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Traumatic brain injury randomized

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https://www.readbyqxmd.com/read/28230712/updating-evidence-for-using-hypothermia-in-pediatric-severe-traumatic-brain-injury-conventional-and-bayesian-meta-analytic-perspectives
#1
Robert C Tasker, Frederick W Vonberg, Elizabeth D Ulano, Alireza Akhondi-Asl
OBJECTIVE: To evaluate clinical trials of hypothermia management on outcome in pediatric patients with severe traumatic brain injury using conventional and Bayesian meta-analyses. DATA SOURCES: Screening of PubMed and other databases to identify randomized controlled trials of hypothermia for pediatric severe traumatic brain injury published before September 2016. STUDY SELECTION: Four investigators assessed and reviewed randomized controlled trial data...
February 20, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28228155/catecholamines-as-outcome-markers-in-isolated-traumatic-brain-injury-the-coma-tbi-study
#2
Sandro B Rizoli, Blessing N R Jaja, Alex P Di Battista, Shawn G Rhind, Antonio Capone Neto, Leodante da Costa, Kenji Inaba, Luis Teodoro da Luz, Bartolomeu Nascimento, Adic Perez, Andrew J Baker, Airton Leonardo de Oliveira Manoel
BACKGROUND: Elevated catecholamine levels might be associated with unfavorable outcome after traumatic brain injury (TBI). We investigated the association between catecholamine levels in the first 24 h post-trauma and functional outcome in patients with isolated moderate-to-severe TBI. METHODS: A cohort of 174 patients who sustained isolated blunt TBI was prospectively enrolled from three Level-1 Trauma Centers. Epinephrine (Epi) and norepinephrine (NE) concentrations were measured at admission (baseline), 6, 12 and 24 h post-injury...
February 23, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28228060/resuscitation-with-lyophilized-plasma-is-safe-and-improves-neurologic-recovery-in-a-long-term-survival-model-of-swine-subjected-to-traumatic-brain-injury-hemorrhagic-shock-and-polytrauma
#3
Patrick E Georgoff, Vahagn C Nikolian, Ihab Halaweish, Kiril Chtraklin, Peter J Bruhn, Hassan Eidy, Monica Rasmussen, Yongqing Li, Ashok Srinivasan, Hasan B Alam
We have previously shown that fresh frozen plasma (FFP) and lyophilized plasma decrease brain lesion size and improve neurologic recovery in a swine model of traumatic brain injury (TBI) and hemorrhagic shock (HS). In this study, we examine whether these findings can be validated in a clinically relevant model of severe TBI, HS, and polytrauma. Female Yorkshire swine were subjected to TBI (controlled cortical impact), hemorrhage (40% volume), grade III liver and splenic injuries, rib fracture, and rectus abdominis crush...
February 22, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28226969/a-machine-learning-based-approach-for-identifying-traumatic-brain-injury-patients-for-whom-a-head-ct-scan-can-be-avoided
#4
Somayeh Molaei, Frederick K Korley, S M Reza Soroushmehr, Hayley Falk, Haris Sair, Kevin Ward, Kayvan Najarian, Somayeh Molaei, Frederick K Korley, S M Reza Soroushmehr, Hayley Falk, Haris Sair, Kevin Ward, Kayvan Najarian, Frederick K Korley, Hayley Falk, Kevin Ward, S M Reza Soroushmehr, Haris Sair, Kayvan Najarian, Somayeh Molaei
Head CT scan is more often used to evaluate patients with suspected traumatic brain injury (TBI). However, the use of head CT scans in evaluating TBI is costly with low value endeavor. In this paper, we propose a new algorithm and a set of features to help clinicians determine which patients evaluated for TBI need a head CT scan using cost sensitive random forest (CSRF) classifier. We show that random forest (RF) and CSRF are useful methods for identifying patients likely to have a positive head CT scan. The proposed algorithm has superior diagnostic accuracy in comparison to the Canadian head CT algorithm, which is currently the most accurate and widely used algorithm for determining which TBI patients need a head CT scan...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28218643/diffusion-assessment-of-cortical-changes-induced-by-traumatic-spinal-cord-injury
#5
Peng Sun, Rory K J Murphy, Paul Gamble, Ajit George, Sheng-Kwei Song, Wilson Z Ray
Promising treatments are being developed to promote functional recovery after spinal cord injury (SCI). Magnetic resonance imaging, specifically Diffusion Tensor Imaging (DTI) has been shown to non-invasively measure both axonal and myelin integrity following traumatic brain and SCI. A novel data-driven model-selection algorithm known as Diffusion Basis Spectrum Imaging (DBSI) has been proposed to more accurately delineate white matter injury. The objective of this study was to investigate whether DTI/DBSI changes that extend to level of the cerebral peduncle and internal capsule following a SCI could be correlated with clinical function...
February 17, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28218343/immediate-affective-responses-of-gait-training-in-neurological-rehabilitation-a-randomized-crossover-trial
#6
Martin Niedermeier, Larissa Ledochowski, Andreas Mayr, Leopold Saltuari, Martin Kopp
OBJECTIVE: To examine the immediate effects of physical therapy and robotic-assisted gait training on affective responses of gait training in neurological rehabilitation. DESIGN: Randomized crossover trial with blinded observers. PATIENTS: Sixteen patients with neurological disorders (stroke, traumatic brain injury, spinal cord injury, multiple sclerosis). METHODS: All patients underwent 2 single treatment sessions: physical therapy and robotic-assisted gait training...
February 16, 2017: Journal of Rehabilitation Medicine
https://www.readbyqxmd.com/read/28214984/dl-3-n-butylphthalide-nbp-provides-neuroprotection-in-the-mice-models-after-traumatic-brain-injury-via-nrf2-are-signaling-pathway
#7
Zhengwei Liu, Handong Wang, Xiaofeng Shi, Liwen Li, Mengliang Zhou, Hui Ding, Youqing Yang, Xiang Li, Ke Ding
The present study was aimed to evaluate the neuroprotective effects of NBP in the mice models of TBI, as well as the possible role of Nrf2-ARE pathways in the assumptive neuroprotection. In mice,a modified Marmarou's weight-drop model was employed to induce TBI. ICR mice were randomly assigned to four experimental groups: sham, TBI, TBI+vehicle(V) and TBI+NBP. NBP (100 mg/kg) was administered via an intraperitoneal (i.p.) injection at 1 h following TBI. The administration of NBP significantly ameliorated the effects of the brain injury, including neurological deficits, brain water content, and cortical neuronal apoptosis...
February 18, 2017: Neurochemical Research
https://www.readbyqxmd.com/read/28212177/neurocognitive-outcomes-for-acute-global-acquired-brain-injury-in-children
#8
Fenella J Kirkham
PURPOSE OF REVIEW: In children, acute global brain injury from traumatic brain injury (TBI) and nontraumatic coma has a substantial cost to the child, the family, and the society. There have historically been relatively few studies looking at long-term cognition and behavioural outcomes. RECENT FINDINGS: Long-term follow-up studies, population-based studies, and meta-analyses are now available for TBI in children as well as adults and suggest that there is a significant cognitive cost, particularly for processing speed, working memory, and intelligence quotient (IQ) in severe TBI...
February 15, 2017: Current Opinion in Neurology
https://www.readbyqxmd.com/read/28209450/the-effect-of-tranexamic-acid-in-traumatic-brain-injury-a-randomized-controlled-trial
#9
Abolfazl Jokar, Koorosh Ahmadi, Tayyebeh Salehi, Mahdi Sharif-Alhoseini, Vafa Rahimi-Movaghar
PURPOSE: Traumatic brain injury (TBI) is a leading cause of death and disability. Intracranial hemorrhage (ICH) secondary to TBI is associated with a high risk of coagulopathy which leads to increasing risk of hemorrhage growth and higher mortality rate. Therefore, antifibrinolytic agents such as tranexamic acid (TA) might reduce traumatic ICH. The aim of the present study was to investigate the extent of ICH growth after TA administration in TBI patients. METHODS: This single-blind randomized controlled trial was conducted on patients with traumatic ICH (with less than 30 ml) referring to the emergency department of Vali-Asr Hospital, Arak, Iran in 2014...
January 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28195952/the-relations-of-cognitive-behavioral-and-physical-activity-variables-to-depression-severity-in-traumatic-brain-injury-reanalysis-of-data-from-a-randomized-controlled-trial
#10
Charles H Bombardier, Jesse R Fann, Evette J Ludman, Steven D Vannoy, Joshua R Dyer, Jason K Barber, Nancy R Temkin
OBJECTIVE: To explore the relations of cognitive, behavioral, and physical activity variables to depression severity among people with traumatic brain injury (TBI) undergoing a depression treatment trial. SETTING: Community. PARTICIPANTS: Adults (N = 88) who sustained complicated mild to severe TBI within the past 10 years, met criteria for major depressive disorder, and completed study measures. DESIGN: Randomized controlled trial...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28195950/reliability-of-videoconferencing-administration-of-a-communication-questionnaire-to-people-with-traumatic-brain-injury-and-their-close-others
#11
Rachael Rietdijk, Emma Power, Melissa Brunner, Leanne Togher
OBJECTIVES: To compare in-person with videoconferencing administration of a communication questionnaire for people with traumatic brain injury (TBI) and their close others. DESIGN: Repeated-measures design with randomized order of administration. PARTICIPANTS: Twenty adults with severe TBI and their close others. METHODS: Both participants with TBI and their close others completed the La Trobe Communication Questionnaire (LCQ) via interview with a clinician, once via Skype and once during a home visit...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28187802/critical-care-management-of-traumatic-brain-injury
#12
D K Menon, A Ercole
Traumatic brain injury (TBI) is a growing global problem, which is responsible for a substantial burden of disability and death, and which generates substantial healthcare costs. High-quality intensive care can save lives and improve the quality of outcome. TBI is extremely heterogeneous in terms of clinical presentation, pathophysiology, and outcome. Current approaches to the critical care management of TBI are not underpinned by high-quality evidence, and many of the current therapies in use have not shown benefit in randomized control trials...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28185976/effects-of-oral-glibenclamide-on-brain-contusion-volume-and-functional-outcome-of-patients-with-moderate-and-severe-traumatic-brain-injury-a-randomized-double-blind-placebo-controlled-clinical-trial
#13
Hosseinali Khalili, Nima Derakhshan, Amin Niakan, Fariborz Ghaffarpasand, Mohammad Salehi, Hamed Eshraghian, Alireza Shakibafard, Bita Zahabi
OBJECTIVE: The aim of the current study was to investigate the effects of oral glibenclamide on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury (TBI). METHODS: This was randomized clinical trial being conducted during a 16-month period from May 2015 and August 2016 in a level I trauma center in Southern Iran. We included 66 patients with moderate (GCS: 9-13) to severe (GCS: 5-8) TBI who had brain contusions of less than 30cc volume...
February 6, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28184360/evaluation-of-the-effect-of-glibenclamide-in-patients-with-diffuse-axonal-injury-due-to-moderate-to-severe-head-trauma
#14
Peyman Zafardoost, Amir Abbas Ghasemi, Firooz Salehpour, Chia Piroti, Ehsan Ziaeii
BACKGROUND: Traumatic brain injury (TBI) is a major health problem worldwide. Secondary injuries after TBI, including diffuse axonal injury (DAI) often occur, and proper treatments are needed in this regard. It has been shown that glibenclamide could reduce secondary brain damage after experimental TBI and improve outcomes. OBJECTIVES: We aim to evaluate the role of glibenclamide on the short-term outcome of patients with DAI due to moderate to severe TBI. PATIENTS AND METHODS: In this controlled randomized clinical trial, 40 patients with moderate to severe TBI were assigned to glibenclamide (n = 20) and control (n = 20) groups...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28180120/effects-of-a-sensory-stimulation-by-nurses-and-families-on-level-of-cognitive-function-and-basic-cognitive-sensory-recovery-of-comatose-patients-with-severe-traumatic-brain-injury-a-randomized-control-trial
#15
Marzieh Moattari, Fatemeh Alizadeh Shirazi, Nasrin Sharifi, Najaf Zareh
BACKGROUND: Several lines of evidence suggest that early sensory stimulation and regular family visiting programs are potential nursing interventions to improve the outcomes of head injured comatose patients. However, little is known about the impacts of family involvement in providing sensory stimulation. OBJECTIVES: To determine the effects of a sensory stimulation program conducted by nurses and families on the consciousness, level of cognitive function, and basic cognitive sensory recovery of head injury comatose patients...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28170141/response-to-letter-to-the-editor
#16
Catherine Varner
We kindly thank the journal for the opportunity to respond to the recent comments made regarding our manuscript entitled, "Cognitive rest and graduated return to usual activities versus usual care for mild traumatic brain injury: a randomized controlled trial of emergency department discharge instructions." This article is protected by copyright. All rights reserved.
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28170134/mild-traumatic-brain-injury-is-something-missing-when-comparing-cognitive-rest-and-graduated-return-to-usual-activities-versus-usual-care
#17
Vaitsa Giannouli
I read with great interest the article by Varner et al.(1) which aims to determine in a simple, concise, and neat way if mild traumatic brain injury (MTBI) patients randomized to graduated return to usual activity discharge instructions have a decrease in their Post Concussion Symptom Score (PCSS) two weeks after MTBI, compared to patients who receive usual care MTBI discharge instructions. This article is protected by copyright. All rights reserved.
February 7, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28169945/causes-and-consequences-of-treatment-variation-in-moderate-and-severe-traumatic-brain-injury-a-multicenter-study
#18
Maryse C Cnossen, Suzanne Polinder, Teuntje M Andriessen, Joukje van der Naalt, Iain Haitsma, Janneke Horn, Gaby Franschman, Pieter E Vos, Ewout W Steyerberg, Hester Lingsma
OBJECTIVES: Although guidelines have been developed to standardize care in traumatic brain injury, between-center variation in treatment approach has been frequently reported. We examined variation in treatment for traumatic brain injury by assessing factors influencing treatment and the association between treatment and patient outcome. DESIGN: Secondary analysis of prospectively collected data. SETTING: Five level I trauma centers in the Netherlands (2008-2009)...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28167305/self-reported-driving-difficulty-in-veterans-with-traumatic-brain-injury-its-central-role-in-psychological-well-being
#19
Laraine Winter, Helene J Moriarty, Thomas H Short
BACKGROUND: The ability to drive is a core function supporting independent living. Traumatic brain injury (TBI) may impair driving capacity in numerous ways. Previous research has documented that individuals with TBI have more driving-related problems than other people and has identified predictors of driving status or capacity, mostly among civilians. But no research has examined the implications of driving limitations for the well-being of individuals with TBI. OBJECTIVE: To examine the association between self-reported difficulty in driving with important domains of psychological well-being in veterans with TBI, adjusting for PTSD and years since most recent TBI...
February 3, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28157822/intracranial-pressure-management-in-patients-with-traumatic-brain-injury-an-update
#20
Nino Stocchetti, Tommaso Zoerle, Marco Carbonara
PURPOSE OF REVIEW: Intracranial pressure (ICP) monitoring and treatment is central in the management of traumatic brain injury. Despite 4 decades of clinical use, several aspects remain controversial, including the indications for ICP and treatment options. RECENT FINDINGS: Two major trials tested surgical decompression and mild hypothermia as treatments for high ICP. Both were rigorous, randomized, multicenter studies, with different designs. Decompression was tested for ICP refractory to conventional treatment, whereas hypothermia was offered as an alternative to conventional medical therapy...
February 2, 2017: Current Opinion in Critical Care
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