Supporting evidence for using perispinal etanercept to inhibit TNFα when treating neuropathologies including dementia, chronic stroke, neuropathic pain or traumatic brain injury: Clinical outcomes and role of TNF in neuropathologies other than Alzheimer’s Dementia (Part III)

2017 ◽  
Vol 43 (5) ◽  
pp. E7 ◽  
Author(s):  
Areej Tariq ◽  
Pedro Aguilar-Salinas ◽  
Ricardo A. Hanel ◽  
Neeraj Naval ◽  
Mohamad Chmayssani

Intracranial pressure (ICP) monitoring has been widely accepted in the management of traumatic brain injury. However, its use in other pathologies that affect ICP has not been advocated as strongly, especially in CNS infections. Despite the most aggressive and novel antimicrobial therapies for meningitis, the mortality rate associated with this disease is far from satisfactory. Although intracranial hypertension and subsequent death have long been known to complicate meningitis, no specific guidelines targeting ICP monitoring are available. A review of the literature was performed to understand the pathophysiology of elevated ICP in meningitis, diagnostic challenges, and clinical outcomes in the use of ICP monitoring.


2020 ◽  
Vol 7 (7) ◽  
pp. 1173
Author(s):  
Anuradha V. Pai ◽  
Jyotsna R. Bankhele

Occupational Therapy is one of the primary professions with knowledge and skills to address the consequences of cognitive decline. Cognitive decline is caused by traumatic brain injury, non-traumatic neurological diseases, Ageing, Chronic psychiatry diseases. Recent thinking on cognitive rehabilitation places various approaches to a continuum, from restorative/ remedial approaches to cognitive compensatory approaches with four models within OT, and functional environmental approach with three models of intervention. Before using any of the above models, it is necessary to assess the needs of the patient, the demands of the environment and his cognitive ability. The issues faced by persons with cognitive dysfunctions demand interdisciplinary work to link the brain, behaviour and performance in everyday life. A 36-year-old male, 4years post-traumatic brain injury with anosognosia, disorientation and anomia was treated using a dynamic interactional model of cognitive retraining and showed dramatic recovery after 8 weeks’ therapy. A 65-year-old female diagnosed as Alzheimer's Dementia since two years with memory problems, neglect of ADL and visual hallucinations, disinhibited behaviour was treated for 8 weeks using Cognitive Disabilities model of 2011 and showed moderate recovery. A 73-year-old male diagnosed as Alzheimer's Dementia with forgetfulness, difficulty in money handling, disorientation and dependent in ADL was treated using Cognitive Disability Reconsidered model showed slight recovery. Each individual with cognitive problems due to disease, trauma and ageing behaves separately. Occupational therapy aims at maintaining independence in ADL and achieving the maximum level of performance in work and leisure.


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