conclusion, hypertension in the young is associated with decreased LVD function and is a risk factor for diastolic dysfunction of the left ventricle. LVD function may be an independent predictor of acute CI in young patients with hypertension and should be considered by clinicians. By predicting the risk of acute CI in young patients with hypertension, LVD testing may aid in the primary prevention of CI or guide early treatment. PMID: 32952651 [PubMed]
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Weng G, Tian P, Yan X, Cheng Q Abstract The present study aimed to determine the clinical significance of heart-type fatty acid-binding protein (H-FABP) in patients with sepsis-induced cardiac dysfunction. A total of 30 healthy subjects served as the control group and 80 patients with sepsis were recruited for the present single-center prospective observational study for the final analysis. Among these patients, 50 developed cardiac dysfunction, while no cardiac dysfunction was detected in the remaining 30 patients. Echocardiography was performed on days 1, 3, 7 and 10 of hospitalization. Routine blood bio...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Yi C, Si L, Xu J, Yang J, Wang Q, Wang X Abstract Myocardial ischemia-reperfusion injury (MIRI) is a major cause of heart failure in patients with coronary heart disease. The excessive accumulation of reactive oxygen species (ROS) during MIRI induces the overactivation of an autophagic response, which aggravates myocardial cell damage. Asiatic acid (AA) is a triterpenoid compound, which is extracted from Centella asiatica and exhibits a variety of pharmacological effects such as hepatoprotective, neuroprotective and antioxidant. However, the association of AA with autophagy in MIRI is not fully understood....
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Huang L, Fang HB, Cheng HH, Mei SL, Cheng YP, Lv Y, Meng QT, Xia ZY Abstract Isoflurane is a broadly used inhalation anesthetic that causes cognitive impairment in rodent models as well as humans. Although previous studies suggested an association between isoflurane exposure and neuro-inflammation, apoptosis and mitochondrial dysfunction, the pathogenesis of isoflurane-induced cognitive decline remains elusive. In the present study, 22-month-old male Sprague-Dawley male rats (n=96) were divided into three groups: Control (Cont), isoflurane (ISO) and MS-275 pre-treated groups. The rats were sacrificed follo...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
Authors: Ram E, Lavee J, Sternik L, Segev A, Peled Y Abstract OBJECTIVES: To investigate the impact of recipient age on the occurrence of rejections, vasculopathy, and mortality after HTx. METHODS: Study population comprised all consecutive 291 patients who underwent HTx between 1991-2016 and were followed at our center. Patients were categorized by age tertiles:
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Conclusions: The sporotrichosis cases underwent both cumulative and linear growth, especially in the group above 60 years. Squamous cell carcinomas appeared several times as a misdiagnosis of sporotrichosis by dermatologists, so it should be considered as an important differential diagnose due to the current context of skin cancers.
Source: The American Journal of Dermatopathology - Category: Pathology Tags: Original Study Source Type: research
Purpose: The impact of peripheral retinal lesions (PL) visualized with ultra–wide-field imaging on diabetic retinopathy (DR) remains unclear. The purpose of this study was to assess the presence of PL and their association with macular microvasculopathy, metabolic dysfunction, and neurodegeneration in patients with Type II diabetes and early retinal disease. Methods: Forty-five degree color fundus (Topcon) and 200° ultra–wide-field images (Optos) were assessed for the presence and severity of DR. Lesions anterior to the 45° were considered peripheral. The foveal avascular zone area, perimeter and a...
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
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Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research
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