Journal of neurotrauma
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Journal of neurotrauma · Dec 2016
ReviewCardiovascular Responses to Sexual Activity in Able-Bodied Individuals and Those Living with Spinal Cord Injury.
Sexuality is an integral part of the human experience and persists in health and disability. The cardiovascular system is crucial to sexual function and can be affected profoundly by spinal cord injury (SCI). The effects of sexual activity on the cardiovascular system in SCI have not been summarized and compared with sexual activity in able-bodied individuals. ⋯ In able-bodied persons, sexual activity results in modest increases in blood pressure. In those with SCI, intense stimulation and higher injury levels result in a higher likelihood of autonomic dysreflexia and elevated blood pressure. Because of rapid changes in blood pressure, continuous monitoring is more advantageous than intermittent measurement, because the latter may miss peak values.
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Journal of neurotrauma · Dec 2016
ReviewCurrent Opinion and Use of Transcranial Doppler Ultrasonography in Traumatic Brain Injury in the Pediatric Intensive Care Unit.
The purpose of this study was to identify and review clinical studies using transcranial Doppler (TCD) ultrasonography in children with severe traumatic brain injury (TBI) in the pediatric intensive care unit (PICU). We identified 16 articles from January 2005 to July 2015 that met inclusion (TBI, five or more cases in case series, subjects <18 years old, TCD performed in PICU) and exclusion criteria (age not stated, data from subjects <18 years not separated from adult data, <85% study population <18 years in mixed population with adults). TCD parameters were used to assess autoregulation, intracranial pressure, and vasospasm, and to predict neurological outcome. ⋯ TCD may be a useful tool to assess autoregulation, intracranial pressure, and vasospasm following TBI in the PICU. Further research is needed to establish gold standards and validate the findings in children. TCD may then impact day-to-day management in the PICU, and potentially improve outcomes in children with severe TBI.
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Journal of neurotrauma · Dec 2016
ReviewInhibition of glycogen synthase kinase-3: an emerging target in the treatment of traumatic brain injury.
Although traumatic brain injury (TBI) has been a major public health concern for decades, the pathophysiological mechanism of TBI is not clearly understood, and an effective medical treatment of TBI is not available at present. Of particular concern is sustained TBI, which has a strong tendency to take a deteriorating neurodegenerative course into chronic traumatic encephalopathy (CTE) and dementia, including Alzheimer's disease. Tauopathy and beta amyloid (Aβ) plaques are known to be the key pathological markers of TBI, which contribute to the progressive deterioration associated with TBI such as CTE and Alzheimer's disease. ⋯ GSK-3 inhibition studies using rodent TBI models demonstrate that GSK-3 inhibition produces diverse neuroprotective actions such as reducing the size of the traumatic injury, tauopathy, Aβ accumulation, and neuronal death, by releasing and activating neuroprotective substrates from GSK-3 inhibition. These effects are correlated with reduced TBI-induced behavioral and cognitive symptoms. Here, we review studies on the therapeutic effects of GSK-3 inhibition in TBI rodent models, and critically discuss the issues that these studies address.