Publications – dr robert dickinson anoxic brain injury stories

Baroness finlay of llandaff I, myers I, dickinson R,

Bennetto L, clarke S, eilersten-feeney K, griffiths L, harrison P, humber A, jackson G, lewis T, mayho B, miller S, sykes O, veiraiah A, walker E, wareing H, white S et al., 2017, carbon monoxide poisoning: saving lives, advancing treatment, carbon monoxide poisoning: saving lives, advancing treatment, london, publisher: all party parliamentary group on carbon monoxide

Carbon monoxide (CO) poisoning is a serious public health issue. In england and wales alone, every year some 4,000 attendances to emergency departments (eds) are the result of accidental CO poisoning.


Statistics show that CO kills more than 30 people a year and leads to around 200 hospital admissions, but these figures are likely to be a gross underestimate.Anoxic brain injury stories consequently, treating accidental CO poisoning may actually be costing much more than the estimated £178 million per annum.Healthcare professionals have a vital role to play in preventing, diagnosing and treating patients exposed to CO. However, these professionals face a number of barriers to action: gaps in knowledge, limited awareness, and a lack of co-ordination within and between the healthcare sectors. These barriers need to be removed if we are to reduce significantly the number of accidental deaths and unnecessary injuries caused by CO poisoning, and to improve patient management and recovery.This report has been prepared by members of comed, the healthcare professionals’ sub-group of the APPCOG stakeholder forum.Anoxic brain injury stories it presents a number of hard-hitting essays that review current knowledge and practice on the diagnosis and management of CO poisoning in the healthcare system. It identifies gaps in knowledge and practice, and makes recommendations to close those gaps so that diagnosis, patient management and recovery can be improved.The findings presented in this report led members of the sub-group to conclude that:A lack of awareness amongst healthcare professionals of CO poisoning as a cause of illness is very likely to be impacting adversely on public health outcomes. much remains to be discovered and explained about the link between low level chronic CO exposure and long-term effects on an individual’s health – for example, its impact on diseases of the cardiovascular and neurological system and whether CO is a casual factor of disease or involved in disease processes not previously

anoxic brain injury stories

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Campos-pires R, koziakova M, yonis A,

Pau A, macdonald W, harris K, edge C, franks NP, mahoney P, dickinson R et al., 2017, xenon protects against blast-induced traumatic brain injury in an in vitro model., J neurotrauma

The aim of this study was to evaluate the neuroprotective efficacy of the inert gas xenon as a treatment for blast-induced traumatic brain injury in an in vitro laboratory model. We developed a novel blast traumatic brain injury model using C57BL/6N mouse organotypic hippocampal brain-slice cultures exposed to a single shockwave, with the resulting injury quantified using propidium iodide fluorescence. A shock tube blast generator was used to simulate open field explosive blast shockwaves, modeled by the friedlander waveform.Anoxic brain injury stories exposure to blast shockwave resulted in significant (p0.01) injury that increased with peak-overpressure and impulse of the shockwave, and which exhibited a secondary injury development up to 72 hours after trauma. Blast-induced propidium iodide fluorescence overlapped with cleaved caspase 3 immunofluorescence, indicating that shockwave-induced cell death involves apoptosis. Xenon (50% atm) applied 1 hour following blast exposure reduced injury 24 hours (p0.01), 48 hours (p0.05) and 72 hours (p0.001) later, compared to untreated control injury. Xenon-treated injured slices were not significantly different to uninjured sham slices at 24 hours and 72 hours. We demonstrate for the first time that xenon-treatment after blast traumatic brain injury reduces initial injury and prevents subsequent injury development in vitro.Anoxic brain injury stories our findings support the idea that xenon may be a potential first-line treatment for blast-induced traumatic brain injury.

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Campos-pires R, dickinson R, 2016, modelling blast brain injury, blast injury science and engineering A guide for clinicians and researchers, editors: clasper, bull, mahoney, publisher: springer, pages: 173-182, ISBN: 9783319218670

The consequences of blast traumatic brain injury (blast-TBI) in humans are largely determined by the characteristics of the trauma insult and, within certain limits, the individual responses to the lesions inflicted (1). In blast-TBI the mechanisms of brain vulnerability to the detonation of an explosive device are not entirely understood.Anoxic brain injury stories they most likely result from a combination of the different physical aspects of the blast phenomenon, specifically extreme pressure oscillations (blast-overpressure wave), projectile penetrating fragments and acceleration-deceleration forces, creating a spectrum of brain injury that ranges from mild to severe blast-TBI (2). The pathophysiology of penetrating and inertially-driven blast-TBI has been extensively investigated for many years. However, the brain damage caused by blast-overpressure is much less understood and is unique to this type of TBI (3). Indeed, there continues to be debate about how the pressure wave is transmitted and reflected through the brain and how it causes cellular damage (4).Anoxic brain injury stories no single model can mimic the clinical and mechanical complexity resulting from a real life blast-TBI (3). The different models, non-biological (in silico or surrogate physical) and biological (ex vivo, in vitro or in vivo), tend to complement each other.

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