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Traumatic brain injury randomized

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https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#1
Randall Chesnut, Nancy Temkin, Sureyya Dikmen, Carlos Rondina, Walter Videtta, Gustavo Petroni, Silvia Lujan, Victor Alanis, Antonio Luis Eiras Falcao, Gustavo La Fuente, Luis Gonzalez, Manuel Jibaja, Arturo Lavendez, Freddy Sandi Lora, Roberto Merida, Ricardo Romero, James Pridgeon, Jason Barber, Joan Machamer, Kelley Chaddock
Purpose - The imaging- and clinical-examination (ICE) algorithm used in the BEST TRIP ICP randomized controlled trial is the only prospectively investigated clinical protocol for TBI management without ICP monitoring. As the default literature standard, it warrants careful evaluation. Methods - We present the ICE protocol in detail and analyse the demographics, outcome, treatment intensity, frequency of intervention usage, and related adverse events in the ICE-protocol cohort. Results - The 167 ICE protocol patients were young (median 29 years) with a median Glasgow Coma Scale motor score of 4 but with anisocoria or abnormal pupillary reactivity in 40%...
July 20, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28725211/critical-evaluation-of-the-lund-concept-for-treatment-of-severe-traumatic-head-injury-25%C3%A2-years-after-its-introduction
#2
REVIEW
Per-Olof Grände
When introduced in 1992, the Lund concept (LC) was the first complete guideline for treatment of severe traumatic brain injury (s-TBI). It was a theoretical approach, based mainly on general physiological principles-i.e., of brain volume control and optimization of brain perfusion and oxygenation of the penumbra zone. The concept gave relatively strict outlines for cerebral perfusion pressure, fluid therapy, ventilation, sedation, nutrition, the use of vasopressors, and osmotherapy. The LC strives for treatment of the pathophysiological mechanisms behind symptoms rather than just treating the symptoms...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28724200/effect-of-memantine-on-serum-levels-of-neuron-specific-enolase-and-on-the-glasgow-coma-scale-in-patients-with-moderate-traumatic-brain-injury
#3
Majid Mokhtari, Hossein Nayeb-Aghaei, Mehran Kouchek, Mir Mohammad Miri, Reza Goharani, Arash Amoozandeh, Sina Akhavan Salamat, Mohammad Sistanizad
Traumatic brain injury (TBI) is a major cause of disability and death globally. Despite significant progress in neuromonitoring and neuroprotection, pharmacological interventions have failed to generate favorable results. We examined the effect of memantine on serum levels of neuron-specific enolase (NSE), a marker of neuronal damage, and the Glasgow Coma Scale (GCS) in patients with moderate TBI. Patients were randomly assigned to the control group (who received standard TBI management) and the treatment group (who, alongside their standard management, received enteral memantine 30 mg twice daily for 7 days)...
July 19, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28712906/a-comparison-of-pharmacologic-therapeutic-agents-used-for-the-reduction-of-intracranial-pressure-following-traumatic-brain-injury
#4
REVIEW
Ahmed M Alnemari, Brianna M Krafcik, Tarek R Mansour, Daniel Gaudin
OBJECTIVE: In neurotrauma care, a better understanding of treatments following traumatic brain injury (TBI) has led to a significant decrease in morbidity and mortality in this population. TBI represents a significant medical problem, and complications following TBI are associated with the initial injury and post-event intracranial processes such as elevated intracranial pressure (ICP) and brain edema. Consequently, appropriate therapeutic interventions are required to reduce brain tissue damage and improve cerebral perfusion...
July 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28706860/targeted-temperature-management-in-neurological-intensive-care-unit
#5
REVIEW
Sombat Muengtaweepongsa, Winchana Srivilaithon
Targeted temperature management (TTM) shows the most promising neuroprotective therapy against hypoxic/ischemic encephalopathy (HIE). In addition, TTM is also useful for treatment of elevated intracranial pressure (ICP). HIE and elevated ICP are common catastrophic conditions in patients admitted in Neurologic intensive care unit (ICU). The most common cause of HIE is cardiac arrest. Randomized control trials demonstrate clinical benefits of TTM in patients with post-cardiac arrest. Although clinical benefit of ICP control by TTM in some specific critical condition, for an example in traumatic brain injury, is still controversial, efficacy of ICP control by TTM is confirmed by both in vivo and in vitro studies...
June 26, 2017: World Journal of Methodology
https://www.readbyqxmd.com/read/28701282/risk-factors-for-myocardial-dysfunction-after-traumatic-brain-injury-a-one-year-follow-up-study
#6
Kang Lu, Cheng-Loong Liang, Ping-Chia Li, Po-Chou Liliang, Chih-Yuan Huang, Yi-Che Lee, Kuo-Wei Wang, San-Nan Yang, Yuan-Ting Sun, Hao-Kuang Wang
INTRODUCTION: Traumatic brain injury has been associated with an increased risk of myocardial dysfunction. Common abnormalities accompanying this pathology include electrocardiographic abnormalities, elevated creatine kinase levels, arrhythmias, and pathologic changes of the myocardium. The aim of this study was to determine if TBI patients have a higher risk of myocardial dysfunction than the general population and to identify the risk factors of myocardial dysfunction in TBI patients...
July 8, 2017: Injury
https://www.readbyqxmd.com/read/28699371/minocycline-attenuates-high-mobility-group-box-1-translocation-microglial-activation-and-thalamic-neurodegeneration-after-traumatic-brain-injury-in-postnatal-day-17-rats
#7
Dennis William Simon, Rajesh K Aneja, Henry Alexander, Michael J Bell, Hulya Bayir, Patrick M Kochanek, Robert S B Clark
In response to cell injury the danger signal high mobility group box-1 (HMGB) is released, activating macrophages by binding pattern recognition receptors. We investigated the role of the anti-inflammatory drug minocycline in attenuating HMGB1 translocation, microglial activation, and neuronal injury in a rat model of pediatric traumatic brain injury (TBI). Postnatal day 17 Sprague-Dawley rats were subjected to moderate-severe controlled cortical impact (CCI). Animals were randomized to treatment with minocycline (90 mg/kg, i...
July 12, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28698031/comparable-impediment-of-cognitive-function-in-female-and-male-rats-subsequent-to-daily-administration-of-haloperidol-after-traumatic-brain-injury
#8
Kristin E Free, Anna M Greene, Corina O Bondi, Naima Lajud, Patricia B de la Tremblaye, Anthony E Kline
Antipsychotic drugs, such as haloperidol (HAL), are prescribed in the clinic to manage traumatic brain injury (TBI)-induced agitation. While preclinical studies have consistently shown that once-daily administration of HAL hinders functional recovery after TBI in male rats, its effects in females are unknown. Hence, the objective of this study was to directly compare neurobehavioral and histological outcomes in both sexes to determine whether the reported deleterious effects of HAL extend to females. Anesthetized adult female and male rats received either a controlled cortical impact (CCI) or sham injury and then were randomly assigned to a dosing regimen of HAL (0...
July 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/28697013/the-clinical-significance-of-isolated-traumatic-subarachnoid-hemorrhage-in-mild-traumatic-brain-injury-a-meta-analysis
#9
Farshad Nassiri, Jetan H Badhiwala, Christopher D Witiw, Alireza Mansouri, Benjamin Davidson, Saleh A Almenawer, Nir Lipsman, Leodante Da Costa, Farhad Pirouzmand, Avery B Nathens
BACKGROUND: The rates of clinical and radiographic progression, and need for neurosurgical intervention in patients with isolated traumatic subarachnoid hemorrhage (itSAH) after mild traumatic brain injury (mTBI, GCS 13-15) has not been well established. OBJECTIVE: To review the evidence regarding patient outcomes after mTBI with itSAH DATA SOURCES: MEDLINE, EMBASE, Web of Science, Google Scholar and the Cochrane Library STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Electronic databases were searched for human studies without language restrictions from January 2000 to February 2017...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28695582/a-joint-logistic-regression-and-covariate-adjusted-continuous-time-markov-chain-model
#10
Maria Laura Rubin, Wenyaw Chan, Jose-Miguel Yamal, Claudia Sue Robertson
The use of longitudinal measurements to predict a categorical outcome is an increasingly common goal in research studies. Joint models are commonly used to describe two or more models simultaneously by considering the correlated nature of their outcomes and the random error present in the longitudinal measurements. However, there is limited research on joint models with longitudinal predictors and categorical cross-sectional outcomes. Perhaps the most challenging task is how to model the longitudinal predictor process such that it represents the true biological mechanism that dictates the association with the categorical response...
July 10, 2017: Statistics in Medicine
https://www.readbyqxmd.com/read/28688622/effects-of-atorvastatin-on-brain-contusion-volume-and-functional-outcome-of-patients-with-moderate-and-severe-traumatic-brain-injury-a-randomized-double-blind-placebo-controlled-clinical-trial
#11
Gholam Reza Farzanegan, Nima Derakhshan, Hosseinali Khalili, Fariborz Ghaffarpasand, Shahram Paydar
The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). The study was conducted as a randomized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz, Southern Iran. We included 65 patients with moderate (GCS: 9-13) to severe (GCS: 5-8) TBI who had brain contusions of less than 30cc volume. We excluded those who required surgical intervention...
July 5, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28686657/phase-i-randomized-clinical-trial-of-n-acetylcysteine-in-combination-with-an-adjuvant-probenecid-for-treatment-of-severe-traumatic-brain-injury-in-children
#12
Robert S B Clark, Philip E Empey, Hülya Bayır, Bedda L Rosario, Samuel M Poloyac, Patrick M Kochanek, Thomas D Nolin, Alicia K Au, Christopher M Horvat, Stephen R Wisniewski, Michael J Bell
BACKGROUND: There are no therapies shown to improve outcome after severe traumatic brain injury (TBI) in humans, a leading cause of morbidity and mortality. We sought to verify brain exposure of the systemically administered antioxidant N-acetylcysteine (NAC) and the synergistic adjuvant probenecid, and identify adverse effects of this drug combination after severe TBI in children. METHODS: IRB-approved, randomized, double-blind, placebo controlled Phase I study in children 2 to 18 years-of-age admitted to a Pediatric Intensive Care Unit after severe TBI (Glasgow Coma Scale [GCS] score ≤8) requiring an externalized ventricular drain for measurement of intracranial pressure (ICP)...
2017: PloS One
https://www.readbyqxmd.com/read/28674247/osthole-enhances-the-therapeutic-efficiency-of-stem-cell-transplantation-in-neuroendoscopy-caused-traumatic-brain-injury
#13
Zhen-Yu Tao, Peng Gao, Yu-Hui Yan, Hong-Yan Li, Jie Song, Jing-Xian Yang
Neuroendoscopy processes can cause severe traumatic brain injury. Existing therapeutic methods, such as neural stem cell transplantation and osthole have not been proven effective. Therefore, there is an emerging need on the development of new techniques for the treatment of brain injuries. In this study we propose to combine the above stem cell based methods and then evaluate the efficiency and accuracy of the new method. Mice were randomly divided into four groups: group 1 (brain injury alone); group 2 (osthole); group 3 (stem cell transplantation); and group 4 (osthole combined with stem cell transplantation)...
2017: Biological & Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/28673512/ready-set-let-s-train-feasibility-of-an-intensive-attention-training-program-and-its-beneficial-effect-after-childhood-traumatic-brain-injury
#14
Marilou Séguin, Annie Lahaie, Célia Matte-Gagné, Miriam H Beauchamp
BACKGROUND: Attention deficits are common after pediatric Traumatic Brain Injury (TBI); they complicate return to activities of daily living and disrupt socioacademic reintegration. Yet, clinicians in rehabilitation settings have limited access to cognitive remediation protocols for which feasibility has been demonstrated. OBJECTIVE: The aim of this study was to evaluate the feasibility of intensive attention process training program Ready! Set? Let's Train! (RST), based on an adaptation of the Attention Process Training-I program...
June 30, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28657432/accelerated-changes-in-cortical-thickness-measurements-with-age-in-military-service-members-with-traumatic-brain-injury
#15
Ricky R Savjani, Brian A Taylor, Laura Acion, Elisabeth A Wilde, Ricardo Jorge
Finding objective and quantifiable imaging markers of mild traumatic brain injury (TBI) has proven challenging, especially in the military population. Changes in cortical thickness after injury have been reported in animals and in humans, but it is unclear how these alterations manifest in the chronic phase and is difficult to accurately characterize with imaging. Here, we used cortical thickness measures derived from Advanced Normalization Tools (ANTs) to predict a continuous demographic variable: age. We trained four different regression models (linear regression, support vector regression, Gaussian process regression, and random forests) to predict age from healthy control brains from publicly available datasets (n = 762)...
June 28, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28655027/zolpidem-for-the-treatment-of-neurologic-disorders-a-systematic-review
#16
Martin N Bomalaski, Edward S Claflin, Whitney Townsend, Mark D Peterson
Importance: Given its selective action on the ω1 subtype of the γ-aminobutyric acid A receptor, zolpidem tartrate presents a potential treatment mechanism for other neurologic disorders. Objective: To synthesize studies that used zolpidem to treat neurologic disorders. Evidence Review: Eligibility criteria included any published English-language article that examined the use of zolpidem for noninsomnia neurologic disorders in humans for all dates up to March 20, 2015...
June 26, 2017: JAMA Neurology
https://www.readbyqxmd.com/read/28653428/effects-of-dextroamphetamine-in-subacute-traumatic-brain-injury-a-randomized-placebo-controlled-pilot-study
#17
Tessa Hart, John Whyte, Thomas Watanabe, Inna Chervoneva
Psychostimulants that affect neurotransmitters implicated in cognitive function and neural plasticity have potential to enhance the rate and extent of recovery after traumatic brain injury (TBI). Ten milligrams dextroamphetamine (DEX) or an identical placebo was administered daily for 3 weeks to 32 participants with moderate to severe TBI, engaged in inpatient rehabilitation, at a mean of 2 months post injury. A variety of outcome measures assessing cognitive function and overall functional status was administered at weekly intervals, to examine effect sizes that may inform a larger trial, and to evaluate safety...
June 27, 2017: Journal of Neuroscience Research
https://www.readbyqxmd.com/read/28640076/efficacy-of-methylphenidate-for-the-treatment-of-mental-sequelae-after-traumatic-brain-injury
#18
RANDOMIZED CONTROLLED TRIAL
Wei-Tao Zhang, Ya-Fei Wang
BACKGROUND: This study aimed to evaluate the effect of methylphenidate for treating mental sequelae after traumatic brain injury (TBI). METHODS: Thirty-six patients with TBI were randomly divided into the intervention group and placebo group. The participants in the intervention group received methylphenidate, while subjects in the placebo group were administered a placebo. This study was conducted from January 2014 to December 2016. The outcome measurements included Mental Fatigue Scale, Choice Reaction Time, Compensatory Tracking Task, Mental Arithmetic Test, Digit Symbol Substitution Test, Mini-Mental State Examination (MMSE), Beck Depression Inventory (BDI), and Hamilton Rating Scale for Depression...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28634000/dose-dependent-effects-of-abobotulinumtoxina-dysport-on-spasticity-and-active-movements-in-adults-with-upper-limb-spasticity-secondary-analysis-of-a-phase-3-study
#19
Michael W O'Dell, Allison Brashear, Robert Jech, Thierry Lejeune, Philippe Marque, Djamel Bensmail, Ziyad Ayyoub, David M Simpson, Magali Volteau, Claire Vilain, Philippe Picaut, Jean Michel Gracies
BACKGROUND: AbobotulinumtoxinA has beneficial effects on spasticity and active movements in hemiparetic adults with upper limb spasticity (ULS). However, evidence-based information on optimal dosing for clinical use is limited. OBJECTIVE: To describe joint-specific dose effects of abobotulinumtoxinA in adults with ULS. DESIGN: Secondary analysis of a phase 3 study (NCT01313299). SETTING: Multicenter, international, double-blind, placebo-controlled clinical trial...
June 19, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28632582/the-effect-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-multiple-injuries-model
#20
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
BACKGROUND: Despite clinical reports of poor outcomes, the degree to which resuscitative endovascular balloon occlusion of the aorta (REBOA) exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared with partial aortic occlusion (PAO) or no intervention. METHODS: Twenty-one swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
July 2017: Journal of Trauma and Acute Care Surgery
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