7 results on '"Aminul Ahmed"'
Search Results
2. IL-1β and HMGB1 are anti-neurogenic to endogenous neural stem cells in the sclerotic epileptic human hippocampus
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Malik Zaben, Niels Haan, Feras Sharouf, Aminul Ahmed, Lars E. Sundstrom, and William P. Gray
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Neurogenesis ,Epilepsy ,Neuroinflammation ,IL-1β and HMGB1 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Background The dentate gyrus exhibits life-long neurogenesis of granule-cell neurons, supporting hippocampal dependent learning and memory. Both temporal lobe epilepsy patients and animal models frequently have hippocampal-dependent learning and memory difficulties and show evidence of reduced neurogenesis. Animal and human temporal lobe epilepsy studies have also shown strong innate immune system activation, which in animal models reduces hippocampal neurogenesis. We sought to determine if and how neuroinflammation signals reduced neurogenesis in the epileptic human hippocampus and its potential reversibility. Methods We isolated endogenous neural stem cells from surgically resected hippocampal tissue in 15 patients with unilateral hippocampal sclerosis. We examined resultant neurogenesis after growing them either as neurospheres in an ideal environment, in 3D cultures which preserved the inflammatory microenvironment and/or in 2D cultures which mimicked it. Results 3D human hippocampal cultures largely replicated the cellular composition and inflammatory environment of the epileptic hippocampus. The microenvironment of sclerotic human epileptic hippocampal tissue is strongly anti-neurogenic, with sustained release of the proinflammatory proteins HMGB1 and IL-1β. IL-1β and HMGB1 significantly reduce human hippocampal neurogenesis and blockade of their IL-1R and TLR 2/4 receptors by IL1Ra and Box-A respectively, significantly restores neurogenesis in 2D and 3D culture. Conclusion Our results demonstrate a HMGB1 and IL-1β-mediated environmental anti-neurogenic effect in human TLE, identifying both the IL-1R and TLR 2/4 receptors as potential drug targets for restoring human hippocampal neurogenesis in temporal lobe epilepsy.
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- 2021
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3. A primate-specific short GluN2A-NMDA receptor isoform is expressed in the human brain
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Hannah Warming, Chrysia-Maria Pegasiou, Aleksandra P. Pitera, Hanna Kariis, Steven D. Houghton, Ksenia Kurbatskaya, Aminul Ahmed, Paul Grundy, Girish Vajramani, Diederik Bulters, Xavier Altafaj, Katrin Deinhardt, and Mariana Vargas-Caballero
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NMDA receptor ,Synapses ,Human ,Primate ,Resected ,Neurosurgery ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Abstract Glutamate receptors of the N-methyl-D-aspartate (NMDA) family are coincident detectors of pre- and postsynaptic activity, allowing Ca2+ influx into neurons. These properties are central to neurological disease mechanisms and are proposed to be the basis of associative learning and memory. In addition to the well-characterised canonical GluN2A NMDAR isoform, large-scale open reading frames in human tissues had suggested the expression of a primate-specific short GluN2A isoform referred to as GluN2A-S. Here, we confirm the expression of both GluN2A transcripts in human and primate but not rodent brain tissue, and show that they are translated to two corresponding GluN2A proteins present in human brain. Furthermore, we demonstrate that recombinant GluN2A-S co-assembles with the obligatory NMDAR subunit GluN1 to form functional NMDA receptors. These findings suggest a more complex NMDAR repertoire in human brain than previously thought.
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- 2019
- Full Text
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4. Delivering Large-Scale Neurosurgical Studies in the UK: The Impact of Trainees
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Aswin Chari, Rory J. Piper, Ellie Edlmann, Julie Woodfield, Paul M. Brennan, Carole Turner, Michael D. Jenkinson, Peter J. Hutchinson, Angelos G. Kolias, Daniel M. Fountain, Ruichong Ma, Ian Coulter, Aminul Ahmed, Aimun A.B. Jamjoom, Fahid T. Rasul, Claudia Craven, Michael T.C. Poon, Josephine Jung, Jignesh Tailor, Abdurrahman I. Islim, Mueez Waqar, Sara Venturini, Soham Bandyopadhyay, Robin Borchert, and Conor S. Gillespie
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Biomedical Research ,Humans ,Surgery ,Neurology (clinical) ,United Kingdom - Abstract
The UK neurosurgical community has a track record of delivering high-quality, practice-changing clinical research studies, facilitated by a robust clinical research infrastructure and close collaborations between neurosurgical centers. More recently, these large-scale studies have been conceived, developed, and delivered by neurosurgical trainees, working under the umbrella of the British Neurosurgical Trainee Research Collaborative (BNTRC). In this paper, we outline the current landscape of large-scale neurosurgical studies in the UK, focusing on the role of trainees in facilitating this research. Importantly, we focus on our experience of trainee-led studies, including the development of the network, current challenges, and future directions. We believe that a similar model can be applied in different settings and countries, which will drive up the quality of neurosurgical research, ultimately benefiting future neurosurgical patients.
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- 2022
5. The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom
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Matthew George Stovell, Ciaran Hill, Stuart Smith, Aminul Ahmed, Lewis Thorne, Angelos Kolias, Andrew King, Malik Zaben, Antonio Belli, Kevin Owusu-Agyemang, Hani Marcus, Paul Brennan, William Scotton, Ian Coulter, David Coope, Julie Woodfield, Diederik Bulters, and Andreas Tarnaris
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Adult ,Male ,medicine.medical_specialty ,Pediatrics ,Multivariate analysis ,medicine.medical_treatment ,Population ,Bed rest ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Modified Rankin Scale ,medicine ,Humans ,Prospective Studies ,Medical prescription ,education ,Aged ,Aged, 80 and over ,education.field_of_study ,business.industry ,General Medicine ,Middle Aged ,United Kingdom ,Treatment Outcome ,Clinical research ,Hematoma, Subdural, Chronic ,030220 oncology & carcinogenesis ,Emergency medicine ,Female ,Neurosurgery ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
OBJECTIVESymptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland. This provides a resource both for current clinical practice and future clinical research on CSDH.METHODSData on management and outcomes for patients with CSDH referred to UK and Ireland NSUs were collected prospectively over an 8-month period and audited against criteria predefined from the literature: NSU mortality < 5%, NSU morbidity < 10%, symptomatic recurrence within 60 days requiring repeat surgery < 20%, and unfavorable functional status (modified Rankin Scale score of 4–6) at NSU discharge < 30%.RESULTSData from 1205 patients in 26 NSUs were collected. Bur-hole craniostomy was the most common procedure (89%), and symptomatic recurrence requiring repeat surgery within 60 days was observed in 9% of patients. Criteria on mortality (2%), rate of recurrence (9%), and unfavorable functional outcome (22%) were met, but morbidity was greater than expected (14%). Multivariate analysis demonstrated that failure to insert a drain intraoperatively independently predicted recurrence and unfavorable functional outcome (p = 0.011 and p = 0.048, respectively). Increasing patient age (p < 0.00001), postoperative bed rest (p = 0.019), and use of a single bur hole (p = 0.020) independently predicted unfavorable functional outcomes, but prescription of high-flow oxygen or preoperative use of antiplatelet medications did not.CONCLUSIONSThis is the largest prospective CSDH study and helps establish national standards. It has confirmed in a real-world setting the effectiveness of placing a subdural drain. This study identified a number of modifiable prognostic factors but questions the necessity of some common aspects of CSDH management, such as enforced postoperative bed rest. Future studies should seek to establish how practitioners can optimize perioperative care of patients with CSDH to reduce morbidity as well as minimize CSDH recurrence. The BNTRC is unique worldwide, conducting multicenter trainee-led research and audits. This study demonstrates that collaborative research networks are powerful tools to interrogate clinical research questions.
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- 2017
6. Influence of Antiplatelet and Anticoagulant Drug Use on Outcomes after Chronic Subdural Hematoma Drainage
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Matthew George Stovell, Aminul Ahmed, Michael Poon, Lewis Thorne, Angelos Kolias, Andrew King, Malik Zaben, William Gray, Paul Brennan, Peter Hutchinson, Julie Woodfield, and Diederik Bulters
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Male ,030506 rehabilitation ,medicine.medical_specialty ,recurrence ,medicine.drug_class ,antiplatelet ,functional outcome ,Cohort Studies ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Chronic subdural hematoma ,Risk Factors ,Preoperative Care ,Trephining ,Antithrombotic ,Humans ,Medicine ,Prospective Studies ,cardiovascular diseases ,Drainage ,Aged ,Aged, 80 and over ,Aspirin ,Anticoagulant drug ,business.industry ,Anticoagulant ,anticoagulant ,Anticoagulants ,Original Articles ,Middle Aged ,Large cohort ,Surgery ,Treatment Outcome ,Pharmaceutical Preparations ,chronic subdural hematoma ,Hematoma, Subdural, Chronic ,Female ,Neurology (clinical) ,0305 other medical science ,business ,Platelet Aggregation Inhibitors ,030217 neurology & neurosurgery - Abstract
We aim to describe the outcomes after chronic subdural hematoma drainage (CSDH) management in a large cohort of patients on antithrombotic drugs, either antiplatelets or anticoagulants, at presentation and to inform clinical decision making on the timing of surgery and recommencement of these drugs. We used data from a previous UK-based multi-center, prospective cohort study. Outcomes included recurrence within 60 days, functional outcome at discharge, and thromboembolic event during hospital stay. We performed Cox regression on recurrence and multiple logistic regression on functional outcome. There were 817 patients included in the analysis, of which 353 (43.2%) were on an antithrombotic drug at presentation. We observed a gradual reduction in risk of recurrence for patients during the 6 weeks post-CSDH surgery. Neither antiplatelet nor anticoagulant drug use influenced risk of CSDH recurrence (hazard ratio, 0.93; 95% confidence interval [CI], 0.58-1.48; p = 0.76) or persistent/worse functional impairment (odds ratio, 1.08; 95% CI, 0.76-1.55; p = 0.66). Delaying surgery after cessation of antiplatelet drug did not affect risk of bleed recurrence. There were 15 in-hospital thromboembolic events recorded. Events were more common in the group pre-treated with antithrombotic drugs (3.3%) compared to the non-antithrombotic group (0.9%). Patients on an antithrombotic drug pre-operatively were at higher risk of thromboembolic events with no excess risk of bleed recurrence or worse functional outcome after CSDH drainage. The data did not support delaying surgery in patients on antithrombotic therapy. In the absence of a randomized controlled trial, early surgery and early antithrombotic recommencement should be considered in those at high risk of thromboembolic events.
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- 2019
7. Outcomes following surgery in subgroups of comatose and very elderly patients with chronic subdural hematoma
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Matthew George Stovell, Ciaran Hill, Stuart Smith, Aminul Ahmed, Timothy Jones, Michael Poon, Lewis Thorne, Angelos Kolias, Andrew King, Malik Zaben, Antonio Belli, Hani Marcus, William Gray, Paul Brennan, William Scotton, Peter Hutchinson, Julie Woodfield, Diederik Bulters, Andreas Tarnaris, and Alhafidz Hamdan
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Male ,medicine.medical_specialty ,030218 nuclear medicine & medical imaging ,Chronic subdural haematoma ,Recurrence risk ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Chronic subdural hematoma ,Recurrence ,DECOMPRESSIVE CRANIECTOMY ,medicine ,MANAGEMENT ,Humans ,Glasgow Coma Scale ,Coma ,Surgical treatment ,RECURRENCE ,Aged ,Outcome ,Aged, 80 and over ,RISK ,business.industry ,Age Factors ,Very elderly ,General Medicine ,Middle Aged ,3. Good health ,Surgery ,Treatment Outcome ,Hematoma, Subdural, Chronic ,Comatose ,Female ,Original Article ,Neurology (clinical) ,Neurosurgery ,medicine.symptom ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Increasing age and lower pre-operative Glasgow coma score (GCS) are associated with worse outcome after surgery for chronic subdural haematoma (CSDH). Only few studies have quantified outcomes specific to the very elderly or comatose patients. We aim to examine surgical outcomes in these patient groups. We analysed data from a prospective multicentre cohort study, assessing the risk of recurrence, death, and unfavourable functional outcome of very elderly (≥ 90 years) patients and comatose (pre-operative GCS ≤ 8) patients following surgical treatment of CSDH. Seven hundred eighty-five patients were included in the study. Thirty-two (4.1%) patients had pre-operative GCS ≤ 8 and 70 (8.9%) patients were aged ≥ 90 years. A higher proportion of comatose patients had an unfavourable functional outcome (38.7 vs 21.7%; p = 0.03), although similar proportion of comatose (64.5%) and non-comatose patients (61.8%) functionally improved after surgery (p = 0.96). Compared to patients aged
- Published
- 2018
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