1,721,006 research outputs found
Neuroprotective properties of erythropoietin (Epo) and its receptor (EpoR) in open spinal dysraphism (OSD): an investigation of EpoR expression in a rat OSD model, along with in vitro studies on the neuroprotective effects of Epo on rat spinal cord-derived neural progenitor cells
No full textAbstract Purpose Research into treatment options that complement surgery for open spinal dysraphism (OSD) is necessary to further improve outcomes following prenatal or postnatal surgery. We investigated erythropoietin (Epo) and its receptor (EpoR) as a potential neuroprotective agent and target in OSD. Methods Epo- and EpoR-expression was examined on mRNA and immunohistochemical level in neuroplacodes obtained from a rat retinoic acid-induced OSD model at E16, E18, E22. Neural progenitor cells (NPCs) derived from spinal cords of adult Long Evans rats were exposed to varying concentrations of human artificial amniotic fluid (aAF). Cytotoxicity assays were conducted to assess the impact of aAF exposure, with and without Epo. The influence of Epo on NPC’s cellular marker expression was analyzed using qRT-PCR. Results EpoR mRNA expression was elevated significantly on E18 and E22 in OSD- compared to control tissue. EpoR immunoreactivity exhibited consistent expression in ventral and dorsal horns, central canal, and ganglia. It co-stained with Hif-2α, β-III-tubulin, NeuN, and Musashi1. Exposure of NPCs to aAF reduced proliferation and increased death rates dose-dependently. Adding Epo significantly counteracted antiproliferative and cytotoxic aAF effects on NPCs, resulting in similar or lower death rates than those observed in untreated controls. Exposure of NPCs to aAF reduced their expression of neuronal markers. Adding Epo restored their differentiation capacities. Conclusion Induction of EpoR in neuroplacodes, its co-staining with neuronal and NPC markers, and the neuroprotective effects of Epo on aAF-treated NPCs in vitro establish Epo as a promising candidate for neuroprotective therapies that can supplement surgical measures for OSD
Fetal and Perinatal Expression Profiles of Proinflammatory Cytokines in the Neuroplacodes of Rats with Myelomeningoceles: A Contribution to the Understanding of Secondary Spinal Cord Injury in Open Spinal Dysraphism
No full textClinical Course and Monitoring Parameters After Continuous Interventional Intra-Arterial Treatment in Patients with Refractory Cerebral Vasospasm
No full textBACKGROUND: In aneurysmal subarachnoid haemorrhage cerebral vasospasm leads to clinical worsening and poor outcome. Interventional treatment with nimodipine might be a therapeutic option. OBJECTIVE: To evaluate the clinical course of patients with different interventional treatment types. METHODS: A retrospective, observational analysis was performed. Inclusion criteria were aneurysmal subarachnoid haemorrhage, clinical and/or radiologic evidence of vasospasm and interventional intra-arterial treatment. Patients were divided into 3 groups: continuous nimodipine infusion, repetitive nimodipine infusions, and singular nimodipine infusion. Pre- and postinterventional parameters were analyzed to evaluate the efficacy of the procedure in terms of responder status. Outcome was determined using the modified Rankin scale. RESULTS: A total of 163 interventions (97 patients) were examined. Patients with continuous treatment showed a greater World Federation of Neurological Surgeons grade. Response to intra-arterial nimodipine in the continuous group was comparatively worse. Transcranial Doppler monitoring as well as brain tissue oxygenation measuring showed good correlation with imaging results. The rate of intraprocedural complications in the continuous treatment group was significantly greater. We observed a worse clinical outcome in the patients who underwent continuous treatment. None of the patients in the continuous group achieved favorable outcome after 3 months. CONCLUSIONS: Facing the poor clinical outcome and the greater complication rate, continuous intra-arterial infusion of nimodipine in patients with angiographically refractory cerebral vasospasm has to be indicated strictly. Transcranial Doppler and brain tissue oxygenation monitoring seem to be reliable tools for evaluation of the clinical postinterventional course
A two-institution pilot study on the psychological burden and distress of parents caring for children with shunted hydrocephalus
No full textOBJECTIVE Little is known about the emotional health of parents caring for children with shunted hydrocephalus. The aim of this pilot study was to find out whether parents caring for shunt-treated hydrocephalic children experience serious psychological problems and psychosocial distress and whether these problems are related to the sociodemographic background of the caregivers, the clinical characteristics of their children, and parents’ illness-related concerns and perceived burden of their children’s illness. METHODS This pilot study was performed in an outpatient setting at two German hospitals. The following questionnaires were handed out to parents of children with shunted hydrocephalus (< 21 years of age): the Patient Health Questionnaire (PHQ-9) for depression, the Generalized Anxiety Disorder Scale (GAD-7) for anxiety, the Distress Thermometer (DT) for psychosocial distress, the Hydrocephalus Concerns Questionnaire (HCQ) for assessment of parents’ illness-related concerns, and the Hydrocephalus Outcome Questionnaire (HOQ) for assessment of perceived children’s disease burden. Clinical data of the respective children were collected from electronic charts. Parents’ demographic data were evaluated via questionnaires. Parents’ psychological variables were correlated with demographic and clinical data and HCQ and HOQ scores. Regression analyses of HCQ and HOQ scores with psychological items were performed. RESULTS Sixty-three parents were included in this study. Of these, 60% reported clinically relevant levels of either depression (11%), anxiety (10%), and/or psychosocial distress (57%). There were no associations between parental sociodemographic or children’s clinical characteristics with parents’ psychosocial well-being or psychosocial distress. Depression, anxiety, and DT scores were highly intercorrelated and significantly correlated with HCQ scores (r = 0.508, r = 0.516, r = 0.442; p < 0.01). Thereby, worries about shunt-related complications were the most reported concern in the HCQ. Depression and anxiety correlated with the scores of some HOQ subcategories. In preliminary regression analyses, higher illness-related concerns predicted occurrence of parents’ anxiety. CONCLUSIONS The authors’ results support the notion that there is a need for psychosocial support for a proportion of parents who care for shunted hydrocephalic children. Perceived child symptom burden and parental illness concerns were identified as relevant correlates of parental psychological well-being. Thus, concerns specific to shunt-related problems could be a first starting point for the development of individual support measures
Clinical and radiological course of intracerebral haemorrhage associated with the new non-vitamin K anticoagulants
No full textBackground Clinical outcome and mortality in intracerebral haemorrhage (ICH) associated with anticoagulant treatment is poor. Novel direct oral anticoagulant drugs (NOACs) are increasingly prescribed. Management of NOAC-associated ICH might be more challenging. The aim of this study was to compare the clinical and radiological course of ICH patients being treated with different forms of oral anticoagulant drugs. Method The study is a retrospective observational study. Haemorrhage in other intracranial compartments except the ventricular system were explicitly excluded. Four groups were categorised and compared with regard to their clinical and radiological course (NOACs, vitamin K antagonists [VKAs], platelet inhibitors and patients without anticoagulant/antiplatelet drugs). Clinical as well as radiological parameters were analysed. Results Overall, 182 patients were included (2011 to early 2016). Twenty-five patients with NOAC-associated ICH were included (47 with VKAs, 50 with platelet inhibitors and 60 patients without anticoagulant/antiplatelet drugs). The frequency of NOAC-associated ICH increased over the years. Diabetes was found significantly more often in the NOAC patients (p = 0.05). The clinical and radiological courses in the three different patient groups with impaired coagulation were similar. Mortality was significantly higher in patient groups with impaired coagulation (p = 0.04) compared to those without anticoagulant/antiplatelet drugs. Multivariate analysis revealed the Glasgow Coma Scale (GCS) score as a strong predictor for worse outcome and mortality. Conclusions The frequency of NOAC-associated ICH increased in the last 5 years. Diabetes might be a risk factor for ICH when receiving NOACs. Clinical outcome in NOAC-associated ICH is poor and mortality is as high as in patients with other oral anticoagulant/antiplatelet drugs
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Die Abhängigkeit der cerebralen Leukoaraiose vom Ausmaß der Atherosklerose hirnversorgender Gefäße in der Computertomographie
Full text linkHINTERGRUND:
Eine Atherosklerose führt sowohl an kleinsten intracerebralen Gefäßen wie auch an großen Arterien zu typischen pathologischen Befunden. An der A. carotis tritt sie häufig an dem intrakraniell gelegenen Carotissiphon als auch an der extrakraniell befindlichen Carotisbifurkation auf. Die cerebrale Mikroangiopathie wird mit dem CT-Befund der Leukoaraiose abgebildet. Sie betrifft mit einer diffusen und einer lakunären Manifestationsform kleinste arterielle Gefäße des weißen Marklagers und der tiefen grauen Substanz.
FRAGESTELLUNG:
Aufgrund klinischer Beobachtung in der diagnostischen Radiologie wurde die Fragestellung untersucht, ob eine Leukoaraiose als cerebrale Marklagerläsion stärker mit einer Carotissiphonkalzifikation assoziiert sei als mit einer Atherosklerose der Carotisbifurkation.
METHODE:
An der Klinik für Radiologie und Neuroradiologie am Universitätsklinikum Schleswig-Holstein (UKSH), Campus Kiel, wurden in einer beobachtenden Querschnittstudie an 372 Patienten (Alter 50 - 99 Jahre, Median 76 Jahre) traumaassoziierte, native CT-Aufnahmen des Kopfes sowie der Halswirbelsäule gesichtet und auf das Vorliegen einer diffusen oder lakunären Mikroangiopathie bzw. einer intrakraniellen oder extrakraniellen Carotiskalzifikation hin untersucht und ausgewertet. In die Studie wurden 300 Patienten eingeschlossen, deren CT-Bildgebung zwischen Januar 2014 und Ende März 2014 erfolgte.
ERGEBNISSE:
Sowohl die diffuse als auch die lakunäre Mikroangiopathie waren jeweils signifikant stärker assoziiert mit der Carotissiphonkalzifikation (Korrelationskoeffizienten z.B. linksseitig: bei diffuser/lakunärer Mikroangiopathie 0,591/0,343, p < 0,001) als mit einer Bifurkationsatherosklerose (Korrelationskoeffizienten z.B. linksseitig: bei diffuser/lakunärer Mikroangiopathie 0,234/0,163, p < 0,001). Im Vergleich untereinander zeigte die diffuse Mikroangiopathie als chronische Manifestationsform die stärkste Assoziation zu einer Carotissiphonkalzifikation mit dem Korrelationskoeffizienten linksseitig 0,591 und rechtsseitig 0,572. Die moderate bis gute Korrelation der diffusen Mikroangiopathie mit einer intrakraniellen Makroangiopathie beinhaltete in dieser Studienpopulation nahezu lineare Zuordnungen von jeweiligen Ausprägungsgraden.
SCHLUSSFOLGERUNG:
Die Ausprägung der Leukoaraiose hängt signifikant vom Ausmaß der intrakraniellen Carotisverkalkungen ab. Dieses Ausmaß könnte ggf. als Surrogatmarker für die cerebrale Mikroangiopathie und potentiell assoziierte klinische Syndrome dienen
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