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Traumatic brain injury randomized

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https://www.readbyqxmd.com/read/28933219/suppression-of-trim32-enhances-motor-function-repair-after-traumatic-brain-injury-associated-with-antiapoptosis
#1
Zi-Bin Zhang, Liu-Lin Xiong, Bin-Tuan Lu, Hui-Xiang Zhang, Piao Zhang, Ting-Hua Wang
To investigate the role of Trim32 in traumatic brain injury (TBI), adult male Sprague Dawley (SD) rats and mice were randomly divided into sham (n = 6) and TBI groups ( n = 24), respectively. Then, mice were assigned into Trim32 knockout mice (Trim32-KO [+/-]) and wild-type (WT) littermates. The TBI model used was the Feeney free-falling model, and neurological function was evaluated after TBI using a neurological severity score (NSS). Reverse transcription polymerase chain reaction (RT-PCR), Western blot, and immunohistochemistry were used to investigate the expression of Trim32 in the damaged cortex...
July 2017: Cell Transplantation
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#2
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930945/effects-of-propranolol-and-clonidine-on-brain-edema-blood-brain-barrier-permeability-and-endothelial-glycocalyx-disruption-following-fluid-percussion-brain-injury-in-the-rat
#3
Gustav Folmer Genét, Peter Bentzer, Morten Bagge Hansen, Sisse Rye Ostrowski, Pär Ingemar Johansson
BACKGROUND: Traumatic brain injury causes a disruption of the vascular endothelial glycocalyx layer that is associated with an overactivation of the sympathoadrenal system. We hypothesized that early and unselective beta-blockade with propranolol alone or in combination with the alfa2-agonist clonidine would decrease brain edema, blood-brain-barrier permeability and glycocalyx disruption at 24 hours after trauma. METHODS: We subjected fifty-three adult male Sprague-Dawley rats to lateral fluid-percussion brain injury and randomized infusion with propranolol (n=16), propranolol+clonidine (n=16), vehicle (n=16) or sham (n=5) for 24 hours...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28922174/evaluating-the-effectiveness-of-facebook-to-impact-the-knowledge-of-evidence-based-employment-practices-by-individuals-with-traumatic-brain-injury-a-knowledge-translation-random-control-study
#4
Katherine J Inge, Carolyn W Graham, James W McLaughlin, Doug Erickson, Paul Wehman, Hannah E Seward
BACKGROUND: Individuals with traumatic brain injury (TBI) experience difficulty with obtaining and maintaining employment post-injury. Although vocational rehabilitation (VR) can be one option to provide individuals with TBI support and services to lead to successful employment outcomes, information about these services can be difficult and confusing to navigate. Providing information on evidence-based employment practices to individuals with TBI through social media could be an effective approach...
September 14, 2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/28895488/a-systematic-review-of-psychological-interventions-for-sleep-and-fatigue-after-mild-traumatic-brain-injury
#5
Karen Sullivan, Hannah Blaine, Sherrie-Anne Kaye, Alice Theadom, Catherine Haden, Simon Smith
This review evaluated the evidence for psychological interventions to improve sleep and reduce fatigue after mild traumatic brain injury (TBI). Eight electronic databases were searched up until August 2016 for studies that: (1) included adults; (2) tested intervention effectiveness on sleep quality and fatigue, post-acutely; (3) applied a broadly-defined psychological intervention (e.g., cognitive behavioural therapy [CBT], counselling, or education). Only randomized controlled trials were eligible for inclusion...
September 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28891908/potential-impact-of-amantadine-on-aggression-in-chronic-traumatic-brain-injury
#6
Flora M Hammond, James F Malec, Ross D Zafonte, Mark Sherer, Jennifer Bogner, Sureyya Dikmen, Marybeth P Whitney, Kathleen R Bell, Susan M Perkins, Elizabeth A Moser
OBJECTIVE: To assess the effects of amantadine on anger and aggression among individuals with a chronic traumatic brain injury (TBI). METHODS: A cohort of 118 persons with chronic TBI (>6 months postinjury) and moderate-severe aggression selected from a larger cohort of 168 participants enrolled in a parallel-group, randomized, double-blind, placebo-controlled trial of amantadine 100 mg twice daily (n = 82) versus placebo (n = 86) for treatment of irritability were studied...
September 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28882376/a-novel-approach-to-improving-the-interpretation-of-ct-brain-in-trauma
#7
L R Evans, M C Fitzgerald, D Varma, B Mitra
BACKGROUND: Computed tomography of the brain (CTB) has a fundamental role in the diagnosis and management of traumatic brain injury (TBI). There may be substantial discordance between initial CTB interpretation by emergency clinicians and the final radiology report. This study aimed to assess the utility of a structured reporting template in improving the accuracy of CTB interpretation by emergency clinicians. METHOD: A prospective pre- and post-intervention cohort study was undertaken using a study population of emergency medicine trainees...
September 4, 2017: Injury
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
#8
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/28878731/head-eye-vestibular-motion-therapy-affects-the-mental-and-physical-health-of-severe-chronic-postconcussion-patients
#9
Frederick Robert Carrick, Joseph F Clark, Guido Pagnacco, Matthew M Antonucci, Ahmed Hankir, Rashid Zaman, Elena Oggero
CONTEXT: Approximately 1.8-3.6 million annual traumatic brain injuries occur in the United States. An evidence-based treatment for concussions that is reliable and effective has not been available. OBJECTIVE: The objective of this study is to test whether head-eye vestibular motion (HEVM) therapy is associated with decreased symptoms and increased function in postconcussive syndrome (PCS) patients that have been severely impaired for greater than 6 months after a mild traumatic brain injury...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28874922/an-overview-of-the-use-of-neurofeedback-biofeedback-for-the-treatment-of-symptoms-of-traumatic-brain-injury-in-military-and-civilian-populations
#10
REVIEW
Sarah N Gray
Background: Neurofeedback, a type of biofeedback, is an operant conditioning treatment that has been studied for use in the treatment of traumatic brain injury (TBI) in both civilian and military populations. In this approach, users are able to see or hear representations of data related to their own physiologic responses to triggers, such as stress or distraction, in real time and, with practice, learn to alter these responses in order to reduce symptoms and/or improve performance. Objective: This article provides a brief overview of the use of biofeedback, focusing on neurofeedback, for symptoms related to TBI, with applications for both civilian and military populations, and describes a pilot study that is currently underway looking at the effects of a commercial neurofeedback device on patients with mild-to-moderate TBIs...
August 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/28852836/indications-for-surgical-stabilization-of-rib-fractures-in-patients-without-flail-chest-surveyed-opinions-of-members-of-the-chest-wall-injury-society
#11
Fredric M Pieracci, Suresh Agarwal, Andrew Doben, Adam Shiroff, Larwence Lottenberg, Sarah Ann Whitbeck, Thomas W White
PURPOSE: There are currently no evidence-based indications for surgical stabilization of rib fractures (SSRF) in patients without flail chest. The purpose of this survey was to identify patients for whom there is relative equipoise (operative vs. non-operative) in order to assist in designing a randomized clinical trial. METHODS: Members of the Chest Wall Injury Society were sent an online survey, in which 18 patient scenarios were presented. The baseline patient had ≥ three displaced, contiguous fractures and had no other contraindications for surgery...
August 29, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28847125/in-reply-to-the-letter-to-the-editor-regarding-effects-of-oral-glibenclamide-on-brain-contusion-volume-and-functional-outcome-of-patients-with-moderate-and-severe-traumatic-brain-injuries-a-randomized-double-blind-placebo-controlled-clinical-trial
#12
LETTER
https://www.readbyqxmd.com/read/28847124/letter-to-the-editor-regarding-effects-of-oral-glibenclamide-on-brain-contusion-volume-and-functional-outcome-of-patients-with-moderate-and-severe-traumatic-brain-injuries-a-randomized-double-blind-placebo-controlled-clinical-trial
#13
LETTER
https://www.readbyqxmd.com/read/28846763/functional-outcome-after-intracranial-pressure-monitoring-for-children-with-severe-traumatic-brain-injury
#14
Tellen D Bennett, Peter E DeWitt, Tom H Greene, Rajendu Srivastava, Jay Riva-Cambrin, Michael L Nance, Susan L Bratton, Desmond K Runyan, J Michael Dean, Heather T Keenan
Importance: Intracranial pressure (ICP) monitoring is a mainstay of therapy for children with traumatic brain injury (TBI), but its overall association with patient outcome is unclear. Objective: To test the hypothesis that ICP monitoring is associated with improved functional survival of children with severe TBI. Design, Setting, and Participants: A propensity-weighted effectiveness analysis was conducted using 2 linked national databases with data from 30 US children's hospitals from January 1, 2007, to December 31, 2012, on 3084 children with severe TBI...
August 28, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28836809/teen-online-problem-solving-for-teens-with-traumatic-brain-injury-rationale-methods-and-preliminary-feasibility-of-a-teen-only-intervention
#15
Shari L Wade, Megan E Narad, Kathleen M Kingery, H Gerry Taylor, Terry Stancin, Michael W Kirkwood, Keith O Yeates
PURPOSE/OBJECTIVE: To describe the Teen Online Problem Solving-Teen Only (TOPS-TO) intervention relative to the original Teen Online Problem Solving-Family (TOPS-F) intervention, to describe a randomized controlled trial to assess intervention efficacy, and to report feasibility and acceptability of the TOPS-TO intervention. Research method and design: This is a multisite randomized controlled trial, including 152 teens (49 TOPS-F, 51 TOPS-TO, 52 IRC) between the ages of 11-18 who were hospitalized for a moderate to severe traumatic brain injury in the previous 18 months...
August 2017: Rehabilitation Psychology
https://www.readbyqxmd.com/read/28828633/effects-of-dimeric-psd-95-inhibition-on-excitotoxic-cell-death-and-outcome-after-controlled-cortical-impact-in-rats
#16
Jens Bak Sommer, Anders Bach, Hana Malá, Mikko Gynther, Ann-Sofie Bjerre, Marie Gajhede Gram, Linda Marschner, Kristian Strømgaard, Jesper Mogensen, Darryl S Pickering
Therapeutic effects of PSD-95 inhibition have been demonstrated in numerous studies of stroke; however only few studies have assessed the effects of PSD-95 inhibitors in traumatic brain injury (TBI). As the pathophysiology of TBI partially overlaps with that of stroke, PSD-95 inhibition may also be an effective therapeutic strategy in TBI. The objectives of the present study were to assess the effects of a dimeric inhibitor of PSD-95, UCCB01-144, on excitotoxic cell death in vitro and outcome after experimental TBI in rats in vivo...
August 21, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28821777/decompressive-craniectomy-in-the-management-of-intracranial-hypertension-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#17
Danfeng Zhang, Qiang Xue, Jigang Chen, Yan Dong, Lijun Hou, Ying Jiang, Junyu Wang
We aim to perform a systematic review and meta-analysis to examine the prognostic value of decompressive craniectomy (DC) in patients with traumatic intracranial hypertension. PubMed, EMBASE, Cochrane Controlled Trials Register, Web of Science, http://clinicaltrials.gov/ were searched for eligible studies. Ten studies were included in the systematic review, with four randomized controlled trials involved in the meta-analysis, where compared with medical therapies, DC could significantly reduce mortality rate [risk ratio (RR), 0...
August 18, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28816837/individualizing-thresholds-of-cerebral-perfusion-pressure-using-estimated-limits-of-autoregulation
#18
Joseph Donnelly, Marek Czosnyka, Hadie Adams, Chiara Robba, Luzius A Steiner, Danilo Cardim, Brenno Cabella, Xiuyun Liu, Ari Ercole, Peter John Hutchinson, David Krishna Menon, Marcel J H Aries, Peter Smielewski
OBJECTIVES: In severe traumatic brain injury, cerebral perfusion pressure management based on cerebrovascular pressure reactivity index has the potential to provide a personalized treatment target to improve patient outcomes. So far, the methods have focused on identifying "one" autoregulation-guided cerebral perfusion pressure target-called "cerebral perfusion pressure optimal". We investigated whether a cerebral perfusion pressure autoregulation range-which uses a continuous estimation of the "lower" and "upper" cerebral perfusion pressure limits of cerebrovascular pressure autoregulation (assessed with pressure reactivity index)-has prognostic value...
September 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#19
Anthony A Figaji, A Graham Fieggen, Ncedile Mankahla, Nico Enslin, Ursula K Rohlwink
In recent years, much progress has been made in our understanding of traumatic brain injury (TBI). Clinical outcomes have progressively improved, but evidence-based guidelines for how we manage patients remain surprisingly weak. The problem is that the many interventions and strategies that have been investigated in randomized controlled trials have all disappointed. These include many concepts that had become standard care in TBI. And that is just for adult TBI; in children, the situation is even worse. Not only is pediatric care more difficult than adult care because physiological norms change with age, but also there is less evidence for clinical practice...
August 14, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28806209/refractory-intracranial-hypertension-the-role-of-decompressive-craniectomy
#20
Martin Smith
Raised intracranial pressure (ICP) is associated with worse outcomes after acute brain injury, and clinical guidelines advocate early treatment of intracranial hypertension. ICP-lowering therapies are usually administered in a stepwise manner, starting with safer first-line interventions, while reserving higher-risk options for patients with intractable intracranial hypertension. Decompressive craniectomy is a surgical procedure in which part of the skull is removed and the underlying dura opened to reduce brain swelling-related raised ICP; it can be performed as a primary or secondary procedure...
August 10, 2017: Anesthesia and Analgesia
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