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10/30/14 CT head after left craniectomy for decompression showing improved midline shift and evolving bilateral traumatic subarachnoid hemorrhage.
Source publication
Background:
Traumatic brain injury remains a challenging and complicated disease process to care for, despite the advance of technology used to monitor and guide treatment. Currently, the mainstay of treatment is aimed at limiting secondary brain injury, with the help of multiple specialties in a critical care setting. Prognosis after TBI is often...
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Electric bicycles (E-bikes) are an increasingly popular means of transport, and have been designed for a higher speed comparable to that of small motorcycles. Accident statistics show that E-bikes are increasingly involved in traffic accidents. To test the hypothesis of whether accidents involving E-bikes bear more resemblance to motor...
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Citations
... A literature search did not reveal any such case in prior history where Ayurveda had been of help recovering a TBI patient in coma with a GCS score as low as 3. There are rare instances of such observations in modern literature as well [8,16,17]. This patient, who had a bad outcome prognosis predicted on the basis of outcome predictors in cases of TBI (GCS score of 3) worsened further on account of development of high-grade fever during the course of care. ...
Road traffic accidents (RTAs) are a common cause of untimely death, particularly of youth. RTA mortality and morbidity are predominantly associated with trauma to the brain tissue resulting in traumatic brain injury (TBI). The Glasgow Coma Scale (GCS) is commonly employed to predict the prognosis of such cases at the time of hospital admission. A lower GCS score is invariably found to be associated with poor prognosis, often resulting in death or severely com-promised recovery. A 17-year-old male suffering from TBI due to a RTA was treated with Ayurveda after initially been kept under modern neurological care. The whole course of Ayurvedic therapy began 2 weeks after the initial trauma, continued for about 3 months, and resulted in coma reversal with near complete recovery. This case is one among few reports describing a complete recovery despite presence of bad prognostic predictors in TBI. This is the first such case reported where Ayurveda was used as the intervention in case of TBI, resulting in coma reversal and near complete recovery of neurological deficits.
© 2019 S. Karger AG, Basel.
... According the World Health Organization, every year the lives of more than 1.25 million people are cut short as a result of a road traffic accidents. Between 20 and 50 million more people suffer non-fatal injuries, with many incurring a disability as a result of their injuries (Khor et al. 2017;Nelson et al. 2016;Kuehn 2018). In Malaysia alone, in the year 2016, 521466 motor vehicle accidents were reported by the Asean Road Safety Centre. ...
... Although HSS is widely administered, there is no definitive protocol for its use. It has been suggested as a treatment option by different studies and guidelines, but there is no clear consensus regarding its specific uses [18][19][20][21]. We did not find that a bolus HSS infusion was effective for controlling ICP. ...
Background
Current clinical treatment methods for refractory intracranial hypertension include elevation of the decubitus, ventilation adjustment, and use of hypertonic solutions such as hypertonic saline and mannitol solutions. Previous studies have shown that hypertonic solutions are particularly effective. Although several concentrations of saline solution have been proposed, a 3% solution is the most widely used. The aim of this study was to evaluate the maintained efficacy of a 3% hypertonic saline solution in an experimental model of intracranial hypertension.
Material/Methods
A porcine model of reversible intracranial hypertension was created by inserting a balloon catheter into the brain parenchyma, which was inflated and deflated to simulate intracranial hypertension and its surgical correction. The experiment included 3 groups of animals (A, B, and C) with different balloon inflation volumes. In group B, balloons were inflated 2 times to simulate reexpansion. A 20 mL/kg bolus of 3% saline solution was infused using a pump 90 minutes after the start of balloon inflation, and the effects of intracranial pressure were evaluated 60 minutes after infusion.
Results
No increases outside of the normal range were observed in mean serum sodium concentrations (p=0.09). In addition, we identified no differences within each group in serum sodium levels measured during hypertonic saline infusion (p=0.21). No significant reductions in intracranial pressure were observed in any of the 3 groups.
Conclusions
Bolus infusion of 3% hypertonic saline solution with the aid of a pump does not significantly reduce intracranial pressure in an animal model of intracranial hypertension.
Citation: Velikic, G.; Maric, D.M.; Maric, D.L.; Supic, G.; Puletic, M.; Dulic, O.; Vojvodic, D. Harnessing the Stem Cell Niche in Regenerative Medicine: Innovative Avenue to Combat Neurodegenerative Diseases. Int. J. Mol. Sci. 2024, 25, 993. doi: 10.3390/ijms25020993
https://www.mdpi.com/1422-0067/25/2/993
Abstract: Regenerative medicine harnesses the body's innate capacity for self-repair to restore malfunctioning tissues and organs. Stem cell therapies represent a key regenerative strategy, but to effectively harness their potential necessitates a nuanced understanding of the stem cell niche. This specialized microenvironment regulates critical stem cell behaviors including quiescence, activation, differentiation, and homing. Emerging research reveals that dysfunction within endogenous neural stem cell niches contributes to neurodegenerative pathologies and impedes regeneration. Strategies such as modifying signaling pathways, or epigenetic interventions to restore niche homeostasis and signaling, hold promise for revitalizing neurogenesis and neural repair in diseases like Alzheimer's and Parkinson's. Comparative studies of highly regenerative species provide evolutionary clues into niche-mediated renewal mechanisms. Leveraging endogenous bioelectric cues and crosstalk between gut, brain, and vascular niches further illuminates promising therapeutic opportunities. Emerging techniques like single-cell transcriptomics, organoids, microfluidics, artificial intelligence, in silico modeling, and transdifferentiation will continue to unravel niche complexity. By providing a comprehensive synthesis integrating diverse views on niche components, developmental transitions, and dynamics, this review unveils new layers of complexity integral to niche behavior and function, which unveil novel prospects to modulate niche function and provide revolutionary treatments for neurodegenerative diseases.
Background: Polytrauma is often associated with a high mortality rate and requires intensive management. Although several cases of polytrauma have been reported as being related to thoracic or brain injury, there are few reports concerning multiple fractures. We aimed to present a case series report about polytrauma with multiple fractures, highlighting several clinical importance and management strategies. Case presentation: The first case is a 31-year-old male patient who was admitted to the emergency department with multiple injuries from violent abuse, including intraperitoneal bladder rupture, right pulmonary contusion, bilateral closed femoral shaft fractures, bilateral closed humeral shaft fractures, and bilateral closed radius and ulna shaft fractures. Case 2 is a 41-year-old female who was involved in a motorcycle accident in a head collision, with multiple wounds and multiple fractures, including the right distal third radius, ulna, 2nd metacarpal, right distal third tibia, and fibula. The last case is a 25-year-old comatose male patient who was hospitalized with several wounds and bruises on the right lower extremity and left forearm after a traffic accident. He was diagnosed with a concussion, crush wound of the right foot with metatarsal fractures, and a closed fracture of the right middle third femur, right middle third tibia, and left distal third radius. Three cases of multiple trauma were reported, in which we successfully internally fixed four to eight fractures at once without any complications after the procedure. The patient's wound status at admission, such as whether they have an open fracture or a complex wound that could become infected and result in sepsis or hemorrhagic shock, should be a crucial factor considered when deciding whether to perform emergency orthopedic surgery. Additionally, patients who have been properly stabilized and do not have any concomitant conditions or concurrent soft tissue injuries can receive early total care. Patient awareness is a critical sign for serial CT brain scans and additional surveillance before definitive fracture fixation. Conclusion: This report can serve as a reference for management decisions in future instances within the context of national healthcare capacity.
Decision-making in patients with severe TBI. Patient outcome, hospital costs, and research practice.
