scholarly journals Defining Acute Traumatic Encephalopathy: Methods of the “HEAD Injury Serum Markers and Multi-Modalities for Assessing Response to Trauma” (HeadSMART II) Study

2021 ◽  
Vol 12 ◽  
Author(s):  
W. Frank Peacock ◽  
Damon Kuehl ◽  
Jeff Bazarian ◽  
Adam J. Singer ◽  
Chad Cannon ◽  
...  
Keyword(s):  
Clinical Study ◽  
Head Injury ◽  
Serum Markers ◽  
Blood Protein ◽  
Neurocognitive Performance ◽  
Protein Biomarkers ◽  
Prognostic Information ◽  
Clinical Assessments ◽  
Neurocognitive Impairments

Despite an estimated 2.8 million annual ED visits, traumatic brain injury (TBI) is a syndromic diagnosis largely based on report of loss of consciousness, post-traumatic amnesia, and/or confusion, without readily available objective diagnostic tests at the time of presentation, nor an ability to identify a patient's prognosis at the time of injury. The recognition that “mild” forms of TBI and even sub-clinical impacts can result in persistent neuropsychiatric consequences, particularly when repetitive, highlights the need for objective assessments that can complement the clinical diagnosis and provide prognostic information about long-term outcomes. Biomarkers and neurocognitive testing can identify brain injured patients and those likely to have post-concussive symptoms, regardless of imaging testing results, thus providing a physiologic basis for a diagnosis of acute traumatic encephalopathy (ATE). The goal of the HeadSMART II (HEAD injury Serum markers and Multi-modalities for Assessing Response to Trauma) clinical study is to develop an in-vitro diagnostic test for ATE. The BRAINBox TBI Test will be developed in the current clinical study to serve as an aid in evaluation of patients with ATE by incorporating blood protein biomarkers, clinical assessments, and tools to measure, identify, and define associated pathologic evidence and neurocognitive impairments. This protocol proposes to collect data on TBI subjects by a multi-modality approach that includes serum biomarkers, clinical assessments, neurocognitive performance, and neuropsychological characteristics, to determine the accuracy of the BRAINBox TBI test as an aid to the diagnosis of ATE, defined herein, and to objectively determine a patient's risk of developing post-concussive symptoms.

Somatosensory and Auditory Brain Stem Conduction after Head Injury: A Comparison with Clinical Features in Prediction of Outcome

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 278-285 ◽  
Author(s):  
Kenneth Lindsay ◽  
Aydin Pasaoglu ◽  
David Hirst ◽  
Gwen Allardyce ◽  
Ian Kennedy ◽  
...  
Keyword(s):  
Head Injury ◽  
Brain Stem ◽  
Evoked Potential ◽  
Predictive Accuracy ◽  
Normal Subjects ◽  
Prediction Of Outcome ◽  
Prognostic Information ◽  
Additional Information ◽  
Auditory Brain Stem ◽  
The Difference

Abstract Evoked potential conduction times in brain stem auditory (BCT) and central somatosensory pathways (CCT) were recorded from 23 normal subjects and 101 patients with severe head injury. Abnormalities in the CCT and the BCT findings correlated with the clinical indices of brain damage (coma score, motor response, pupil response, and spontaneous and reflex eye movements) in the head-injured patients and each correlated with outcome at 6 months from the injury. The CCT in the “best” hemisphere produced the strongest correlation with outcome (P<0.001). The correlation of the CCT with outcome was stronger in the 47 patients examined 2 to 3 days after the injury (P<0.001) compared to the 34 patients examined within 24 hours after the injury (P<0.02). No such difference was noted for the BCT. Serial studies within the first 2 weeks of injury did not show a consistent pattern and repetition of the investigation over this period did not provide any additional information. We used an INDEP-SELECT discriminant analysis program to determine whether information from the evoked potential data could improve prediction of outcome based on clinical data alone. With the addition of the CCT, the predictive accuracy (expressed as the correct classification probability) increased only slightly from 77 to 80%, and the difference was not significant. We conclude that central somatosensory and auditory brain stem conduction times provide useful prognostic information in paralyzed or sedated patients, but when neurological examination is feasible the benefits of evoked potential analysis do not justify the effort involved in data collection.

scholarly journals Laboratory and clinical trials of cocamide diethanolamine lotion against head lice

PeerJ ◽  
2015 ◽  
Vol 3 ◽  
pp. e1368 ◽  
Author(s):  
Ian F. Burgess ◽  
Elizabeth R. Brunton ◽  
Christine M. Brown
Keyword(s):  
Clinical Study ◽  
Laboratory Tests ◽  
Head Louse ◽  
Test Material ◽  
Single Application ◽  
Louse Infestation ◽  
Treatment Regimens ◽  
Significant Difference ◽  
Head Louse Infestation

Context.During the late 1990s, insecticide resistance had rendered a number of treatment products ineffective; some companies saw this as an opportunity to develop alternative types of treatment. We investigated the possibility that a surfactant-based lotion containing 10% cocamide diethanolamine (cocamide DEA) was effective to eliminate head louse infestation.Settings and Design.Initialin vitrotesting of the lotion formulation versus laboratory reared body/clothing lice, followed by two randomised, controlled, community-based, assessor blinded, clinical studies.Materials and Methods.Preliminary laboratory tests were performed by exposing lice or louse eggs to the product using a method that mimicked the intended use. Clinical Study 1: Children and adults with confirmed head louse infestation were treated by investigators using a single application of aqueous 10% cocamide DEA lotion applied for 60 min followed by shampooing or a single 1% permethrin creme rinse treatment applied to pre-washed hair for 10 min. Clinical Study 2: Compared two treatment regimens using 10% cocamide DEA lotion that was concentrated by hair drying. A single application left on for 8 h/overnight was compared with two applications 7 days apart of 2 h duration, followed by a shampoo wash.Results.The initial laboratory tests showed a pediculicidal effect for a 60 min application but limited ovicidal effect. A longer application time of 8 h or overnight was found capable of killing all eggs but this differed between batches of test material. Clinical Study 1: Both treatments performed badly with only 3/23 (13%) successful treatments using cocamide DEA and 5/25 (23.8%) using permethrin. Clinical Study 2: The single overnight application of cocamide DEA concentrated by hair drying gave 10/56 (17.9%) successes compared with 19/56 (33.9%) for the 2 h application regimen repeated after 1 week. Intention to treat analysis showed no significant difference (p= 0.0523) between the treatments. Over the two studies, there were 18 adverse events possibly or probably associated with treatment, most of which were increased pruritus after treatment.Conclusions.Cocamide DEA 10% lotion, even when concentrated by hair drying, showed limited activity to eliminate head louse infestation.

The Clinical Study of In Vitro Fertilization and Embryo Transfer

1993 ◽  
Vol 16 (2) ◽  
pp. 155
Author(s):  
Hye Won Chung ◽  
Seung Eun Oh ◽  
Young Soo Son ◽  
Han Ki Yoo ◽  
Bock Hi Woo
Keyword(s):  
Clinical Study ◽  
In Vitro Fertilization ◽  
Embryo Transfer ◽  
Vitro Fertilization

scholarly journals Myeloid Lineage Ablation of Phlpp1 Regulates M-CSF Signaling and Tempers Bone Resorption in Female Mice

2021 ◽  
Vol 22 (18) ◽  
pp. 9702
Author(s):  
Ismael Y. Karkache ◽  
Jeyaram R. Damodaran ◽  
David H. H. Molstad ◽  
Kim C. Mansky ◽  
Elizabeth W. Bradley
Keyword(s):  
Bone Resorption ◽  
Bone Mass ◽  
Cell Types ◽  
Serum Markers ◽  
In Vitro Assays ◽  
Bovine Bone ◽  
Micro Computed Tomography ◽  
Myeloid Lineage ◽  
Trabecular Bone Mass

Prior work demonstrated that Phlpp1 deficiency alters trabecular bone mass and enhances M-CSF responsiveness, but the cell types and requirement of Phlpp1 for this effect were unclear. To understand the function of Phlpp1 within myeloid lineage cells, we crossed Phlpp1 floxed mice with mice harboring LysM-Cre. Micro-computed tomography of the distal femur of 12-week-old mice revealed a 30% increase in bone volume per total volume of Phlpp1 female conditional knockouts, but we did not observe significant changes within male Phlpp1 cKOLysM mice. Bone histomorphmetry of the proximal tibia further revealed that Phlpp1 cKOLysM females exhibited elevated osteoclast numbers, but conversely had reduced levels of serum markers of bone resorption as compared to littermate controls. Osteoblast number and serum markers of bone formation were unchanged. In vitro assays confirmed that Phlpp1 ablation enhanced osteoclast number and area, but limited bone resorption. Additionally, reconstitution with exogenous Phlpp1 suppressed osteoclast numbers. Dose response assays demonstrated that Phlpp1−/− cells are more responsive to M-CSF, but reconstitution with Phlpp1 abrogated this effect. Furthermore, small molecule-mediated Phlpp inhibition enhanced osteoclast numbers and size. Enhanced phosphorylation of Phlpp substrates—including Akt, ERK1/2, and PKCζ—accompanied these observations. In contrast, actin cytoskeleton disruption occurred within Phlpp inhibitor treated osteoclasts. Moreover, Phlpp inhibition reduced resorption of cells cultured on bovine bone slices in vitro. Our results demonstrate that Phlpp1 deficiency within myeloid lineage cells enhances bone mass by limiting bone resorption while leaving osteoclast numbers intact; moreover, we show that Phlpp1 represses osteoclastogenesis and controls responses to M-CSF.

scholarly journals Hemp Seeds in Post-Arthroplasty Rehabilitation: A Pilot Clinical Study and an In Vitro Investigation

Nutrients ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 4330
Author(s):  
Samantha Maurotti ◽  
Rosario Mare ◽  
Roberta Pujia ◽  
Yvelise Ferro ◽  
Elisa Mazza ◽  
...  
Keyword(s):  
Clinical Study ◽  
Bone Metabolism ◽  
Human Study ◽  
Seed Extract ◽  
Control Group ◽  
Hemp Seed ◽  
Bone Formation Markers ◽  
In Vitro Investigation ◽  
Arthroplasty Surgery

Osteoarthritis is a type of degenerative joint disease that results from the breakdown of joint cartilage and underlying bone. Due to their antioxidants and anti-inflammatory action, the phytochemical constituents of many vegetable varieties could represent a new frontier for the treatment of patients with Osteoarthritis and are still being explored. The aim of this pilot human study was to investigate the effects of pasta enriched with hemp seed flour on osteoarticular pain and bone formation markers in patients in post-arthroplasty rehabilitation. Another purpose was to evaluate the effect of hemp seed extract on bone metabolism, in vitro. A pilot, controlled, clinical study was conducted to verify the feasibility of pain symptom reduction in patients with Osteoarthritis undergoing arthroplasty surgery. We also investigated the effect of hemp seed extract on the Wnt/β-catenin and ERK1/2 pathways, alkaline phosphatase, RANKL, RUNX-2, osteocalcin, and COL1A on Saos-2. After 6 weeks, the consumption of hemp seed pasta led to greater pain relief compared to the regular pasta control group (−2.9 ± 1.3 cm vs. −1.3 ± 1.3 cm; p = 0.02). A significant reduction in serum BALP was observed in the participants consuming the hemp seed pasta compared to control group (−2.8 ± 3.2 µg/L vs. 1.1 ± 4.3 µg/L; p = 0.04). In the Saos-2 cell line, hemp seed extract also upregulated Wnt/β-catenin and Erk1/2 pathways (p = 0.02 and p = 0.03) and osteoblast differentiation markers (e.g., ALP, OC, RUNX2, and COL1A) and downregulated RANKL (p = 0.02), compared to the control. Our study demonstrated that hemp seed can improve pain symptoms in patients with osteoarthritis undergoing arthroplasty surgery and also improves bone metabolism both in humans and in vitro. However, more clinical studies are needed to confirm our preliminary findings.

Carbamazepine pharmacokinetics are not affected by zonisamide: in vitro mechanistic study and in vivo clinical study in epileptic patients

2004 ◽  
Vol 62 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Isabelle Ragueneau-Majlessi ◽  
Rene H. Levy ◽  
Donna Bergen ◽  
William Garnett ◽  
William Rosenfeld ◽  
...  
Keyword(s):  
Clinical Study ◽  
Mechanistic Study ◽  
Epileptic Patients

Hop Bract Polyphenols Reduced Three-day Dental Plaque Regrowth

2007 ◽  
Vol 86 (9) ◽  
pp. 848-851 ◽  
Author(s):  
K. Shinada ◽  
M. Tagashira ◽  
H. Watanabe ◽  
P. Sopapornamorn ◽  
A. Kanayama ◽  
...  
Keyword(s):  
Clinical Study ◽  
Oral Hygiene ◽  
Dental Plaque ◽  
Mutans Streptococci ◽  
Healthy Male ◽  
Inhibitory Effects ◽  
Performance Score ◽  
Double Blind ◽  
The Mean

Previous research has shown the inhibitory effects of hop bract polyphenols (HBP) on cariogenic streptococci in vitro, but their effects in humans have not been investigated. This double-blind, crossover clinical study tested the hypothesis that HBP delivered in a mouthrinse suppresses plaque regrowth in humans. Twenty-nine healthy male volunteers had all plaque removed, and refrained from all oral hygiene for 3 days, except for rinsing with a mouthrinse containing 0.1% HBP or a placebo. The results showed that the mean amount of plaque assessed by the Patient Hygiene Performance score after the volunteers used the HBP mouthrinse was significantly less than that after they used the placebo (p < 0.001). The number of mutans streptococci in the plaque samples after volunteers used the HBP mouthrinse was significantly lower than that after they used the placebo (p < 0.05). These findings suggested that HBP, delivered in a mouthrinse, successfully reduced dental plaque regrowth in humans.

Impairment of helper T-cell function and lymphokineactivated killer cytotoxicity following severe head injury

1991 ◽  
Vol 75 (5) ◽  
pp. 766-773 ◽  
Author(s):  
Keith B. Quattrocchi ◽  
Edmund H. Frank ◽  
Claramae H. Miller ◽  
Asim Amin ◽  
Bernardo W. Issel ◽  
...  
Keyword(s):  
T Cell ◽  
Head Injury ◽  
Severe Head Injury ◽  
Cell Cytotoxicity ◽  
Content Type ◽  
Lak Cell ◽  
Head Injured ◽  
Injured Patients ◽  
Fine Print

✓ Infection is a major complication of severe head injury, occurring in 50% to 75% of patients who survive to hospitalization. Previous investigations of immune activity following head injury have demonstrated suppression of helper T-cell activation. In this study, the in vitro production of interferon-gamma (INF-γ), interleukin-1 (IL-1), and interleukin-2 (IL-2) was determined in 25 head-injured patients following incubation of peripheral blood lymphocytes (PBL's) with the lymphocyte mitogen phytohemagglutinin (PHA). In order to elucidate the functional status of cellular cytotoxicity, lymphokine-activated killer (LAK) cell cytotoxicity assays were performed both prior to and following incubation of PBL's with IL-2 in five patients with severe head injury. The production of INF-γ and IL-2 by PHA-stimulated PBL's was maximally depressed within 24 hours of injury (p < 0.001 for INF-γ, p = 0.035 for IL-2) and partially normalized within 21 days of injury. There was no change in the production of IL-1. When comparing the in vitro LAK cell cytotoxicity of PBL's from head-injured patients and normal subjects, there was a significant depression in LAK cell cytotoxicity both prior to (p = 0.010) and following (p < 0.001) incubation of PBL's with IL-2. The results of this study indicate that IL-2 and INF-γ production, normally required for inducing cell-mediated immunity, is suppressed following severe head injury. The failure of IL-2 to enhance LAK cell cytotoxicity suggests that factors other than decreased IL-2 production, such as inhibitory soluble mediators or suppressor lymphocytes, may be responsible for the reduction in cellular immune activity following severe head injury. These findings may have significant implications in designing clinical studies aimed at reducing the incidence of infection following severe head injury.

Sign in / Sign up

Export Citation Format

Share Document