Hyperbaric Oxygen and Outcomes Following the Brain Injury: A Systematic Review.

Introduction: Hyperbaric oxygen therapy (HBO2) aims to address ischemia resulting from brain injury by subjecting patients to an atmosphere that dramatically raises the concentration of inspired oxygen (100% O2 at greater than 1 ATA). This results in elevated levels of oxygen in the plasma, which in turn boosts the delivery of oxygen for diffusion to the brain tissue. Objective: To study the efficacy of hyperbaric oxygen (HBO)-based modalities in brain injury. Method: Preferred reporting items for systematic reviews protocol was applied to perform literature search regarding this analytical review. Results: In our study, fifteen studies are included in this review, involving 1067 people. The mean age group of patients enrolled was 57.0±11.6 and the mean NIHSS score was 10.5±8.7, of which 21 participants had moderate to severe neurological impairment. The total number of HBO treatments was 8 to 70 times (28.3±17.9), at the end of the 6-month follow-up period. mRS (modified Rankin scale) ≤3 was found in 25 cases, of which 12 patients with high-grade aSAH recovered. Poor prognosis was prevalent in patients who experienced delayed cerebral ischemia, this was true for 22.7% of patients in this study. In 3 studies conducted by Rockswold, ICP (mm Hg) was significantly lower in the HBO2 group after the treatment than pretreatment. (p<0.05). 4 studies showed an improvement in GCS score after HBO2 therapy.One trial (Imai 2006) reported that three patients in the HBO group died due to pneumonia (two) and heart failure (one) and one patient died in the control group due to heart failure. Overall, it is relatively safe to use HBO in the treatment of brain-related haemorrhage, strokes, and injury as there were no major complications reported. Conclusion: This systematic review demonstrates that HBO2 has significant clinical potential in treatment of brain related haemorrhages, stroke and injury.

The touch in action: exploring sensorimotor interactions with motor imagery.

The current research investigates the role of tactile information and its associated neural substrates in controlling the action. We employ a combination of motor and sensory components by asking participants to imagine exerting force with the index finger while either touching or not touching a surface. Assuming action imagination and action performance present similar patterns of activation along the motor system, we applied single-pulse transcranial magnetic stimulation over the primary motor cortex (M1) during action imagination. We observed increased amplitude of motor-evoked potentials (MEPs) of the relevant muscle when imagined actions were performed concurrently with tactile stimulation, suggesting a facilitatory effect of touch on the motor system. The motor system activity was scaled-based on the different amounts of force required, and crucially, this effect was specific to the body part involved in the action imagined. An intriguing positive correlation was observed between participants' ratings of their imagery level of vividness and the activation of the motor system, indicating that those participants exhibiting MEPs scaled correctly also had strong visualization abilities, as reflected by their capacity to accurately distinguish between varying levels of force.

Clinical characteristics and sequelae of intrapartum hypertension - a retrospective cohort study.

BACKGROUND: In a significant proportion of pregnant women, elevated blood pressure may first present during the intrapartum period. This phenomenon, intrapartum hypertension, is often overlooked as blood pressure during delivery is attributed to labour pain, analgesic agents and haemodynamic changes. Thus the true prevalence and clinical significance of intrapartum hypertension remains unknown. This study sought to define the prevalence of intrapartum hypertension in previously normotensive women, identify associated clinical characteristics, and its impact on maternal and fetal outcomes. METHODS: In this single-center retrospective cohort study, all available partograms were reviewed over a 1-month period at an outer metropolitan hospital in Sydney (Campbelltown Hospital). Women with diagnosed hypertensive disorders of pregnancy during the incident pregnancy were excluded. A total of 229 deliveries were included in the final analysis. Intrapatum hypertension (IH) was defined as two or more systolic blood pressure (SBP)⩾140 mmHg or diastolic blood pressure (DBP)⩾90 mmHg during the intrapartum. Demographic data at the time of the first antenatal visit for the incident pregnancy as well as final maternal outcomes (intrapartum and post-partum) and fetal outcomes were collected. Statistical analyses were carried out using SPSSv27 with adjustments for baseline variables. RESULTS: Amongst 229 deliveries, 32 women (14%) had intrapartum hypertension. Older maternal age (p = 0.02), higher body mass index (p < 0.01) and higher diastolic blood pressure at the first antenatal visit (p = 0.03) were associated with intrapartum hypertension. A longer second stage of labour (p = 0.03), intrapartum non-steroidal anti-inflammatory medications (p < 0.01) and epidural anaesthesia (p = 0.03) were associated with intrapartum hypertension, while IV syntocin for labour induction was not. Women with intrapartum hypertension had a longer inpatient admission following delivery (p < 0.01), and elevated postpartum BP (p = 0.02) with discharge on antihypertensive medications (p < 0.01). Intrapartum hypertension was not associated with poor fetal outcomes, though subgroup analyses showed that women who had at least a single elevated blood pressure reading during the intrapartum experienced poorer fetal outcomes. CONCLUSION: In previously normotensive women, 14% developed intrapartum hypertension during delivery. This was associated with postpartum hypertension, longer maternal admission and discharge with antihypertensive medications. There was no difference in fetal outcomes.

Neural underpinnings of the interplay between actual touch and action imagination in social contexts.

While there is established evidence supporting the involvement of the sense of touch in various actions, the neural underpinnings of touch and action interplay in a social context remain poorly understood. To prospectively investigate this phenomenon and offer further insights, we employed a combination of motor and sensory components by asking participants to imagine exerting force with the index finger while experiencing their own touch, the touch of one another individual, the touch of a surface, and no touch. Based on the assumption that the patterns of activation in the motor system are similar when action is imagined or actually performed, we proceeded to apply a single-pulse transcranial magnetic stimulation over the primary motor cortex (M1) while participants engaged in the act of imagination. Touch experience was associated with higher M1 excitability in the presence and in the absence of force production imagination, but only during force production imagination M1 excitability differed among the types of touch: both biological sources, the self-touch and the touch of one other individual, elicited a significant increase in motor system activity when compared to touching a non-living surface or in the absence of touch. A strong correlation between individual touch avoidance questionnaire values and facilitation in the motor system was present while touching another person, indicating a social aspect for touch in action. The present study unveils the motor system correlates when the sensory/motor components of touch are considered in social contexts.