Pediatric Glasgow Coma Scale Pdf In Vector

Introduction: The Pediatric Glasgow Coma Scale allows clinicians to obtain, track, and communicate the mental status and level of consciousness in preverbal.

Preliminary discoveries of the efficacy of cell therapy are currently being translated to clinical trials. Whereas a significant amount of work has been focused on cell therapy applications for a wide array of diseases, including cardiac disease, bone disease, hepatic disease, and cancer, there continues to be extraordinary anticipation that stem cells will advance the current therapeutic regimen for acute neurological disease. Traumatic brain injury is a devastating event for which current therapies are limited. In this report the authors discuss the current status of using adult stem cells to treat traumatic brain injury, including the basic cell types and potential mechanisms of action, preclinical data, and the initiation of clinical trials. Traumatic brain injury directly affects an estimated 1.5 million Americans annually, although the resultant acute and/or chronic deficits in motor, cognitive, behavioral, and/or social functioning have equally devastating effects on friends, families, and society.

Of the TBIs suffered each year, ~50,000 deaths result, and nearly 100,000 injuries lead to life-long impairment with substantial loss of function. Traumatic brain injury contributes to 50% of all trauma-related deaths.

The national economic impact is difficult to quantify, due to the highly variable nature of the disease, but has been estimated in the tens of billions of dollars annually. Current acute treatment of TBI is limited to controlling intracranial pressure and optimizing cerebral perfusion pressure to prevent further cerebral edema, inflammation, and cell death, while chronic treatment centers on motor, cognitive, and behavioral rehabilitation. Advances in early recognition, acute care, the overall trauma system, and rehabilitation strategies have led to improved survival and, consequently, survivors with significant motor, cognitive, and social impairments. Although the injured brain has shown some limited capacity to recover autonomously, no current therapeutic intervention alters the underlying pathological processes via salvage, support, repair, or replacement at the tissue, cellular, or subcellular level. Background: Stem/Progenitor Cells Adult stem cells are derived from a niche in a developing or developed organism. These cells are considered multi- or pluripotent because they can differentiate into multiple adult cell types.

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Examples of adult stem cells (and their respective niche) that have been used to treat neural diseases include MSCs (bone marrow), NSCs (brain), and UCB/stroma (umbilical cord), a mixture of hematopoietic stem cells and MSCs. Some adult stem cells have been shown to have the ability to differentiate into cell types from multiple germ layers. Jiang and coworkers discovered that adult stem cells from the bone marrow, similar to MSCs, had the ability to differentiate (phenotypically) down all 3 germ cell lines (ecto-, meso-, and endoderm). These cells, termed multipotent adult progenitor cells, were differentiated to phenotypic endothelial, hepatic, and neural cells. Some bone marrow–derived cells have also shown the propensity to develop phenotypic characteristics of neural cell lineage after transplantation in animal models.,, Such transdifferentiation, both in vitro and in vivo, remains highly controversial,,,,, and the general consensus is that transdifferentiation to neural lineages, even if it occurs, is not likely to play a significant role in central nervous system repair/protection.

Mesenchymal stem cells (also termed mesenchymal stromal cells or multipotent mesenchymal stromal cells ) () were first discovered in 1970 when Friedenstein and colleagues found that certain cells from the bone marrow adhered to plastic when cultured. More than 20 years later, the ability of the MSC to proliferate extensively and differentiate down multiple lineages was identified.,, The criteria for defining human MSCs include: 1) adherence to plastic in standard culture conditions; 2) expression of CD105, CD73, and CD90 combined with a lack of expression of CD45, CD34, CD14 or CD11b, CD79 or CD19, and HLA-DR surface molecules; and 3) differentiation to osteoblasts, adipocytes, and chondroblasts in vitro. Although this finding is controversial, MSCs have also been shown to develop neural phenotypes under specific conditions in vitro,, and in vivo., Their beneficial mechanism of action may not be tissue replacement, but rather microenvironment milieu alteration through growth factor production, cell-cell interaction, or inflammatory modulation. Light microscopic image showing MSCs grown in vitro after isolation from bone marrow and several passages.