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Neural Regeneration Research 2017年第5期12卷 677-686页

作者： Christopher J.andrews andrew d.reisner Faculty of Medicine-The University of Queensland HerstonAustraliaLightning and Electrical InjuriesMt Ommaney Family PracticeMt OmmaneyBrisbaneAustralia Forensic diagnostic Center of district Nine CambridgeOHUSA

Injuries from lightning and electrical injuries involve multiple systems of the body, however neurological symptoms are very widely reported. A disabling neuropsychological syndrome is also noted. This paper presents a comprehensive review of neurological and neuropsychological symptoms. Partial theories of causation for these injuries have been advanced, however, there is no convincing explanation for both delay in onset of symptoms and also the genesis of the neuropsychological syndrome. A theory of causation is proposed which satisfies both these constraints. This theory suggests circulating hormones such as cortisol, together with nitric oxide and oxidant free radicals from glutamatergic hyper-stimulation, act on tissues remote from the injury path including the hippocampus. This theory opens a research path to explore treatment options.

关键词： electrical injury lightning injury neurology neuropsychology neuropsychiatry injury trauma

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Post electrical or lightning injury syndrome: a proposal for an American Psychiatric Association's diagnostic and Statistical Manual formulation with implications for treatment

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Neural Regeneration Research 2017年第9期12卷 1405-1412页

作者： Christopher J.andrews andrew d.reisner Mary Ann Cooper Medicine The University of Queensland Lightning and Electrical Injuries Mt Ommaney Family Practice Forensic diagnostic Center of district Nine Lightning Injury Research Program University of Illinois at Chicago African Centres for Lightning and Electromagnetics Network

In the past, victims of electrical and lightning injuries have been assessed in a manner lacking a system- atic formulation, and against ad hoc criteria, particularly in the area of neuropsychological disability. In this manner patients have, for example, only been partially treated, been poorly or incorrectly diagnosed, and have been denied the full benefit of compensation for their injuries. This paper contains a proposal for diagnostic criteria particularly for the neuropsychological aspects of the post injury syndrome. It pays attention to widely published consistent descriptions of the syndrome, and a new cluster analysis of post electrical injury patients. It formulates a proposal which could be incorporated into future editions of the American Psychiatric Association＇s diagnostic and Statistical Manual （dSM）. The major neuropsycholog- ical consequences include neurocognitive dysfunction, and memory subgroup dysfunction, with ongoing consequences, and sometimes including progressive or delayed psychiatric, cognitive, and/or neurological symptoms. The proposed diagnostic criteria insist on a demonstrated context for the injury, both specifying the shock circumstance, and also physical consequences. It allows for a certain delay in onset of symptoms. It recognizes exclusory conditions. The outcome is a proposal for a dSM classification for the post electrical or lightning injury syndrome. This proposal is considered important for grounding patient treatment, and for further treatment trials. Options for treatment in electrical or lightning injury are summarised, and future trials are foreshadowed.

关键词： electrical injury lightning injury neuropsychology neuropsychiatry injury American Psychiatric Association's diagnostic and Statistical Manual

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delayed neural damage induced by lightning and electrical injury: neural death, vascular necrosis and demyelination?

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Neural Regeneration Research 2014年第9期9卷 907-908页

作者： andrew d. reisner Forensic diagnostic Center of district Nine

The structural damage to vascular endothelial cell In a recent article in the journal Brain Injury, four potential hypotheses for delayed neurological disorders following lightning and electrical injury were suggested （reisner, 2013）. The phenomenon of delayed neurodegenerative syndromes following lighting and electrical injury has been known since the early 1930s （Critchley, 1934）, but to the present day, the mechanisms involved have been poorly un- derstood. An initial and still plausible theory is that the electrical insult causes damage to the vascular structures feeding the spinal cord via damage to vascular endothelial cells （Farrell and Starr, 1968）.

关键词： neural death delayed neural damage induced by lightning and electrical injury

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急诊室CT:医生制定决策改变的实时研究

国际医学放射学杂志 2016年第3期 304-304页

作者： P.V.Pandharipande A.T.reisner W.d.Binder A.Zaheer M.L.Gunn K.F.Linnau 李志鹏 department of Radiology Institute for Technology AssessmentMassachusetts General Hospital

摘要目的明确急诊室CT如何影响医生的诊断、诊断的不确定性以及收治决策。材料与方法本研究由伦理委员会批准,并符合HIPAA。数据收集时间为2012年7月12日—2014年1月13日,未征求病人的同意。在这项4个中心的前瞻性研究中,病人以腹痛、... 详细信息

摘要目的明确急诊室CT如何影响医生的诊断、诊断的不确定性以及收治决策。材料与方法本研究由伦理委员会批准,并符合HIPAA。数据收集时间为2012年7月12日—2014年1月13日,未征求病人的同意。在这项4个中心的前瞻性研究中,病人以腹痛、胸痛和/或呼吸困难、或头痛到急诊部就诊,并接受CT检查。分别于CT检查前后调查医生的主要诊断、诊断的信心(范围:0～100%)、可能的排除

关键词：急诊室呼吸困难胸痛主要诊断疼痛科学管理决策 CT