Background
Two randomised trials assessing the effectiveness of decompressive craniectomy (DC) following traumatic brain injury (TBI) were published in recent years: DECRA in 2011 and RESCUEicp in ...2016. As the results have generated debate amongst clinicians and researchers working in the field of TBI worldwide, it was felt necessary to provide general guidance on the use of DC following TBI and identify areas of ongoing uncertainty via a consensus-based approach.
Methods
The International Consensus Meeting on the Role of Decompressive Craniectomy in the Management of Traumatic Brain Injury took place in Cambridge, UK, on the 28th and 29th September 2017. The meeting was jointly organised by the World Federation of Neurosurgical Societies (WFNS), AO/Global Neuro and the NIHR Global Health Research Group on Neurotrauma. Discussions and voting were organised around six pre-specified themes: (1) primary DC for mass lesions, (2) secondary DC for intracranial hypertension, (3) peri-operative care, (4) surgical technique, (5) cranial reconstruction and (6) DC in low- and middle-income countries.
Results
The invited participants discussed existing published evidence and proposed consensus statements. Statements required an agreement threshold of more than 70% by blinded voting for approval.
Conclusions
In this manuscript, we present the final consensus-based recommendations. We have also identified areas of uncertainty, where further research is required, including the role of primary DC, the role of hinge craniotomy and the optimal timing and material for skull reconstruction.
There has been an increase in the global prevalence of diabetic polyneuropathy and research evidence suggests that insulin resistance plays an important role in its development and prognosis. ...However, there seem to be a dearth of information in understanding the likely interplay between beta endorphin, insulin resistance and pain perception especially in the setting of painful diabetic neuropathy.
This study recruited 120 volunteers divided into four groups (30 per group): group 1 healthy volunteer (control); group 2 DM type 2 without neuropathy (DM group); group 3 DM type 2 with painful neuropathy (DPN group); group 4 DM type 2 without painful neuropathy (DN). All subjects were evaluated for pain threshold and neuropathy using an ischemia-induced pain model and biothesiometer respectively. Their beta-endorphin, glycated hemoglobin, fasting plasma insulin, and HOMA values were determined and means compared using ANOVA.
Serum beta-endorphin is significantly reduced in DN and DPN (∗p < 0.001) compared with the control and DM group. Also, DPN and DN patients have significantly increased insulin resistance compared to those without neuropathy (∗p < 0.001; ∗p < 0.0001 respectively). There is a significant positive correlation between the pain threshold and beta-endorphin in all the groups except DN group. The correlation between beta-endorphin and insulin resistance was negative and significant in control and DM groups only. Suggestive that the fact that insulin resistance plays an important role in diabetes polyneuropathy, does not alone explain the chronic pain perception noticed in the DPN patients.
The present study demonstrates that diabetic neuropathy patients have a poor endogenous opioid peptide system which is associated with increased pain perception and high insulin resistance. However, insulin resistance alone does not explain the chronic pain perception noticed in the DPN patients. Thus, further study is required.
Diabetic neuropathy, β-Endorphin, Ischemic-induced pain model, Pain threshold, Insulin resistance, Environmental science, Biological sciences, Neuroscience, Veterinary medicine, Health sciences
This study evaluated the effect of apple cider vinegar (ACV) on the carcass characteristics and meat quality of broiler chickens. A total of 300 broilers (Arbor Acre) were randomized to six ...treatments replicated 5 times (50 birds/treatment and 10 birds/replicate) from 2 days old till the sixth week of age in a 2 by 3 factorial layout consisting of dosages (5.0 mL/L and 10.0 mL/L ACV) and administration frequency (antibiotics following standard schedule, twice/week ACV and thrice/week ACV). At the sixth week, sixty birds (10 birds/treatment) were selected for carcass yield, cut part yield, organ weight, meat technological properties, lipid profiles, and malondialdehyde (MDA) level evaluation. Data obtained were subjected to two-way ANOVA followed by Tukey’s test at a
P
< 0.05 significant level. Birds administered 5.0 mL/L ACV thrice weekly presented a significantly (
P
< 0.05) higher plucked, eviscerated, dressed, thigh and breast weight compared with the other treatments. The spleen of birds in the control group was significantly (
P
< 0.05) heavier than those administered ACV. The meat from the 5.0 mL/L ACV group had significantly higher (
P
< 0.05) water absorptive power and lower refrigeration loss, as depicted in the main effect table. Meat cholesterol, phospholipids, and MDA levels did not differ across the treatments except triglyceride, which was significantly (
P
< 0.05) lower in the 5.0 mL/L ACV thrice-weekly group. This study concludes that ACV administration could improve carcass yield and meat quality indices. Thus, its use as an alternative to conventional antibiotics for broiler chickens might be beneficial.
In this biphasic study, 45 male wistar rats were divided into 9 groups. In Phase 1, Group 1 was treated with normal saline and served as the overall control, group 2 was treated with 95% Ethanol and ...represents the ulcer control, groups 3 and 4 received coconut water (CW; 4ml/100g BWt) and milk (CM; 4ml/100g BWt) for 4weeks while group 5 received Omeprazole (Omep; 20mg/kg BWt) during terminal week. 95% Ethanol-induced ulceration followed the treatments in all except group 1. In the second phase, Group 1 was the overall control, group 2 served as ulcer control by receiving acetic acid only, group 3 received coconut milk, and group 4 received omep. CM and omep were administered post-ulcer induction for 3 and 6days twice daily. Blood collection after 1hour was through cardiac puncture for haemocytometry, and gastric tissues harvested for histopathological investigations. Results showed significantly reduced ulcer score and gastric lesion index in Omep, CW and CM groups compared to ulcer control. WBC, neutrophil, lymphocyte counts in Omep, CW and CM groups were significantly reduced compared to ulcer and overall control groups. C-reactive protein was significantly reduced in CM compared to control. Neutrophil Infiltration score reduced while mucus cell density increased significantly in Omep; CM compared to control. EGFR and CD 31 assessment revealed significantly higher expressions in coconut-milk group compared to the ulcer control. We conclude that the protective effects of coconut (water and milk) is expressed by inflammation suppression, upregulation of mucus cell population and catalyses mucosa homeostasis via angiogenesis and mucosal cell proliferation following mucosa. erosion.
It has been long thought that hyperactivation of N-methyl-
d-aspartate (NMDA) receptors underlies neurological decline after traumatic brain injury. However, all clinical trials with NMDA receptor ...antagonists failed. Since NMDA receptors are down-regulated from 4
h to 2
weeks after brain injury, activation at 24
h, rather than inhibition, of these receptors, was previously shown to be beneficial in mice. Here, we tested the therapeutic window, dose regimen and mechanism of action of the NMDA receptor partial agonist
d-cycloserine (DCS) in traumatic brain injury. Male mice were subjected to trauma using a weight-drop model, and administered 10
mg/kg (i.p.) DCS or vehicle once (8, 16, 24, or 72
h) twice (24 and 48
h) or three times (24, 48 and 72
h). Functional recovery was assessed for up to 60
days, using a Neurological Severity Score that measures neurobehavioral parameters. In all groups in which treatment was begun at 24 or 72
h neurobehavioral function was significantly better than in the vehicle-treated groups. Additional doses, on days 2 and 3 did not further improve recovery. Mice treated at 8
h or 16
h post injury did not differ from the vehicle-treated controls. Co-administration of the NMDA receptor antagonist MK-801 completely blocked the protective effect of DCS given at 24
h. Infarct volume measured by 2,3,5-triphenyltetrazolium chloride staining at 48
h or by cresyl violet at 28
days was not affected by DCS treatment. Since DCS is used clinically for other indications, the present study offers a novel approach for treating human traumatic brain injury with a therapeutic window of at least 24
h.
Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans.
To ...evaluate the association of SHSE with stroke among indigenous Africans.
We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05.
Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes.
Culturally relevant primary prevention strategies targeted at SHSE might be promising in preventing stroke among Africans.
•SHSE is associated with the risk of stroke among Africans.•Profiling SHSE might be promising in estimating the overall significance of smoke exposure in stroke epidemiology•Public health interventions are necessary to protect vulnerable populations from SHSE.
Aim: The study identified and evaluated bacteria exhibiting multiple plant growth traits in the Rhizosphere of Yellow Bell Pepper (Capsicum ...chinense).
Study Design: Seeds of Capsicum chinense were planted in a soil and allowed to grow. After five eeks of planting, soil samples from the rhizosphere were collected and the bacterial community present in the rhizosphere soil of Capsicum chinense was studied. The isolated organisms were assessed for their ability to produce plant growth promoting traits.
Place and Duration of Study: This study was carried out at an agricultural research farmland in the Federal University of Technology, Owerri, Nigeria.
Methodology: Seeds of Capiscum chinense were planted in the soil samples in a greenhouse. Rhizosphere soil was collected for analysis to identify the bacterial composition of the rhizosphere soil.
Results: In this study the presence of Bacillus cereus, Staphylococcus aureus, Corynebacterium sp, Enterococcus feacalis and Bacillus polymyxa were evident in the rhizosphere samples collected. All isolates showed multiple plant growth promoting traits except Staphylococcus aureushich was positive for hydrogen cyanide production only.
Conclusion: The results from this study showed that the bacterial community present in the soil can be used to effect significant vegetative crop yield and agricultural production. The isolated rhizobacteria can be formulated as bio-fertilizers or bioinnoculants, etc.
Quality in medical care must be measured in order to be improved. Trauma management is part of health care, and by definition, it must be checked constantly. The only way to measure quality and ...outcomes is to systematically accrue data and analyze them.
A systematic revision of the literature about quality indicators in trauma associated to an international consensus conference RESULTS: An internationally approved base core set of 82 trauma quality indicators was obtained: Indicators were divided into 6 fields: prevention, structure, process, outcome, post-traumatic management, and society integrational effects.
Present trauma quality indicator core set represents the result of an international effort aiming to provide a useful tool in quality evaluation and improvement. Further improvement may only be possible through international trauma registry development. This will allow for huge international data accrual permitting to evaluate results and compare outcomes.
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