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[PMID]:29505539
[Au] Autor:Kim HH; Choi SC; Chae MK; Min YG
[Ad] Endereço:Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
[Ti] Título:Neuroprotective effect of ethanol in acute carbon monoxide intoxication: A retrospective study.
[So] Source:Medicine (Baltimore);97(1):e9569, 2018 Jan.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In acute carbon monoxide (CO) intoxication, treatment of neurologic injury and prevention of neurological sequelae are primary concerns. Ethanol is the one of the frequent substances which is co-ingested in intentional CO poisoning. Neuroprotective effect of ethanol was highlighted and demonstrated in isolated brain injury recently. We assessed the neuroprotective effect of ethanol in acute CO intoxication using magnetic resonance imaging (MRI).We retrospectively reviewed medical records for patients who visited an emergency medical center of a university-affiliated hospital during a period of 73 months, from March 2009 to April 2015. Enrolled patients were divided into 2 groups, patients with or without abnormal brain lesion in brain MRI. Multivariate logistic regression analysis was performed to assess the factors associated with brain injury in MRI.A total of 109 patients with acute CO intoxication were evaluated of which 66 (60.55%) tested positive in brain MRI. MRI lesion-positive patients were more likely to have electrocardiogram change, elevation of serum troponin I and s100 protein level and lower serum ethanol level. Serum ethanol positivity was an independent factor for prevalence of brain injury in MRI in acute CO poisoning.This study revealed that ethanol which is co-ingested in acute CO intoxication may work the neuroprotective effect and could consequence more favorable neurological outcome in acute CO intoxication.
[Mh] Termos MeSH primário: Lesões Encefálicas/etiologia
Encéfalo/efeitos dos fármacos
Intoxicação por Monóxido de Carbono/complicações
Depressores do Sistema Nervoso Central/farmacologia
Etanol/farmacologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Encéfalo/diagnóstico por imagem
Lesões Encefálicas/sangue
Lesões Encefálicas/diagnóstico por imagem
Lesões Encefálicas/prevenção & controle
Intoxicação por Monóxido de Carbono/sangue
Intoxicação por Monóxido de Carbono/diagnóstico por imagem
Depressores do Sistema Nervoso Central/sangue
Etanol/sangue
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Estudos Retrospectivos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Central Nervous System Depressants); 3K9958V90M (Ethanol)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180309
[Lr] Data última revisão:
180309
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180306
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009569


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[PMID]:29237531
[Au] Autor:Yue Y; Qu Y; Mu DZ
[Ad] Endereço:Department of Pediatrics, West China Second Hospital, Sichuan University/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu 610041, China. mudz@scu.edu.cn.
[Ti] Título:[Research advances in mesenchymal stem cell-derived exosomes in treatment of brain injury].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1285-1290, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Mesenchymal stem cell (MSC) transplantation is considered one of the most promising therapeutic strategies for the repair of brain injuries and plays an important role in various links of nerve repair. Recent studies have shown that MSC-derived exosomes may dominate the repair of brain injuries and help to promote angiogenesis, regulate immunity, inhibit apoptosis, and repair the nerves, and therefore, they have a great potential in the treatment of brain injuries in neonates. With reference to these studies, this article reviews the mechanism of action of exosomes in the repair of brain injuries and related prospects and challenges, in order to provide new directions for the treatment of brain injuries in neonates with stem cells.
[Mh] Termos MeSH primário: Lesões Encefálicas/terapia
Exossomos/fisiologia
Transplante de Células-Tronco Mesenquimais
[Mh] Termos MeSH secundário: Apoptose
Seres Humanos
Inflamação/prevenção & controle
Neovascularização Fisiológica
Linfócitos T/imunologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


  3 / 45638 MEDLINE  
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[PMID]:29237520
[Au] Autor:Mao J
[Ad] Endereço:Neonatologist Society, Chinese Medical Doctor Association.
[Ti] Título:[Patterns of brain injury in neonatal hypoxic-ischemic encephalopathy on magnetic resonance imaging: recommendations on classification].
[So] Source:Zhongguo Dang Dai Er Ke Za Zhi;19(12):1225-1233, 2017 Dec.
[Is] ISSN:1008-8830
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:Although there are unified criteria for the clinical diagnosis and grading of neonatal hypoxic-ischemic encephalopathy (HIE), clinical features and neuropathological patterns vary considerably among the neonates with HIE due to birth asphyxia in the same classification. The patterns and progression of brain injury in HIE, which is closely associated with long-term neurodevelopment outcomes, can be well shown on magnetic resonance imaging (MRI), but different sequences may lead to different MRI findings at the same time. It is suggested that diffusion-weighted imaging sequence be selected at 2-4 days after birth, and the conventional MRI sequence at 4-8 days. The major patterns of brain injury in HIE on MRI are as follows: injury of the thalamus and basal ganglia and posterior limbs of the internal capsules; watershed injury involving the cortical and subcortical white matter; focal or multifocal minimal white matter injury; extensive whole brain injury. Severe acute birth asphyxia often leads to deep grey matter injury (thalamus and basal ganglia), and the brain stem may also be involved; the pyramidal tract is the most susceptible white matter fiber tract; repetitive or intermittent hypoxic-ischemic insults, with inflammation or hypoglycemia, usually cause injuries in the watershed area and deep white matter. It is worth noting that sometimes the pattern of brain injury among those described above cannot be determined exactly, but rather a predominant one is identified; not all cases of HIE have characteristic MRI findings.
[Mh] Termos MeSH primário: Lesões Encefálicas/classificação
Encéfalo/diagnóstico por imagem
Hipóxia-Isquemia Encefálica/diagnóstico por imagem
Imagem por Ressonância Magnética/métodos
[Mh] Termos MeSH secundário: Lesões Encefálicas/diagnóstico por imagem
Imagem de Difusão por Ressonância Magnética/métodos
Seres Humanos
Recém-Nascido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE


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[PMID]:28744672
[Au] Autor:Jayaraman MV; McTaggart RA; Goyal M
[Ad] Endereço:Department of Diagnostic Imaging, Warren Alpert School of Medicine at Brown University, Rhode Island Hospital, 593 Eddy Street, Room 377, Providence, RI, 02903, USA. mahesh.jayaraman@gmail.com.
[Ti] Título:Unresolved Issues in Thrombectomy.
[So] Source:Curr Neurol Neurosci Rep;17(9):69, 2017 Sep.
[Is] ISSN:1534-6293
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE OF REVIEW: Trials demonstrating marked benefit of mechanical thrombectomy (MT) for acute stroke caused by large vessel occlusion (LVO) in the anterior circulation have been the most significant advance in acute ischemic stroke in the past 20 years. However, despite this marked advance, there are still many hurdles to improving access to thrombectomy worldwide. Additionally, despite these advances, a substantial portion of patients with LVO still are left disabled. RECENT FINDINGS: The major randomized trials focused on patients within 6 h from symptom onset, with occlusion of the ICA or proximal MCA, small amount of permanently damaged brain, and a moderate to large clinical deficit. We will explore the role of thrombectomy outside of these areas, but also explore larger issues as they pertain to re-organization of stroke systems of care to improve access to this remarkable therapy. Now that we have proven, without a shadow of doubt, that rapid revascularization with mechanical thrombectomy improves outcomes in LVO stroke, we must reorganize our systems of care to improve access and assess the role for MT outside of the patients who meet trial criteria.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/normas
Trombólise Mecânica/normas
Acidente Vascular Cerebral/terapia
Tempo para o Tratamento/normas
[Mh] Termos MeSH secundário: Lesões Encefálicas/diagnóstico
Lesões Encefálicas/terapia
Serviços Médicos de Emergência/métodos
Seres Humanos
Trombólise Mecânica/métodos
Acidente Vascular Cerebral/diagnóstico
Trombectomia/métodos
Trombectomia/normas
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170727
[St] Status:MEDLINE
[do] DOI:10.1007/s11910-017-0776-4


  5 / 45638 MEDLINE  
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[PMID]:27778377
[Au] Autor:Kyyriäinen J; Ekolle Ndode-Ekane X; Pitkänen A
[Ad] Endereço:Department of Neurobiology, A. I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, FI-70211, Finland.
[Ti] Título:Dynamics of PDGFRß expression in different cell types after brain injury.
[So] Source:Glia;65(2):322-341, 2017 02.
[Is] ISSN:1098-1136
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Platelet-derived growth factor receptor ß (PDGFRß) is upregulated after brain injury and its depletion results in the blood-brain barrier (BBB) damage. We investigated the time-window and localization of PDGFRß expression in mice with intrahippocampal kainic acid-induced status epilepticus (SE) and in rats with lateral fluid-percussion-induced traumatic brain injury (TBI). Tissue immunohistochemistry was evaluated at several time-points after SE and TBI. The distribution of PDGFRß was analyzed, and its cell type-specific expression was verified with double/triple-labeling of astrocytes (GFAP), NG2 cells, and endothelial cells (RECA-1). In normal mouse hippocampus, we found evenly distributed PDGFRß+ parenchymal cells. In double-labeling, all NG2+ and 40%-60% GFAP+ cells were PDGFRß+. After SE, PDGFRß+ cells clustered in the ipsilateral hilus (178% of that in controls at fourth day, 225% at seventh day, P < 0.05) and in CA3 (201% at seventh day, P < 0.05), but the total number of PDGFRß+ cells was not altered. As in controls, PDGFRß-immunoreactivity was detected in parenchymal NG2+ and GFAP+ cells. We also observed PDGFRß+ structural pericytes, detached reactive pericytes, and endothelial cells. After TBI, PDGFRß+ cells clustered in the perilesional cortex and thalamus, particularly during the first post-injury week. PDGFRß immunopositivity was observed in NG2+ and GFAP+ cells, structural pericytes, detached reactive pericytes, and endothelial cells. In some animals, PDGFRß vascular staining was observed around the cortical glial scar for up to 3 months. Our data revealed an acute accumulation of PDGFRß+ BBB-related cells in degenerating brain areas, which can be long lasting, suggesting an active role for PDGFRß-signaling in blood vessel and post-injury tissue recovery. GLIA 2017;65:322-341.
[Mh] Termos MeSH primário: Astrócitos/classificação
Astrócitos/metabolismo
Lesões Encefálicas/patologia
Células Endoteliais/metabolismo
Molécula-1 de Adesão Celular Endotelial de Plaquetas/metabolismo
Receptor alfa de Fator de Crescimento Derivado de Plaquetas/metabolismo
[Mh] Termos MeSH secundário: Animais
Antígenos/metabolismo
Modelos Animais de Doenças
Proteína Glial Fibrilar Ácida/metabolismo
Proteínas de Fluorescência Verde/genética
Proteínas de Fluorescência Verde/metabolismo
Masculino
Camundongos
Camundongos Endogâmicos C57BL
Camundongos Transgênicos
Pericitos/metabolismo
Pericitos/patologia
Proteoglicanas/metabolismo
Ratos
Ratos Sprague-Dawley
Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Antigens); 0 (Glial Fibrillary Acidic Protein); 0 (Platelet Endothelial Cell Adhesion Molecule-1); 0 (Proteoglycans); 0 (chondroitin sulfate proteoglycan 4); 147336-22-9 (Green Fluorescent Proteins); EC 2.7.10.1 (Receptor, Platelet-Derived Growth Factor alpha)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1002/glia.23094


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[PMID]:29244046
[Au] Autor:O'Reilly K
[Ad] Endereço:Western Sydney University, Sydney, Australia.
[Ti] Título:Humor-A Rehabilitative Tool in the Post-Intensive Care of Young Adults With Acquired Brain Injury.
[So] Source:Rehabil Nurs;42(4):230-234, 2017 Jul/Aug.
[Is] ISSN:2048-7940
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aim of the study was to describe how paid carers use humor in providing compassionate post-intensive rehabilitation care to young adults with acquired brain injury (ABI) who are unable to perform or direct their own care. DESIGN: This is a qualitative study underpinned by symbolic interactionism. METHODS: Paid carers in a residential aged care facility were interviewed. Interview data were analyzed using grounded theory methods of coding, comparative analysis, memoing, and theoretical sampling. FINDINGS: With young adult's assent, paid carers appropriately used humor, at times even crude humor, as a rehabilitative tool to activate and elicit responses from young people with ABI who could not perform or direct their own care. The use of humor while caring for this population demonstrated that compassion still exists within nursing; however, it may not always be reverent. CONCLUSIONS/CLINICAL RELEVANCE: Humor may be an effective way to provide compassionate care and can be used as a rehabilitative tool to elicit responses from young people with ABI who have no means of verbal communication.
[Mh] Termos MeSH primário: Lesões Encefálicas/reabilitação
Enfermagem em Reabilitação/métodos
Senso de Humor e Humor como Assunto/psicologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Lesões Encefálicas/enfermagem
Empatia
Feminino
Teoria Fundamentada
Seres Humanos
Unidades de Terapia Intensiva/organização & administração
Masculino
Meia-Idade
Pesquisa Qualitativa
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171216
[St] Status:MEDLINE
[do] DOI:10.1097/rnj.0000000000000015


  7 / 45638 MEDLINE  
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[PMID]:27775164
[Au] Autor:Wilson HJ; Dasgupta K; Michael K
[Ti] Título:Implementation of the Agitated Behavior Scale in the Electronic Health Record.
[So] Source:Rehabil Nurs;43(1):21-25, 2018 Jan/Feb.
[Is] ISSN:2048-7940
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the study was to implement an Agitated Behavior Scale through an electronic health record and to evaluate the usability of the scale in a brain injury unit at a rehabilitation hospital. DESIGN: A quality improvement project was conducted in the brain injury unit at a large rehabilitation hospital with registered nurses as participants using convenience sampling. METHODS: The project consisted of three phases and included education, implementation of the scale in the electronic health record, and administration of the survey questionnaire, which utilized the system usability scale. FINDINGS: The Agitated Behavior Scale was found to be usable, and there was 92.2% compliance with the use of the electronic Electronic Agitated Behavior Scale. CONCLUSION: The Agitated Behavior Scale was effectively implemented in the electronic health record and was found to be usable in the assessment of agitation. CLINICAL RELEVANCE: Utilization of the scale through the electronic health record on a daily basis will allow for an early identification of agitation in patients with traumatic brain injury and enable prompt interventions to manage agitation.
[Mh] Termos MeSH primário: Escala de Avaliação Comportamental
Registros Eletrônicos de Saúde/tendências
Agitação Psicomotora/psicologia
[Mh] Termos MeSH secundário: Adulto
Lesões Encefálicas/complicações
Feminino
Seres Humanos
Masculino
Estudos Prospectivos
Melhoria de Qualidade
Enfermagem em Reabilitação/métodos
Enfermagem em Reabilitação/tendências
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180226
[Lr] Data última revisão:
180226
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:161025
[St] Status:MEDLINE
[do] DOI:10.1002/rnj.297


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[PMID]:29381730
[Au] Autor:Biervoye A; Meert G; Apperly IA; Samson D
[Ad] Endereço:Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la Neuve, Belgium.
[Ti] Título:Assessing the integrity of the cognitive processes involved in belief reasoning by means of two nonverbal tasks: Rationale, normative data collection and illustration with brain-damaged patients.
[So] Source:PLoS One;13(1):e0190295, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Every day, we engage in social interactions with other people which require understanding their as well as our own mental states. Such capacity is commonly referred to as Theory of Mind (ToM). Disturbances of ToM are often reported in diverse pathologies which affect brain functioning and lead to problems in social interactions. Identifying ToM deficits is thus crucial to guide the clinicians in the establishment of adequate rehabilitation strategies for patients. Previous studies have demonstrated that ToM is not a unitary function yet currently there are very few standardized tests which allow identifying the type of cognitive processes affected when a patient exhibits a ToM deficit. In the current study, we present two belief reasoning tasks which have been used in previous research to disentangle two types of processes involved in belief reasoning: self-perspective inhibition and the spontaneous inference of another person's belief. A three-step procedure was developed to provide clinicians with the tools to interpret the patients' performances on the tasks. First, these tasks were standardized and normative data was collected on a sample of 124 healthy participants aged between 18 and 74. Data collected showed a decrease in performance as a function of age only in the task that loaded most in spontaneous other-perspective demands. There was however no effect of gender or educational level. Cut-off scores to identify deficits were then calculated for the different age groups separately. Secondly, the three-step procedure was applied to 21 brain-damaged patients and showed a large diversity of profiles, including selective deficits of the two targeted ToM processes. The diversity of profiles shows the importance to take into account the multiple facets of ToM during the diagnosis and rehabilitation of patients with suspected ToM deficits.
[Mh] Termos MeSH primário: Lesões Encefálicas/fisiopatologia
Transtornos Cognitivos/fisiopatologia
Cognição
Análise e Desempenho de Tarefas
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Lesões Encefálicas/complicações
Transtornos Cognitivos/complicações
Coleta de Dados
Feminino
Seres Humanos
Masculino
Meia-Idade
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180131
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190295


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[PMID]:28469998
[Au] Autor:Yang X; Xie J; Jia L; Liu N; Liang Y; Wu F; Liang B; Li Y; Wang J; Sheng C; Li H; Liu H; Ma Q; Yang C; Du X; Qiu S; Song H
[Ad] Endereço:Center for Infectious Disease Control, Institute of Disease Control and Prevention, Academy of Military Medical SciencesBeijing, China.
[Ti] Título:Analysis of miRNAs Involved in Mouse Brain Damage upon Enterovirus 71 Infection.
[So] Source:Front Cell Infect Microbiol;7:133, 2017.
[Is] ISSN:2235-2988
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Enterovirus 71 (EV71) infects the central nervous system (CNS) and causes brainstem encephalitis in children. MiRNAs have been found to play various functions in EV71 infection in human cell lines. To identify potential miRNAs involved in the inflammatory injury in CNS, our study, for the first time, performed a miRNA microarray assay using EV71 infected mice brains. Twenty differentially expressed miRNAs were identified (four up- and 16 down-regulated) and confirmed by qRT-PCR. The target genes of these miRNAs were analyzed using KEGG (Kyoto Encyclopedia of Genes and Genomes) analysis, revealing that the miRNAs were mainly involved in the regulation of inflammation and neural system function. MiR-150-5p, -3082-5p, -3473a, -468-3p, -669n, -721, -709, and -5107-5p that regulate MAPK and chemokine signaling were all down-regulated, which might result in increased cytokine production. In addition, miR-3473a could also regulate focal adhesion and leukocyte trans-endothelial migration, suggesting a role in virus-induced blood-brain barrier disruption. The miRNAs and pathways identified in this study could help to understand the intricate interactions between EV71 and the brain injury, offering new insight for the future research of the molecular mechanism of EV71 induced brainstem encephalitis.
[Mh] Termos MeSH primário: Lesões Encefálicas/patologia
Encéfalo/virologia
Enterovirus Humano A/patogenicidade
MicroRNAs/metabolismo
MicroRNAs/farmacologia
[Mh] Termos MeSH secundário: Animais
Barreira Hematoencefálica
Encéfalo/patologia
Lesões Encefálicas/virologia
Linhagem Celular
Sistema Nervoso Central/patologia
Sistema Nervoso Central/virologia
Quimiocinas/metabolismo
Citocinas/metabolismo
Regulação para Baixo
Enterovirus Humano A/genética
Infecções por Enterovirus
Perfilação da Expressão Gênica
Seres Humanos
Inflamação
Camundongos
MicroRNAs/genética
Quinases de Proteína Quinase Ativadas por Mitógeno/metabolismo
Reação em Cadeia da Polimerase em Tempo Real
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Chemokines); 0 (Cytokines); 0 (MicroRNAs); EC 2.7.12.2 (Mitogen-Activated Protein Kinase Kinases)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170505
[St] Status:MEDLINE
[do] DOI:10.3389/fcimb.2017.00133


  10 / 45638 MEDLINE  
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[PMID]:28449903
[Au] Autor:Suzuki Y; Khoury S; El-Khatib H; Chauny JM; Paquet J; Giguère JF; Denis R; Gosselin N; Lavigne GJ; Arbour C
[Ad] Endereço:Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Faculty of Dental Medicine, Université de Montréal, Montreal, Quebec, Canada.
[Ti] Título:Individuals with pain need more sleep in the early stage of mild traumatic brain injury.
[So] Source:Sleep Med;33:36-42, 2017 May.
[Is] ISSN:1878-5506
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Hypersomnia is frequently reported after mild traumatic brain injury (mTBI), but its cause(s) remain elusive. This study examined sleep/wake activity after mTBI and its association with pain, a comorbidity often associated with insomnia. METHODS: Actigraphy recording was performed for 7 ± 2 consecutive days in 56 individuals at one month post-mTBI (64% male; 38 ± 12 years), 24 individuals at one year post-mTBI (58% male; 44 ± 11years), and in 20 controls (50% male; 37 ± 12 years). Pain intensity and its effect on quality of life was assessed with a visual analogue scale and the Short Form Health Survey (SF-36) bodily pain subscale. RESULTS: Overall, few differences in sleep/wake patterns were found between mTBI patients and controls. However, higher percentages of mTBI individuals with moderate-to-severe pain were found to require more than eight hours of sleep per day (37% vs11%; p = 0.04) and to be frequent nappers (defined as those who took three or more naps per week) (42% vs 22%; p = 0.04) compared to those with mild or no pain at one month postinjury. Correcting for age and depression, The SF-36 score was found to be a significant predictor of sleep duration exceeding eight hours per day at one month (odds ratio = 0.95; 95% confidence interval = 0.92-0.99; p = 0.01), but not at one year post-mTBI. Pain and increased sleep need (in terms of hours per day or napping frequency) were found to co-exist in as much as 29% of mTBI patients at one month postinjury. CONCLUSION: Pain could be associated with more pronounced sleep need in about one-third of mTBI patients during early recovery. Unalleviated pain, found in more than 60% of mTBI patients, should therefore be looked for in all mTBI patients reporting new onset of sleep disorder, not only in those with insomnia.
[Mh] Termos MeSH primário: Concussão Encefálica/complicações
Lesões Encefálicas/complicações
Distúrbios do Sono por Sonolência Excessiva/complicações
Dor/complicações
Transtornos do Sono-Vigília/complicações
Sono/fisiologia
[Mh] Termos MeSH secundário: Actigrafia/métodos
Adulto
Concussão Encefálica/epidemiologia
Concussão Encefálica/fisiopatologia
Lesões Encefálicas/epidemiologia
Comorbidade
Distúrbios do Sono por Sonolência Excessiva/fisiopatologia
Feminino
Seres Humanos
Masculino
Meia-Idade
Dor/epidemiologia
Dor/fisiopatologia
Dor/psicologia
Estudos Prospectivos
Qualidade de Vida
Autorrelato
Índice de Gravidade de Doença
Distúrbios do Início e da Manutenção do Sono/complicações
Transtornos do Sono-Vigília/epidemiologia
Transtornos do Sono-Vigília/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE



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