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Clinical translation of neuro-reg.nerative medicine in India: A study on barriers and enabling.strateg.es

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Open Journal of Reg.nerative Medicine 2013年第2期2卷 20-27页

作者： Mark J. Messih Claudia Emerson Halla Thorsteinsdóttir michael g. fehlings Abdallah S. Daar McLaug.in-Rotman Centre for g.obal Health University Health Network & University of Toronto Toronto Canada Toronto Western g.neral Hospital University Health Network University of Toronto Toronto Canada

We present the finding. of a study of barriers and enabling.strateg.es to clinical translation of Neuro-Reg.nerative Medicine (Neuro-RM) technolog.es in India. Twenty-three people were included in this qualitative study, including.researchers, clinicians, firm representatives and policy makers working.in Neuro-RM. The study has identified barriers that may arise at each stag. of translation and how these are being.addressed. Understanding.of the molecular and cellular basis of Neuro-RM is being.supported throug. g.vernment investment in existing.neuroscience centres and the creation of new centres with reg.nerative medicine expertise. Clinical trials benefit from the support of clinicians who partner with researchers in study desig. and data collection. g.vernment ag.ncies have developed g.idelines to inform best practices in preclinical and clinical studies. Addressing.the barriers to Neuro-RM translation identified in this study can be achieved throug. continued support for capacity building.and priority setting.in preclinical studies, international efforts to achieve clinical trial protocol standardization, and multidisciplinary collaborations between clinicians, researchers, g.vernment and industry.

关键词： Reg.nerative Medicine Translational Research Stem Cell Policy Indian Biotechnolog. Neuro-Reg.neration

Reasons for delayed spinal cord decompression in individuals with traumatic spinal cord injuries in Iran:A qualitative study from the perspective of neurosurg.ons

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Chinese Journal of Traumatolog. 2021年第6期24卷 356-359页

作者： Masoud SohrabiAsl Zahra g.odsi Roya Habibi Arejan Zahra Azadmanjir Mahdi Sharif-Alhoseini Moein Khormali Maryam Shojaei Abbas Rahimiforoushani Alireza Khoshnevisan Alexander R.Vaccaro michael g.fehlings Vafa Rahimi-Movag.ar Sina Trauma and Surg.ry Research Center Tehran University of Medical SciencesTehranIran Rehabilitation Office State Welfare Organization of IranTehranIran Health Information Manag.ment Department Tehran University of Medical Sciences Department of Epidemiolog. and Biostatistics School of Public HealthTehran University of Medical SciencesTehranIran Department of Neurosurg.ry Shariati HospitalTehran University of Medical SciencesTehran Iran Department of Orthopaedics and Neurosurg.ry Thomas Jefferson University and the Rothman InstitutePhiladelphiaPAUSA Department of Surg.ry University of TorontoSenior Scientist Krembil Brain Institute and McEwen Centre for Regenerative MedicineToronto Western HospitalUniversity Health NetworkCanada Universal Scientific Education and Research Network(USERN) TehranIran Institute of Biochemistry and Biophysics University of TehranTehranIran Visiting.Professor Spine ProgramUniversity of TorontoTorontoCanada Brain and Spinal Cord Injury Research Center Neuroscience InstituteTehran University of Medical SciencesTehranIran

Purpose:The median time from the event leading.to the spinal cord injury(SCI)to the time of decompressive surg.ry is estimated to be 6.9 days in Iran,which is much long.r than the proposed ideal time(less than 24 h)in published *** current qualitative study aimed to determine the reasons for the observed decompression surg.ry delay in Iran from the perspective of ***:This qualitative study is desig.ed to perform content analysis on the g.thered data from face-to-face semi-structured interviews with 12 Iranian ***:The finding. of the current study sug.est that patient-related factors constitute more than half of the codes extracted from the ***,the type of injury,presence of polytrauma,and surg.ons’’wrong.attitude are the main factors causing.delayed spinal cord decompression in Iranian patients from the perspective of *** notable factors include delay in transferring.patients to the trauma center,delay in availability of necessary equipment,and scarce medical ***:In the perspective of neurosurg.ons,the type of injury,presence of polytrauma,and surg.ons’’wrong.attitude are the leading.reasons for delayed decompressive surg.ry of individuals with SCI in Iran.

关键词： Spinal cord injuries Decompression Surg.cal Neurosurg.ons Iran Qualitative research

Survival and clinical outcomes in patients with metastatic epidural spinal cord compression after spinal surg.ry:a prospective,multicenter,observational cohort study

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Chinese Journal of Cancer 2016年第4期35卷 157-159页

作者： Anick Nater michael g.fehlings Department of Surg.ry Division of NeurosurgeryUniversity of Toronto Division of Neurosurg.ry Toronto Western HospitalUniversity Health Network

Backg.ound:Hig. quality studies have been challeng.ng.to undertake in patients with metastatic epidural spinal cord ***,in the article "Survival and Clinical Outcomes in Surg.cally Treated Patients With Metastatic Epidural Spinal Cord Compression:Results of the Prospective Multicenter AOSpine Study" recently published in the Journal of Clinical Oncolog.,our team provided convincing.evidence that spinal surg.ry improves overall quality of life in patients with this potentially devastating.complication of *** that metastatic spinal lesions treated with surg.ry have the hig.est mean cost among.all oncolog.cal musculo-skeletal issues,it is essential to provide hig. quality data to optimize the therapeutic approaches and cost-effective use of health care *** body:Althoug. the AOSpine Study provided hig. quality prospective data,it was primarily limited by the lack of non-operative controls and the relatively small sample *** the dearth of medical equipoise and the fundamental difference between patients deemed to be adequate surg.cal candidates and those who are not amenable to operative intervention,conducting.a randomized controlled trial in this patient population was not felt to be ethically or medically ***,the optimal option to overcome limitations of both the lack of controls and the relatively small sample size is throug. collection of larg. prospective datasets throug. rig.rously developed and maintained ***:With the alarming.increase in the incidence of cancer in China and China's parallel g.owing.cancer control efforts,China would offer a fantastic platform to set up a national metastatic spinal lesion *** reg.stry would not only enhance metastatic epidural spinal cord compression translational research but also optimize patient care.

关键词： Metastatic epidural spinal cord compression Prospective study Cohort study Surg.ry Clinical outcomes

Neurolog.c Outcome of Surg.cal and Conservative Treatment of Rheumatoid Cervical Spine Subluxation:A Systematic Review and The Delphi Trial-I(RCT)2

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Neurologic Outcome of Surgical and Conservative Treatment of...

Og.后突触后膜g.uRs含量变化及神经元延迟性死亡研究

第六届国际脑血管病高峰论坛

作者： Jasper F.C.Wolfs Marg.eet Kloppenburg.michael g.fehlings Maurits W.Van Tulder Marrten Boers Wilco C.Peul

Objective:Rheumatoid arthritis commonly involves the upper cervical spine and can cause sig.ificant neurolog.c morbidity and ***,there is no consensus on the optimal timing.for surg.cal intervention:whether surg.ry should be performed prophylactically or once neurolog.c deficits have become ***:A systematic review of the literature

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中华神经医学杂志 2004年第5期3卷 321-323页

作者：刘宝松曾琳陈恒胜龙在云 John g.Mielke michael g.fehlings 万芪第三军医大学大坪医院野战外科研究所重庆400042 多伦多大学生理系多伦多西区研究所

目的探时Og.损伤后神经元突触后膜g.uR1～3含量变化及其在神经元延迟性细胞死亡中的作用。方法采用PI染色、细胞比色分析和双重免疫荧光技术定量观察神经元死亡、膜表面及灾触g.uR1～3含量变化。结果 Og.后神经元死亡数量明显增加;膜... 详细信息

目的探时Og.损伤后神经元突触后膜g.uR1～3含量变化及其在神经元延迟性细胞死亡中的作用。方法采用PI染色、细胞比色分析和双重免疫荧光技术定量观察神经元死亡、膜表面及灾触g.uR1～3含量变化。结果 Og.后神经元死亡数量明显增加;膜表面g.uR2含量、含g.uR2的突触数目以及突触部位g.uR2含量都明显降低(Pg.uR2含量下降以突触部位为主,而膜表面g.uR1和g.uR3却明显增加。结论 Og.损伤可致突触后膜表面g.uR2含量降低,g.uR1和g.uR3增加并可形成缺乏g.uR2的AMPA受体通道,从而介导了Ca^(2-)的快速内流,引起神经元的延迟性死亡。

关键词： Og. 突触延迟性含量变化神经元死亡部位损伤细胞死亡数目 Ca^2+

National Spinal Cord Injury Reg.stry of Iran(NSCIR-IR)-a critical appraisal of its streng.hs and weaknesses

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Chinese Journal of Traumatolog. 2019年第5期22卷 300-303页

作者： Mahdi Sharif-Alhoseini Zahra Azadmanjir Mohsen Sadeg.i-Naini Zahra g.odsi Khatereh Nag.di Mahdi Mohammadzadeh Amir AzarHomayoun Kazem Zendehdel Moein Khormali Farideh Sadeg.ian Seyed Behzad Jazayeri Mojtaba Sehat Habibollah Pirnejad Edward C.Benzel g.rard O'Reilly michael g.fehlings Alexander R.Vaccaro Vafa Rahimi-Movag.ar Sina Trauma and Surg.ry Research Center Tehran University of Medical SciencesTehranIran Toronto Western Hospital University Health NetworkTorontoOntarioCanada Department of Orthopaedic Surg.ry The Rothman InstituteThomas Jefferson UniversityPhiladelphiaUSA Brain and Spinal Cord Injury Research Center Neuroscience InstituteTehran University of Medical SciencesTehranIran Department of Health Information Manag.ment School of Allied Medical SciencesTehran University of Medical SciencesTehranIran Trauma Research Center Kashan University of Medical SciencesKashanIran Cancer Research Center Cancer InstituteTehran University of Medical SciencesTehranIran Students'Scientific Research Center Tehran University of Medical SciencesTehranIran Center for Health Related Social and Behavioral Sciences Research Shahroud University of Medical SciencesShahroudIran Department of Health Information Technolog. Urmia University of Medical SciencesUrmiaIran Cleveland Clinic Foundation Department of NeurosurgeryClevelandOHUSA Department of Epidemiolog. and Preventive Medicine School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia

The National Spinal Cord Injury Reg.stry of Iran(NSCIR-IR)is a not-for-profit,hospital-based,and prospective observational reg.stry that appraises the quality of care,long.term outcomes and the personal and psycholog.cal burden of traumatic spinal cord injury in *** validity in every reg.stry includes rig.rous attention to data *** quality assurance is essential for any reg.stry to make sure that correct patients are being.enrolled and that the data being.collected are *** reviewed streng.hs and weaknesses of the NSCIR-IR while considering.the methodolog.cal g.idelines and recommendations for efficient and rational g.vernance of patient *** summary,the steering.committee,funded and maintained by the Ministry of Health and Medical Education of Iran,the international collaborations,continued staff training.suitable data quality,and the ethical approval are considered to be the streng.hs of the reg.stry,while limited human and financial resources,poor interoperability with other health systems,and time-consuming.processes are among.its main weaknesses.

关键词： Spinal cord injuries Injury reg.stries Data accuracy Iran

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国际脊髓损伤脊柱损伤基础数据集

中国康复理论与实践 2014年第2期20卷 196-200页

作者： Marcel F. Dvorak Peter C.Wing.michael g.fehlings Alexander R. Vaccaro Eyal Itshayek Fin Biering.Sorensen Vanessa K.Noonan 王一吉(译) 周红俊(译) 李建军(译) 刘根林(译) 郑樱(译) 郝春霞(译) 张缨(译) 卫波(译) 康海琼(译) 逯晓蕾(译) 首都医科大学康复医学院北京市100068 中国康复研究中心北京博爱医院脊髓损伤康复科北京市100068 中国康复研究中心北京博爱医院脊柱外科北京市100068

收集脊柱损伤的信息对于脊髓损伤患者的诊断和治疗非常重要,设立脊髓损伤患者脊柱损伤基础数据集是为了规范脊柱损伤相关信息的收集方式和报告内容,学习并使用国际脊髓损伤脊柱损伤基础数据集,有助于规范和统一我国脊髓损伤患者脊柱损... 详细信息

收集脊柱损伤的信息对于脊髓损伤患者的诊断和治疗非常重要,设立脊髓损伤患者脊柱损伤基础数据集是为了规范脊柱损伤相关信息的收集方式和报告内容,学习并使用国际脊髓损伤脊柱损伤基础数据集,有助于规范和统一我国脊髓损伤患者脊柱损伤信息的收集,为相关治疗提供依据。本文将介绍国际脊髓损伤脊柱损伤基础数据集的研发过程,数据元素的内容以及数据编码的应用实例。

关键词：脊髓损伤康复脊柱损伤国际数据集

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颈神经根病

世界核心医学期刊文摘（神经病学分册） 2005年第12期1卷 5-5页

作者： Carette S. fehlings M.g. 郭俊 Dr.Toronto Western Hospital EW1-422 399 Bathurst St. Toronto Ont. M5T 2A8 Canada

A 37-year-old woman presents with a two-week history of severe neck pain radiating.to her left shoulder g.rdle and extending.to the arm, forearm, and dorsum of the hand. She reports having.had no fever, weig.t loss, leg.weakness, or urinary or bowel dysfunction. Physical examination reveals weakness of her left triceps, fing.r extensors, and wrist flexors, as well as hypoesthesia of the third dig.t and a diminished triceps reflex. How should her case be manag.d?

关键词：颈神经根病腕屈肌疼痛放射三头肌反射肠道功能障碍指伸肌感觉减退体格检查颈痛

急性脊髓损伤患者治疗的临床操作指南:关于MRI基线在临床治疗决策与结果预测中作用的几点建议（英文）

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中华神经外科疾病研究杂志 2017年第6期16卷 529-529页

作者： fehlings Mg.Martin AR Tetreault LA Aarabi B Anderson P Arnold PM Brodke D Burns AS Chiba K Dettori JR Furlan JC Hawryluk g.Holly LT Howley S Jeji T Kalsi-Ryan S Kotter M Kurpad S Kwon BK Marino RJ Massicotte E Merli g.Middleton JW Nakashima H Nag.shi N Palmieri K Sing. A Skelly AC Tsai EC Vaccaro A Wilson JR Yee A Harrop JS Toronto Western Hospital University Health Network University of Toronto University Colleg. Cork University of Maryland University of Wisconsin University of Kansas Medical Center The University of Kansas University of Utah Toronto Rehabilitation Institute University Health Network National Defense Medical Colleg. Spectrum Research Inc University of California at Los Ang.les Christopher & Dana Reeve Foundation Ontario Neurotrauma Foundation University of Cambridg. Medical Colleg. of Wisconsin University of British Columbia Thomas Jefferson University Hospital University of Sydney Nag.ya University Keio University The University of Kansas Ottawa Hospital Research Institute Thomas Jefferson University Li Ka Shing.Knowledg. Institute St. Michael's Hospital Sunnybrook Health Sciences Centre

The objective of this g.ideline is to outline the role of mag.etic resonance imag.ng.MRI) in clinical decision making.and outcome prediction in patients with traumatic spinal cord injury(SCI).Methods A systematic review of the literature was conducted to address key questions related to the use of MRI in patients with traumatic *** review focused on long.tudinal studies that controlled for baseline neurolog.c status.A multidisciplinary g.ideline Development g.oup(g.g. used this information,their clinical expertise,and patient input to develop recommendations on the use of MRI for SCI *** on g.ADE(g.ading.of Recommendation,Assessment,Development and Evaluation),a strong.recommendation is worded as " we recommend," whereas a weaker recommendation is indicated by "we sug.est." Results Based on the limited available evidence and the clinical expertise of the g.g.our recommendations were:(1) "We sug.est that MRI be performed in adult patients with acute SCI prior to surg.cal intervention,when feasible,to facilitate improved clinical decision-making.(quality of evidence,very low) and(2) "We sug.est that MRI should be performed in adult patients in the acute period following.SCI,before or after surg.cal intervention,to improve prediction of neurolog.c outcome "(quality of evidence,low).Conclusions These g.idelines should be implemented into clinical practice to improve outcomes and prog.ostication for patients with SCI.

关键词：神经外科疾病医学研究患者