Day 2 :
Keynote Forum
Esther M Remeta
Chiropractic Research Institute, USA
Keynote: Chiropractic sacro occipital technique (SOT) and cranial treatment model for traumatic brain injury along with monitoring and supplementing for neurotransmitter balance: A case report
Biography:
Esther M Remeta is a practicing Chiropractor and Clinical Researcher. She is currently the Executive Director at Chiropractic Research Institute (CRI) in Clemmons. She completed her Doctor of Chiropractic Degree at National College of Chiropractic in Illinois. She is a SOTO-USA Board Certified Sacro Occipital Technique and Craniopathy Practitioner and a Diplomat with the American Academy of Pain Management.
Abstract:
The purpose of this presentation is to present a novel treatment model incorporating Sanesco Laboratories to evaluate patient neurotransmitter balance and chiropractic cranial care for the treatment of a patient with traumatic brain injury. A 33-year-old female presented for care secondary to an attack affecting blood flow due to strangulation and repeated facial trauma. Her main symptom was chronic debilitating headaches unresponsive to rest, medication, or other interventions. Prior to being seen at this office was under care of neurologist and taking various prescription medications causing extreme side-effects without any headache relief. She has been under care for three-years which consisted of chiropractic sacro occipital technique (SOT) and cranial treatment. Within the past year, laboratory tests were instituted to monitor neurotransmitter balance of the HPA axis and used to help direct nutritional supplementation. The patient was seen once-per-week for chiropractic care and laboratory tests performed annually. Headaches decreased from daily constant chronic to 2-3 times per week with significantly less intensity, allowing her to function in her activities of daily living which was not possible prior to institution of care. When instituting laboratory guided nutritional supplementation focused on balancing neurotransmitters headaches, her function significantly improved. Treatment of brain trauma is a very individualize process and what may help one patient may not help another. However, it is worthy of consideration when a patient is non-responsive to traditional approaches or has an adverse reaction to medications that a chiropractor trained in SOT and cranial care might be considered for collaborative care.
Keynote Forum
Fagogenis Gerasimos
Athens University School of Medicine Postgraduate, Greece
Keynote: Electroencephalogram – Electroencephalogram Interchange [EEG – EEG Interchange] /Thinking Proceedings Transmission
Biography:
Fagogenis Gerasimos has completed his Post-graduation at Athens University and Doctorate in Medicine. He has done his practice in Pediatrics at University Clinics of Evangelismos Hospital, Athens. In the year 1979, he got License for Medical Practice in Pediatrics.
Abstract:
Over preliminary avocation to (virtual) experimentation, upon the feasibility of regional or overall transmission of human brain’s electromagnetic waves, an EEG signal configuration can be used for the transmission of signals to another person’s cerebral cortex, but remotely like a modulated signal of compatible frequency magnitude, without implementation of mediators like microchip, cerebral implants or skull electrodes in open air and any GPS parameter. Emission interaction from brain-to-brain (B-B Interface) is like radio antennas sensors and satellite mediated procedures. Primary schedule runs as: EEG graphic waves properly detected through specific sensitive appliances gathered to be transmitted to other participant’s brain. It follows a detectable phase difference elaboration of those EEG graphic signals because these are compatible with human brain’s electrophysiology. Here, not a PC but cortex is the decoding matter. Effects are impressive and constitute cognitive communication of other’s cerebral function thoughts included resulting in comprehension of them as a copied speech analog on parallel, coinciding technically to the long spoken concept of telepathy, that goes back even to the very early origination of mental constructions’ that is to thought and intangible (sensed) images making. Furthermore, this brain-to-brain transmission comprises not only cognitive but also sensory interpretations. The quality of perception and interaction from person to person coincides with reality in some fields while simultaneously and at any moment intangible sensory and cognitive images noetic forms Gestalt are realized bilaterally: Psychesthetism is the essence in perception and comprehension. Always, speech and interaction simulate open space conversation.
- Brain Disorders | Brain Therapeutics | Neurosurgery
Location: Chambers Suite
Chair
Aguinaldo Pereira Catanoce
Pontifi cia Catholica University of Campinas, Brazil
Session Introduction
Aguinaldo Pereira Catanoce
Pontifi cia Catholica University of Campinas, Brazil
Title: Held important development with the description and improvement of surgical treatment of pituitary tumor through video - endoscopic technique
Biography:
Aguinaldo Pereira Catanoce completed his Graduation and Post-graduation in Medicine and Neurosurgery at Catholic University of Campinas in Brazil in 2007. He is a member of Brazilian Society of Neurosurgery since 2009. He has eight years of experience in “Neurosurgery and video endoscopes for brain tumors at the base of skull and intra-ventricular area in addition to the improvement of microsurgical treatment of vascular lesions”. He is a Neurosurgeon and Professor in Department of Neurosurgery at University of Campinas, Brazil; Manager; Medical and Technical Director at University Hospital, São Paulo, Brazil with seven years of experience in Hospital Management.
Abstract:
This paper reports about the important development with the description and improvement of surgical treatment of pituitary tumor through video-endoscopic technique. This video-endoscopic technique describes the endoscopic fully endonasal transsphenoidal surgery for pituitary tumors. A series of, over 120 cases, of procedures over last seven years, in a particular and University Hospitals in Brazil were included in this study. It described statistics biochemical, clinical and radiologic results with a specific radiologic pre and post- operative image. An angiotopographic bone study for sphenoid sinus details and magnetic brain image is used. In the fully endonasal endoscopic technique, we encountered less morbidity/mortality statistics and more patient satisfaction. The advancements of fully endoscopic endonasal surgery of pituitary adenomas lead to a better endocrinologic clinical and radiologic control, less morbidity.
Androulis Antonios & Derventzi Anastasia
National and Kapodistrian University of Athens, Greece
Title: Osteopontin as indicator of Traumatic Brain Injury severity and progression
Biography:
A Androulis is a qualified Neurosurgeon operating as Complex Spine Fellow at the 2nd Neurosurgical department of Attikon University Hospital and Director of Neurosurgery at IASO General Private Hospital. He is currently pursuing his PhD at National and Kapodistrian University of Athens, Greece. His research work focuses on issues of cerebrospinal surgery and in vitro models for studying neurodegenerative and immunosuppressive neuropathies.
Abstract:
Background: Most patients with heavy traumatic brain injury (TBI) are nursed in ICUs. Clinical trials indicate significant mortality and morbidity in cases with sustained increases in intracranial pressure (ICP). A current way of controlling intracranial pressure in ICU is therapeutic hypothermia. The benefit of hypothermia on functional outcome is unclear. Methods: 26 patients were randomly enrolled in the experimental group and 26 patients in the control group. Patients in the experimental group (n=26) were subjected to therapeutic hypothermia and monitored by 24 hour-recording of temperature and intracranial pressure. In control group (n=26), 24 hours recording of body temperature ​​and intracranial pressure was also performed but without the use of therapeutic hypothermia. Patient recording ranged from 1 to 6 days. Results: There were 1638 hourly measurements of intracranial pressure in the control patient group. ICP exceeded ≥ 15 mmHg in 1192 of these hourly measurements while in remaining 446 values ranged from 8-14 mmHg. In experimental group, 2.208 hourly ICP measurements were performed. ICP values exceeded ≥15 mmHg in 685 and ranged from 5-14 mmHg in 1523 hourly measurements. The effect of therapeutic hypothermia was found significant (F=14.34, p=0.000). Conclusions: Our investigation showed that therapeutic hypothermia can be used as an additional form of treatment of intracranial hypertension although the benefit in secondary injuries when patient intracranial pressure was ≥ 20 mmHg remains unclear. In particular, in patients with ICP>20 mmHg after TBI, therapeutic hypothermia does not improve results than the traditional form of care.
Anatoly B Uzdensky
Southern Federal University, Russia
Title: Involvement of calcium-dependent signaling in the axotomy-induced death of satellite glial cells
Biography:
Anatoly B Uzdensky is a Head of the Laboratory of Molecular Neurobiology at Southern Federal University, Russia. He completed his PhD and Doctor of Science Degree in Physiology and Biophysics in 1980 and 2005, respectively. He is the Author of about 120 journal papers and four books. His current research interests include Neuroscience, Neuro-degeneration and Neuroprotection, Stroke, Cell-signaling and Proteomics.
Abstract:
Neurons and satellite glia mutually support survival of each other, but signaling processes that control their life and death after axotomy (AT) are insufficiently explored. We used a simple model object- axotomized crayfish mechanoreceptor consisting of single sensory neuron surrounded by glial envelope. Control: Undamaged mechanoreceptor that saved connection with abdominal ganglion. Necrosis and apoptosis of glial cells increased at 8 hours after AT when death of neurons was not detected yet. 3-fold increase in [Са2+]o induced glial apoptosis in axotomized but not control samples. Unexpectedly, glial necrosis decreased in 3[Са2+]o, but increased in (1/3)[Са2+]o. Inhibition of endoplasmic reticulum Ca-ATPase (SERCA) by thapsigargin induced glial apoptosis after AT but not in control. Calcium ionophore ionomycin induced glial apoptosis both after AT and in control samples. Fluphenazine, inhibitor of calmodulin did not influence glial apoptosis, but induced glial necrosis. Dantrolene and ochratoxin A that release Ca2+ from endoplasmic reticulum stimulated AT-induced glial apoptosis but not necrosis. The blockage of mitochondrial permeability pores with cyclosporine A, which prevented calcium release from mitochondria, reduced cell death. Thus, AT combination with high [Са2+]o or with activation of pathways increased [Са2+]i induced apoptosis of glial cells. Decrease in [Са2+]o, inhibition of SERCA, calmodulin, or Ca2+ ionophore promoted glial necrosis. Blockage of mitochondrial permeability pores protected glia from axotomy-induced death. So, axotomy induces necrosis and apoptosis of satellite glial cells and Ca2+ is involved in the detrimental effect of AT.
Wei-Chun HSU
National Taiwan University of Science & Technology, Taiwan
Title: Comparison of Temporal-Spatial Gait Variabels and Joint Kinematics Between Stepping Exercise and Walking Pattern in Patients with Stroke – a Pilot Study
Biography:
Wei-Chun Hsu received the B.S. degree in physical therapy in 1998, and the M.S. degree in Mechanical Engineering from National Paris XII University, France, in 2000, and the Ph.D. degree in biomechanical engineering in 2009 from the National Taiwan University. After several years working as physical therapist in Shin-Kong hospital and one year working as post-doctoral Research Fellow at National Taiwan University, she joined National Taiwan University of Science and Technology where she is now Associate Professor at Graduate Institute of Biomedical Engineering. Her research interests include motion analysis, rehabilitation engineering, sports science, motor control and learning, and biomechanics.
Abstract:
Recumbent seated stepper exercise is becoming popular for the lower extremity rehabilitation as it is than upright cycling and treadmill walking and thus is an ideal exercise option. Two patients with stroke were invited to participate in the experiments. Passive markers were placed on the pelvis and lower limbs while ultra-high resolution infrared cameras (Qualisys, 700+, Sweden) were used to perform motion capturing when stepping and walking. In comparisons with stepping and walking, the stepping task had shorter pushing phase compared with the corresponding weight-bearing stance phase of walking. Hip angle kept flexed throughout the stepping phase which was very different from those during level walking. The pattern of knee angular displacement during pushing phase were not similar to those during stance phase of level walking; while the peak flexion pattern found during returning phase was similar the necessity of a prominent peak found during swing phase of the walking condition. Although the swing phase of walking and returning phase of stepping were fundamentally different due to the weight bearing condition, non-weight bearing for the walking and partial weight bearing for the steeping tasks, this peak might be helpful to transfer the ability of flexion movement of the knee joint during training to a sufficient foot clearance during swing phase of level walking. Ankle angle had an opposite direction of movement during these two motions. As a whole, the patterns of stepping and level walking were different except the swing/retuning phase of walking/stepping.
Dimitris E. Papageorgiou
General Hospital of Athens “G. Gennimatasâ€, Greece
Title: Hypothermia for intracranial hypertension after traumatic brain injury: A randomized clinical study
Biography:
Dimitris E. Papageorgiou is a lecturer in the Department οf Nursing B' of the Faculty of Health and Caring Professions of Athens. He graduated from the Department of Nursing B’ of the Technological Educational Institution of Athens as well as from the Department of Nursing of the University of Athens. He holds a Master’s degree in Nursing from the University of Cardiff and a doctorate diploma from the Faculty of Medicine of the University of Ioannina. He has worked as a visiting lecturer in the Faculty of Nursing of the University of Peloponnese and of the Technological Educational Institution of Larissa. He is member of the editorial Board of Nursing Journal.
Abstract:
Background: Most patients with heavy traumatic brain injury (TBI) are nursed in ICUs. Clinical trials indicate significant mortality and morbidity in cases with sustained increases in intracranial pressure (ICP). A current way of controlling intracranial pressure in ICU is therapeutic hypothermia. The benefit of hypothermia on functional outcome is unclear.
Methods: 26 patients were randomly enrolled in the experimental group and 26 patients in the control group. Patients in the experimental group (n=26) were subjected to therapeutic hypothermia and monitored by 24 hour-recording of temperature and intracranial pressure. In control group (n=26), 24 hours recording of body temperature ​​and intracranial pressure was also performed but without the use of therapeutic hypothermia. Patient recording ranged from 1 to 6 days.
Results: There were 1638 hourly measurements of intracranial pressure in the control patient group. ICP exceeded ≥ 15 mmHg in 1192 of these hourly measurements while in remaining 446 values ranged from 8-14 mmHg. In experimental group, 2.208 hourly ICP measurements were performed. ICP values exceeded ≥15 mmHg in 685 and ranged from 5-14 mmHg in 1523 hourly measurements. The effect of therapeutic hypothermia was found significant (F=14.34, p=0.000).
Conclusions: Our investigation showed that therapeutic hypothermia can be used as an additional form of treatment of intracranial hypertension although the benefit in secondary injuries when patient intracranial pressure was ≥ 20 mmHg remains unclear. In particular, in patients with ICP>20 mmHg after TBI, therapeutic hypothermia does not improve results than the traditional form of care.
Biography:
Abbas Alnaji completed his Degree in Neurosurgery FICMS NS from University of Baghdad 1999. He is interested in research work and have twelve papers published in the field of Surgical Pathology Causations.
Abstract:
Introduction: Neurosurgeons often faces many complications after head injuries, one of these complications is '' low grade meningitis'' which of normal and sterile CSF and does not responds to empirical antibiotic treatment ( e.g. combinations of betalactams ).
Aim: To reveal the nature and show the incidence of a hiding pre-traumatic pathologic agent that causes many post traumatic events one of them is our subject here the " Low grade meningitis".
Method and patients: Over 20 years of my career I found near to one third of head injured patients of all ages and both genders who recovered from any trauma severity at least in Iraq and two other Arabian countries show features of low grade meningitis either they show it as they regain consciousness or very short period of 2-3 days after head injury with or without history of loss of consciousness. Features are very variable could be all, or some of them available, and could be rising with time or stationary; Head ache, photophobia, irritability in pediatric age group, anorexia, intermittent low grade fever, periodic malaise, meningism, Babinski, kernig's sign and brudzinski's sign and reflex (or simply neck stiffness), CT scan is negative for SAH, CSF nearly normal , CSF C/S is sterile for bacteria and AFB (Tb), culture is difficult for Brucella around us . CSF sample is negative for TB in PCR not done for Brucella due not available in general hospital and expensive in private sector . As a traditional work in or centers in Iraq and some of Arabic countries I work in the patient is either already on wide a spectrum betalactam antibiotics as a prophylaxis ( amoxicillin and cefitrioxone of different doses) or he put on them when developed such a picture. Results: patients do not respond to such regimen for long time even when amoxicillin is replaced by vancomycin. While very good and dramatic response when patients are given Doxycyclin and cotrimoxazole when above six years and cotrimoxazole alone or Azothromycin plus cefixime in usual doses below six years.
Discussion: This interpretation was born from two facts; First, as I am originally interested in the biological bases for the surgical pathologies which gave me a good visions to many events as long as I proceed in this prospect. The Second, intermittent or undulant low grade fever if present !! relative good general health of the patient in presence of the above mentioned clinical picture generally give a clue to presence of a pre-traumatic opportunistic hiding infection, or it might be presented differently, but the community consider it either with normal limit, or an unexplained ill health triggered by simple exertion or by some other usual daily events ( in third world this is seen as low weight or any other feature like poor appetite before the trauma). For that the possible causative agent in this regard is chronic Brucellosis. We lack the PCR kits to prove it in public hospitals, serology is not dependable and it is negative in most of these patients who recovered dramatically. Other possible pathogens whom I enlisted need to be proved and discriminated from Brucella, but due to our severe shortage in modern lab aids we could not do so.
Conclusion: If this very successful trial treatment and concept is true !!! We need to re-direct our principles and efforts not to treat post traumatic meningitis successfully only, rather we to have look on the incidence of hidden pathologies which might be the same all over the world which forms an underestimated national hazards. HOW or why national hazards ?? because the one third of my patients over very long time ( 20 years ; 5 years as a resident and 15 as specialist) is a considerable number in any community general health considerations.
Recommendations: For me, I seek from interested organizations the aid to proceed with detection of the real causative agents with PCR and other modern lab techniques. Generally I depend on my personal resources which are not much, also on the patients when seeking my medical services in private sector which also is not much in a country suffers from crises for decades especially the present war on ISIS like Iraq. And I hope this mode of analysis and treatment is applied elsewhere if such complication is found, with knowledge sharing