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Traumatic brain injury randomized

Jeanette R Little, Holly H Pavliscsak, Mabel R Cooper, Lois A Goldstein, Stephanie J Fonda
Introduction: Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare...
March 1, 2018: Military Medicine
Xiao-Fei Bai, Yong-Kai Gao
BACKGROUND: This study aimed to explore the efficacy and safety of recombinant human erythropoietin (RHE) for the treatment of severe traumatic brain injury (STBI). METHODS: One hundred and twenty eligible patients with STBI were randomly divided into an intervention group or a control group equally. Patients in the intervention group received RHE. The participants in the control group received 0.9% saline. The outcome measurements included the Glasgow Outcome Scale (GOS) scores, mortality, and any adverse events...
January 2018: Medicine (Baltimore)
Rebecca A Johnson, David L Albright, James R Marzolf, Jessica L Bibbo, Hayley D Yaglom, Sandra M Crowder, Gretchen K Carlisle, Amy Willard, Cynthia L Russell, Karen Grindler, Steven Osterlind, Marita Wassman, Nathan Harms
BACKGROUND: Large numbers of post-deployment U.S. veterans are diagnosed with post-traumatic stress disorder (PTSD) and/or traumatic brain injury (TBI), leading to an urgent need for effective interventions to reduce symptoms and increase veterans' coping. PTSD includes anxiety, flashbacks, and emotional numbing. The symptoms increase health care costs for stress-related illnesses and can make veterans' civilian life difficult. METHODS: We used a randomized wait-list controlled design with repeated measures of U...
January 19, 2018: Military Medical Research
Rune Rasmussen, Mette Midttun, Tine Kolenda, Anne-Mette Ragle, Thea Winther Sørensen, Anders Vinther, Bo Zerahn, Maria Pedersen, Karsten Overgaard
BACKGROUND: Fall accidents are a major cause of mortality among the elderly and the leading cause of traumatic brain injury. After a fall, many elderly people never completely recover and need help in coping with everyday life. Due to the increasing older population in the world, injuries, disabilities, and deaths caused by falls are a growing worldwide problem. Muscle weakness leads to greatly increased risk of falling, decreased quality of life, and decline in functional capacity. Muscle mass and muscle power decrease about 40% from age 20 to 80 years, and the level of testosterone decreases with age and leads to impaired muscle mass...
March 2, 2018: JMIR Research Protocols
Halinder S Mangat
Traumatic brain injury (TBI) remains a major cause of mortality and disability. Post-traumatic intracranial hypertension (ICH) further complicates the care of patients. Hyperosmolar agents are recommended for the treatment of ICH, but no consensus or high-level data exist on the use of any particular agent or the route of administration. The two agents used commonly are hypertonic saline (HTS) and mannitol given as bolus therapy. Smaller studies suggest that HTS may be a superior agent in reducing the ICH burden, but neither agent has been shown to improve mortality or functional outcome...
February 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
M Katherine Henry, Benjamin French, Chris Feudtner, Mark R Zonfrillo, Daniel M Lindberg, James D Anderst, Rachel P Berger, Joanne N Wood
OBJECTIVES: The aim of this study was to evaluate cervical magnetic resonance imaging (MRI) and computed tomography (CT) practices and cervical spine injuries among young children with non-motor vehicle crash (MVC)-associated traumatic brain injury (TBI). METHODS: We performed a retrospective study of a stratified, systematic random sample of 328 children younger than 2 years with non-MVC-associated TBI at 4 urban children's hospitals from 2008 to 2012. We defined TBI etiology as accidental, indeterminate, or abuse...
February 15, 2018: Pediatric Emergency Care
Ata Mahmoodpoor, Ghaffar Shokouhi, Hadi Hamishehkar, Hassan Soleimanpour, Sarvin Sanaie, Jahan Porhomayon, Fatemeh Rasouli, Nader D Nader
OBJECTIVE: To investigate the effects of l-Carnitine on neuron specific enolase (NSE) as a marker of inflammation in patients with traumatic brain injury (TBI). METHODS: Forty patients with severe TBI were randomized into 2 groups. The (LCA-) group received standard treatment with placebo while the (LCA+) group received l-Carnitine 2g/day for one week. NSE was measured on days 1, 3 and 7 after the initiation of the study. Neurocognitive and neurobehavioral disorders were recorded on the first and third months...
February 9, 2018: Journal of Critical Care
Viraj Pandit, Muhammad Khan, El Rasheid Zakaria, Tally M Largent-Milnes, Mohammad Hamidi, Terence O'Keeffe, Todd W Vanderah, Bellal Joseph
INTRODUCTION: While studies show that single-dose remote ischemic conditioning (RIC) improves outcomes, the effect of continuous (daily) RIC is unknown. Thus, we aimed to investigate the role of continuous-RIC on cognitive and motor function following traumatic brain injury (TBI). METHODS: We subjected 24 male C57BL mice to a cortical-controlled TBI. Two-hours after TBI the animals were randomly allocated to the RIC group (n=12) or the Sham group (n=12). RIC was induced by non-invasive external compression of the hind limb using an occlusive band (six 4-min cycles/24 hours) for consecutive 6 days...
February 14, 2018: Journal of Trauma and Acute Care Surgery
Corina O Bondi, Narayana K Yelleswarapu, Julian Day-Cooney, Kimiya Memarzadeh, Kaitlin A Folweiler, Carine E Bou-Abboud, Jacob B Leary, Jeffrey P Cheng, Roya Tehranian-DePasquale, Anthony E Kline
BACKGROUND: The acetylcholinesterase inhibitor (AChEI) donepezil (DON) is recommended as a potential treatment for cognition after clinical traumatic brain injury (TBI) and therefore may be prescribed as an adjunct therapy during rehabilitation. However, a dose-response study evaluating DON after a controlled cortical impact (CCI) injury in rats did not reveal cognitive benefits. OBJECTIVE: The aim of this study was to determine the effect of DON on behavioral and histological outcome when combined with environmental enrichment (EE), a preclinical model of neurorehabilitation...
2018: Restorative Neurology and Neuroscience
Marsh Königs, Eva A Beurskens, Lian Snoep, Erik J A Scherder, Jaap Oosterlaan
OBJECTIVE: To systematically review evidence on the effects of timing and intensity of neurorehabilitation on the functional recovery of patients with moderate to severe traumatic brain injury (TBI) and aggregate the available evidence using meta-analytic methods. DATA SOURCES: Pubmed, Embase, PsycINFO and Cochrane Database. DATA SELECTION: Electronic databases were searched for prospective controlled clinical trials assessing the effect of timing or intensity of multidisciplinary neurorehabilitation programs on functional outcome of patients with moderate or severe TBI...
February 8, 2018: Archives of Physical Medicine and Rehabilitation
Frederick Kofi Korley, Vahagn C Nikolian, Aaron M Williams, Isabel S Dennahy, Michael Weykamp, Hasan B Alam
The primary aim of this study was to examine the effects of valproic acid (VPA) treatment on serum glial fibrillary acidic protein (GFAP) and neurofilament light chain (NF-L) levels. To achieve this aim, we obtained serum samples from: (1) ten Yorkshire swine subjected to controlled cortical impact (CCI) TBI + polytrauma and randomized to receive either normal saline (NS) + VPA (n=5) or NS alone (n=5) and (2) five additional swine subjected to CCI TBI without polytrauma and treated with VPA. GFAP and NF-L levels were measured in samples obtained from baseline until 10 days post-injury using a digital immunoassay from Quanterix Corporation...
February 7, 2018: Journal of Neurotrauma
Kim Peterson, Johanna Anderson, Erin Boundy, Lauren Ferguson, Ellen McCleery, Kallie Waldrip
BACKGROUND: Continued racial/ethnic health disparities were recently described as "the most serious and shameful health care issue of our time." Although the 2014 US Affordable Care Act-mandated national insurance coverage expansion has led to significant improvements in health care coverage and access, its effects on life expectancy are not yet known. The Veterans Health Administration (VHA), the largest US integrated health care system, has a sustained commitment to health equity that addresses all 3 stages of health disparities research: detection, understanding determinants, and reduction or elimination...
March 2018: American Journal of Public Health
Ao Xiong, Ge Jin, Renping Xiong, Hong Lu
OBJECTIVE: To observe the protein expression related to cognitive and learning memory function, and to investigate the effect of aquaporin 4 (AQP4) silence on learning and memory function in traumatic brain injury (TBI) rats. METHODS: Ninety-six healthy adult male Wistar rats were divided into groups according to the random number table. (1) Forty-eight rats were divided into sham operation (sham) group, TBI group (by using modified Feeney method), AQP4 RNA interference (RNAi) negative group [TBI+meaningless small interfering RNA (siRNA)-AQP4 liposome solution 10 μL], and AQP4 RNAi group (TBI+siRNA-AQP4 liposome solution 10 μL)...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Frederick Adam Zeiler, Peter Smieleweski, Joseph Donnelly, Marek Czosnyka, David Menon, Ari Ercole
To derive models that estimate pressure reactivity index (PRx) using non-invasive transcranial Doppler (TCD) based systolic flow index (Sx_a) and mean flow index (Mx_a), both based on mean arterial pressure, in traumatic brain injury (TBI). Using a retrospective database of 347 TBI patients with ICP and TCD time series recordings we derived PRx, Sx_a and Mx_a. We first derived the autocorrelative structure of PRx based on: A. autoregressive integrative moving average (ARIMA) modelling in representative patients, and B...
February 3, 2018: Journal of Neurotrauma
Mengyang Wang, Faliang Duan, Jinglei Wu, Qiang Min, Qiaochun Huang, Ming Luo, Zhuqiang He
Post‑traumatic stress disorder (PTSD) is characterized by re‑experiencing of a traumatic event, avoidance of trauma‑associated stimulation, general changes in mood and cognition, and hyper arousal symptoms. Cyclooxygenase is involved in the production of prostaglandins and thromboxanes, and its inducible form cyclooxygenase‑2(COX‑2), an important mediator of cell injury in inflammation, is primarily expressed in leukocytes and brain cells. The present study investigated the expression of COX‑2 in the hippocampi of rats with PTSD and evaluated the effect of COX‑2 inhibition on PTSD...
January 31, 2018: Molecular Medicine Reports
Gyu-Sik Choi, Sang Gyu Kwak, Han Do Lee, Min Cheol Chang
OBJECTIVE: Central pain can occur following traumatic brain injury, leading to poor functional recovery, limitation of activities of daily living, and decreased quality of life. The aim of this study was to determine whether high-frequency (10 Hz) repetitive transcranial magnetic stimulation, applied over the primary motor cortex of the affected hemisphere, can be used to manage chronic central pain after mild traumatic brain injury. DESIGN: Prospective randomized feasibility study...
January 31, 2018: Journal of Rehabilitation Medicine
Ann Glang, Bonnie Todis, Debbie Ettel, Shari L Wade, Keith Owen Yeates
OBJECTIVE: To evaluate the utility of the STEP model, a systematic hospital-school transition protocol for children hospitalized for TBI. SETTING: Five children's hospitals in Colorado, Ohio, and Oregon. PARTICIPANTS: Hundred families of children with mild, complicated mild, moderate, or severe TBI. DESIGN: Randomized controlled trial (RCT); participants were randomized while hospitalized to the STEP (a standardized hospital-school transition protocol for children treated for TBI) or usual care condition...
February 1, 2018: Brain Injury: [BI]
Benno Mahler, Sofia Carlsson, Tomas Andersson, Torbjörn Tomson
OBJECTIVE: To study the risk for injuries/accidents in people with newly diagnosed epileptic seizures in relation to comorbidities. METHODS: Between September 1, 2001, and August 31, 2008, individuals in northern Stockholm with incident unprovoked seizures (epilepsy; n = 2,130) were included in a registry. For every epilepsy patient, 8 individuals matched for sex and inclusion year (n = 16,992) were randomly selected as references from the population of the catchment area...
January 31, 2018: Neurology
Janet D Pierce, Raeesa Gupte, Amanda Thimmesch, Qiuhua Shen, John B Hiebert, William M Brooks, Richard L Clancy, Francisco J Diaz, Janna L Harris
Following traumatic brain injury (TBI), there is significant secondary damage to cerebral tissue from increased free radicals and impaired mitochondrial function. This imbalance between reactive oxygen species (ROS) production and the effectiveness of cellular antioxidant defenses is termed oxidative stress. Often there are insufficient antioxidants to scavenge ROS, leading to alterations in cerebral structure and function. Attenuating oxidative stress following a TBI by administering an antioxidant may decrease secondary brain injury, and currently many drugs and supplements are being investigated...
January 30, 2018: Journal of Neuroscience Research
Gentian Toshkezi, Michele Kyle, Sharon L Longo, Lawrence S Chin, Li-Ru Zhao
OBJECTIVE Traumatic brain injury (TBI) is a major cause of long-term disability and death in young adults. The lack of pharmaceutical therapy for post-acute TBI recovery remains a crucial medical challenge. Stem cell factor (SCF) and granulocyte colony-stimulating factor (G-CSF), which are 2 key hematopoietic growth factors, have shown neuroprotective and neurorestorative effects in experimental stroke. The objective of this study was to determine the therapeutic efficacy of combined treatment (SCF + G-CSF) in subacute TBI...
January 26, 2018: Journal of Neurosurgery
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