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severe trauma brain injury

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https://www.readbyqxmd.com/read/28936067/external-validation-of-the-rotterdam-computed-tomography-score-in-the-prediction-of-mortality-in-severe-traumatic-brain-injury
#1
Jose D Charry, Jesus D Falla, Juan D Ochoa, Miguel A Pinzón, Jorman H Tejada, Maria J Henriquez, Juan Pablo Solano, Camilo Calvache
INTRODUCTION: Traumatic brain injury (TBI) is a public health problem. It is a pathology that causes significant mortality and disability in Colombia. Different calculators and prognostic models have been developed to predict the neurological outcomes of these patients. The Rotterdam computed tomography (CT) score was developed for prognostic purposes in TBI. We aimed to examine the accuracy of the prognostic discrimination and prediction of mortality of the Rotterdam CT score in a cohort of trauma patients with severe TBI in a university hospital in Colombia...
August 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28935892/bioenergetic-state-regulates-innate-inflammatory-responses-through-the-transcriptional-co-repressor-ctbp
#2
Yiguo Shen, David Kapfhamer, Angela M Minnella, Ji-Eun Kim, Seok Joon Won, Yanting Chen, Yong Huang, Ley Hian Low, Stephen M Massa, Raymond A Swanson
The innate inflammatory response contributes to secondary injury in brain trauma and other disorders. Metabolic factors such as caloric restriction, ketogenic diet, and hyperglycemia influence the inflammatory response, but how this occurs is unclear. Here, we show that glucose metabolism regulates pro-inflammatory NF-κB transcriptional activity through effects on the cytosolic NADH:NAD(+) ratio and the NAD(H) sensitive transcriptional co-repressor CtBP. Reduced glucose availability reduces the NADH:NAD(+) ratio, NF-κB transcriptional activity, and pro-inflammatory gene expression in macrophages and microglia...
September 22, 2017: Nature Communications
https://www.readbyqxmd.com/read/28933212/impact-of-traumatic-brain-injury-on-dopaminergic-transmission
#3
Yuan-Hao Chen, Eagle Yi-Kung Huang, Tung-Tai Kuo, Jonathan Miller, Yung-Hsiao Chiang, Barry J Hoffer
Brain trauma is often associated with severe morbidity and is a major public health concern. Even when injury is mild and no obvious anatomic disruption is seen, many individuals suffer disabling neuropsychological impairments such as memory loss, mood dysfunction, substance abuse, and adjustment disorder. These changes may be related to subtle disruption of neural circuits as well as functional changes at the neurotransmitter level. In particular, there is considerable evidence that dopamine (DA) physiology in the nigrostriatal and mesocorticolimbic pathways might be impaired after traumatic brain injury (TBI)...
July 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28926484/alcohol-and-drug-use-before-and-during-the-first-year-after-traumatic-brain-injury
#4
Simon Beaulieu-Bonneau, Frédéric St-Onge, Marie-Claude Blackburn, Andrée Banville, Andrée-Anne Paradis-Giroux, Marie-Christine Ouellet
OBJECTIVES: To compare individuals with mild and moderate/severe traumatic brain injury (TBI) on alcohol and drug use and substance use disorders before and in the first year post-TBI; to explore sociodemographic and injury-related variables associated with substance use disorders. PARTICIPANTS: A total of 225 adults hospitalized in a level I trauma center after TBI. DESIGN: Observational cohort study with retrospective (pre-TBI) and prospective (4, 8, and 12 months post-TBI) assessments...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28921171/high-fibrin-fibrinogen-degradation-product-to-fibrinogen-ratio-is-associated-with-28-day-mortality-and-massive-transfusion-in-severe-trauma
#5
D H Lee, B K Lee, S M Noh, Y S Cho
PURPOSE: There is a lack of association between coagulation biomarkers and long-term mortality in severe trauma. We aimed to investigate the association between coagulation biomarkers on admission and outcome of late stage of trauma. METHODS: This retrospective observational study included patients admitted with severe trauma between 2012 and 2015. We used the area under the receiver operating characteristic curve (AUROC) of coagulation biomarkers to determine 28-day mortality...
September 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28919762/risk-of-post-traumatic-epilepsy-after-severe-head-injury-in-patients-with-at-least-one-seizure
#6
Wei Chen, Ming-De Li, Gui-Fang Wang, Xia-Feng Yang, Lin Liu, Fan-Gang Meng
BACKGROUND: To explore the incidence and risk factors, including type of seizures for post-traumatic epilepsy (PTE) after severe traumatic brain injury (TBI). SUBJECTS AND METHODS: This was a retrospective follow-up study of patients discharged from Liaocheng People's Hospital between March 2011 and June 2015 with a diagnosis of post-traumatic seizures. Risk factors for PTE were evaluated in 68 inpatients by using Kaplan-Meier curves and the Cox model. RESULTS: Complete clinical information was available for 68 patients...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#7
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#8
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28912029/inclusion-of-highest-glasgow-coma-scale-motor-score-in-mortality-risk-adjustment-for-benchmarking-of-trauma-center-performance
#9
David Gomez, James P Byrne, Aziz S Alali, Wei Xiong, Chris Hoeft, Melanie Neal, Harris Subacius, Avery B Nathens
BACKGROUND: The Glasgow Coma Scale (GCS) score is the most widely utilized measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor score (mGCS) is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including highest mGCS on the performance of risk-adjustment models and subsequent external benchmarking results...
September 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28895474/temporal-profile-of-microtubule-associated-protein-map-2-a-novel-indicator-of-diffuse-brain-injury-severity-and-early-mortality-after-brain-trauma
#10
Linda Papa, Steven A Robicsek, Gretchen M Brophy, Kevin K W Wang, H Julia Hannay, Shelley C Heaton, Ilona Schmalfuss, Andrea Gabrielli, Ronald L Hayes, Claudia S Robertson
This study compared CSF levels of MAP-2 from adult patients with severe TBI to uninjured controls over ten days, and examined the relationship between MAP-2 concentrations and acute clinical and radiologic measures of injury severity along with mortality at 2-weeks and over 6-months. This prospective study, conducted at two Level 1 Trauma Centers, enrolled adults with severe TBI (GCS ≤8) requiring a ventriculostomy as well as controls. Ventricular CSF was sampled from each patient at 6, 12, 24, 48, 72, 96, 120, 144, 168, 192, 216 and 240 hours following TBI and analyzed via ELISA for MAP-2 (ng/ml)...
September 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28880678/assault-related-mild-traumatic-brain-injury-expectations-of-injury-outcome-and-the-effect-of-different-perpetrators-a-vignette-study
#11
Karen A Sullivan, Christina Wade
Few studies have examined the effect of varying the assault perpetrator on expectations of outcome from mild TBI. Using a cross sectional between groups design, individuals with no history of mild TBI were randomly allocated to one of two vignette conditions. The vignette depicted a mild TBI with fixed injury parameters and a different assault perpetrator (partner, n = 27; or stranger, n = 27). The participants were instructed to imagine that they had been injured as per the depiction, and then to anticipate the injury consequences 6-months later...
September 7, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/28878814/thoracic-trauma-severity-contributes-to-differences-in-intensive-care-therapy-and-mortality-of-severely-injured-patients-analysis-based-on-the-traumaregister-dgu%C3%A2
#12
Jörg Bayer, Rolf Lefering, Sylvia Reinhardt, Jan Kühle, Jörn Zwingmann, Norbert P Südkamp, Thorsten Hammer
BACKGROUND: Thoracic trauma is a relevant source of comorbidity throughout multiply-injured patient care. We aim to determine a measurable influence of chest trauma's severity on early resuscitation, intensive care therapy, and mortality in severely injured patients. METHODS: Patients documented between 2002 and 2012 in the TraumaRegister DGU®, aged ≥ 16 years, injury severity score (ISS) ≥ 16 are analyzed. Isolated brain injury and severe head injury led to exclusion...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28875887/the-spectrum-and-outcome-of-paediatric-traumatic-brain-injury-in-kwazulu-natal-province-south-africa-has-not-changed-over-the-last-two-decades
#13
J J P Buitendag, V Y Kong, J L Bruce, G L Laing, D L Clarke, P Brysiewicz
OBJECTIVES: This retrospective review of a prospectively entered and maintained hybrid electronic trauma registry was intended to develop a comprehensive overview of traumatic brain injury (TBI) in children and adolescents and to compare it with previous audits from our local environment and from other developing world centres. All TBI patients admitted to hospital were included in this study. We reviewed the age, gender, outcomes, radiological findings and treatment of the patients. METHODS: All patients aged ≤18 years old who were admitted by the Pietermaritzburg Metropolitan Trauma Service (PMTS) with TBI between December 2012 and December 2016 were included in this audit...
August 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28874206/variation-in-monitoring-and-treatment-policies-for-intracranial-hypertension-in-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-center-tbi-study
#14
Maryse C Cnossen, Jilske A Huijben, Mathieu van der Jagt, Victor Volovici, Thomas van Essen, Suzanne Polinder, David Nelson, Ari Ercole, Nino Stocchetti, Giuseppe Citerio, Wilco C Peul, Andrew I R Maas, David Menon, Ewout W Steyerberg, Hester F Lingsma
BACKGROUND: No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. METHODS: A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers...
September 6, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28872351/neuropsychological-outcome-of-children-with-traumatic-brain-injury-and-its-association-with-late-magnetic-resonance-imaging-findings-a-cohort-study
#15
Daniele S J Volpe, Nátali C A C Oliveira, A Carlos Santos, Maria B M Linhares, Ana P C P Carlotti
OBJECTIVES: To evaluate neuropsychological outcome after traumatic brain injury (TBI) and its association with trauma severity and late magnetic resonance imaging (MRI) findings. METHODS: Prospective cohort study of patients with TBI admitted to the paediatric intensive care unit over 5 years. Trauma severity was determined by Glasgow Coma Scale (GCS), neurological outcome by King's Outcome Scale for Childhood Head Injury (KOSCHI) and neuropsychological outcome by Wechsler Intelligence Scale for Children - Fourth Edition...
September 5, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28868043/metabolomics-profiling-as-a-diagnostic-tool-in-severe-traumatic-brain-injury
#16
REVIEW
Jussi P Posti, Alex M Dickens, Matej Orešič, Tuulia Hyötyläinen, Olli Tenovuo
Traumatic brain injury (TBI) is a complex disease with a multifaceted pathophysiology. Impairment of energy metabolism is a key component of secondary insults. This phenomenon is a consequence of multiple potential mechanisms including diffusion hypoxia, mitochondrial failure, and increased energy needs due to systemic trauma responses, seizures, or spreading depolarization. The degree of disturbance in brain metabolism is affected by treatment interventions and reflected in clinical patient outcome. Hence, monitoring of these secondary events in peripheral blood will provide a window into the pathophysiological course of severe TBI...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28866283/traumatic-brain-injury-comparison-between-autopsy-and-ante-mortem-ct
#17
Stephanie Panzer, Lidia Covaliov, Peter Augat, Oliver Peschel
PURPOSE: The aim of this study was to compare pathological findings after traumatic brain injury between autopsy and ante-mortem computed tomography (CT). A second aim was to identify changes in these findings between the primary posttraumatic CT and the last follow-up CT before death. METHODS: Through the collaboration between clinical radiology and forensic medicine, 45 patients with traumatic brain injury were investigated. These patients had undergone ante-mortem CT as well as autopsy...
August 26, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28864102/presenting-hypertension-burn-injury-and-mortality-in-combat-casualties
#18
Anders J Davidson, Sarah-Ashley E Ferencz, Jonathan A Sosnov, Jeffrey T Howard, Jud C Janak, Kevin K Chung, Ian J Stewart
INTRODUCTION: The effect of presenting hypertension is poorly studied in combat casualties. We hypothesized that elevated mean arterial pressure (MAP) on presentation to combat hospitals would be associated with poor outcomes. METHODS: Data was obtained from the Department of Defense Trauma Registry and the Armed Forces Medical Examiner System. Variables analyzed included presenting vital signs to Role II-III military theater hospital, demographic variables, injury severity score (ISS), location and mechanism of injury, presence of traumatic brain injury (TBI), acute kidney injury (AKI), and mortality...
August 29, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28863195/risk-factors-for-14-day-rehospitalization-following-trauma-with-new-traumatic-spinal-cord-injury-diagnosis-a-10-year-nationwide-study-in-taiwan
#19
Carlos Lam, Ping-Ling Chen, Jiunn-Horng Kang, Kuang-Fu Cheng, Ray-Jade Chen, Kuo-Sheng Hung
OBJECTIVES: Fourteen-day rehospitalization with new traumatic spinal cord injury (tSCI) diagnosis is used as an indicator for the diagnostic quality of the first hospitalization. In this nationwide population-based cohort study, we identified risk factors for this indicator. METHODS: We conducted a nested case-control study by using the data of patients who received a first hospitalization for trauma between 2001 and 2011. The data were retrieved from Taiwan's National Health Insurance Research Database...
2017: PloS One
https://www.readbyqxmd.com/read/28860853/disability-from-posttraumatic-headache-is-compounded-by-coexisting-posttraumatic-stress-disorder
#20
Louise S Roper, Peter Nightingale, Zhangjie Su, James L Mitchell, Antonio Belli, Alexandra J Sinclair
BACKGROUND: Posttraumatic headache (PTH) occurs in up to 82% of patients with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD) occurs in 39% of those with PTH. This study evaluates whether PTSD affects PTH disability. METHODS: Eighty-six patients with TBI were prospectively evaluated in a secondary care trauma center. Headache disability was assessed using the Headache Impact Test version 6 and signs indicative of PTSD using the PTSD Check List Civilian version...
2017: Journal of Pain Research
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