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Traumatic brain injury randomized

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https://www.readbyqxmd.com/read/28808845/targeted-treatment-in-severe-traumatic-brain-injury-in-the-age-of-precision-medicine
#1
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
#2
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
https://www.readbyqxmd.com/read/28803030/neurofeedback-sham-neurofeedback-and-cognitive-behavioural-group-therapy-in-adults-with-attention-deficit-hyperactivity-disorder-a-triple-blind-randomised-controlled-trial
#3
Michael Schönenberg, Eva Wiedemann, Alexander Schneidt, Jonathan Scheeff, Alexander Logemann, Philipp M Keune, Martin Hautzinger
BACKGROUND: Many studies suggest that electroencephalographic (EEG) neurofeedback might be beneficial in the treatment of attention-deficit hyperactivity disorder (ADHD). However, numbers of well controlled studies are low and neurofeedback techniques are regarded as highly controversial. The present trial examined the efficacy (compared with sham neurofeedback) and efficiency (compared with meta-cognitive therapy) of a standard EEG neurofeedback protocol in adults with ADHD. METHODS: We did a concurrent, triple-blind, randomised, controlled trial using authorised deception in adults with ADHD from one centre (University of Tübingen) in Tübingen, Germany...
August 9, 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28795831/problem-solving-therapy-for-suicide-prevention-in-veterans-with-moderate-to-severe-traumatic-brain-injury
#4
Sean M Barnes, Lindsey L Monteith, Georgia R Gerard, Adam S Hoffberg, Beeta Y Homaifar, Lisa A Brenner
OBJECTIVE: Develop and test the acceptability and feasibility of Problem-Solving Therapy for Suicide Prevention (PST-SP), a group intervention aimed at improving problem solving and preventing suicide, among Veterans with hopelessness and moderate-to-severe traumatic brain injury (TBI). RESEARCH METHOD: Following treatment development, 16 U.S. Veterans with moderate-to-severe TBI and a Beck Hopelessness Scale score ≥4 participated in an acceptability and feasibility pilot study of PST-SP at a Veterans Affairs Medical Center...
August 10, 2017: Rehabilitation Psychology
https://www.readbyqxmd.com/read/28782542/supported-employment-for-veterans-with-traumatic-brain-injury-patient-perspectives
#5
Kathleen F Carlson, Terri K Pogoda, Tess Gilbert, Sandra G Resnick, Elizabeth Twamley, Maya E O'Neil, Nina A Sayer
OBJECTIVE: To quantify the need for, and interest in, Supported Employment (SE) among recent military Veterans with traumatic brain injury (TBI), and to examine characteristics associated with Veterans' interest in SE. DESIGN: Stratified random sample of Iraq and Afghanistan War Veterans confirmed to have TBI through the Veterans Health Administration (VHA) screening and evaluation system. SETTING: Community-based via mailed survey. PARTICIPANTS: We recruited 1,800 Veterans with clinician-confirmed TBI (1,080 mild TBI; 720 moderate/severe TBI) through multiple mailings...
August 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28781918/primary-decompressive-craniectomy-is-associated-with-worse-neurological-outcome-in-patients-with-traumatic-brain-injury-requiring-acute-surgery
#6
Julius Tapper, Markus B Skrifvars, Riku Kivisaari, Jari Siironen, Rahul Raj
BACKGROUND: The role of decompressive craniectomy in treating raised intracranial pressure (ICP) after traumatic brain injuries (TBI) is controversial. The aim of this study was to assess the differences in prognosis of patients initially treated by decompressive craniectomy, craniotomy, or conservatively. METHODS: We conducted a single-center retrospective study on adult blunt TBI patients admitted to a neurosurgical intensive care unit during 2009-2012. Patients were divided into three groups based on their initial treatment - decompressive craniectomy, craniotomy, and conservative...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28772270/induction-of-the-vitamin-d-receptor-attenuates-autophagy-dysfunction-mediated-cell-death-following-traumatic-brain-injury
#7
Changmeng Cui, Jianzhong Cui, Feng Jin, Ying Cui, Ran Li, Xiaohua Jiang, Yanxia Tian, Kaijie Wang, Pei Jiang, Junling Gao
BACKGROUND/AIMS: Traumatic brain injury (TBI) is a major public health problem in the world and causes high rates of mortality and disability. Recent evidence suggests that vitamin D (VD) has neuroprotective actions and can promote function recovery after TBI. In vitro and in vivo studies have demonstrated that autophagy could be enhanced following supplementation with an active metabolite of VD (calcitriol). However, it is unclear whether autophagy participates in the protective effects of calcitriol after TBI...
August 3, 2017: Cellular Physiology and Biochemistry
https://www.readbyqxmd.com/read/28771528/plasma-metabolomics-profiles-in-rats-with-acute-traumatic-brain-injury
#8
Fei Zheng, Zi-An Xia, Yi-Fu Zeng, Jie-Kun Luo, Peng Sun, Han-Jin Cui, Yang Wang, Tao Tang, Yan-Tao Zhou
Traumatic brain injury (TBI) is a major cause of mortality and disability worldwide. We validated the utility of plasma metabolomics analysis in the clinical diagnosis of acute TBI in a rat model of controlled cortical impact (CCI) using gas chromatography/mass spectrometry (GC/MS). Thirty Sprague-Dawley rats were randomly divided into two groups of 15 rats each: the CCI group and sham group. Blood samples were obtained from the rats within the first 24 h after TBI injury. GC/MS measurements were performed to evaluate the profile of acute TBI-induced metabolic changes, resulting in the identification of 45 metabolites in plasma...
2017: PloS One
https://www.readbyqxmd.com/read/28757598/selective-serotonin-reuptake-inhibitors-for-treating-neurocognitive-and-neuropsychiatric-disorders-following-traumatic-brain-injury-an-evaluation-of-current-evidence
#9
REVIEW
John K Yue, John F Burke, Pavan S Upadhyayula, Ethan A Winkler, Hansen Deng, Caitlin K Robinson, Romain Pirracchio, Catherine G Suen, Sourabh Sharma, Adam R Ferguson, Laura B Ngwenya, Murray B Stein, Geoffrey T Manley, Phiroz E Tarapore
The prevalence of neuropsychiatric disorders following traumatic brain injury (TBI) is 20%-50%, and disorders of mood and cognition may remain even after recovery of neurologic function is achieved. Selective serotonin reuptake inhibitors (SSRI) block the reuptake of serotonin in presynaptic cells to lead to increased serotonergic activity in the synaptic cleft, constituting first-line treatment for a variety of neurocognitive and neuropsychiatric disorders. This review investigates the utility of SSRIs in treating post-TBI disorders...
July 25, 2017: Brain Sciences
https://www.readbyqxmd.com/read/28753497/disease-modifying-effect-of-atipamezole-in-a-model-of-post-traumatic-epilepsy
#10
Jari Nissinen, Pedro Andrade, Teemu Natunen, Mikko Hiltunen, Tarja Malm, Katja Kanninen, Joana I Soares, Olena Shatillo, Jukka Sallinen, Xavier Ekolle Ndode-Ekane, Asla Pitkänen
Treatment of TBI remains a major unmet medical need, with 2.5 million new cases of traumatic brain injury (TBI) each year in Europe and 1.5 million in the USA. This single-center proof-of-concept preclinical study tested the hypothesis that pharmacologic neurostimulation with proconvulsants, either atipamezole, a selective α2-adrenoceptor antagonist, or the cannabinoid receptor 1 antagonist SR141716A, as monotherapy would improve functional recovery after TBI. A total of 404 adult Sprague-Dawley male rats were randomized into two groups: sham-injured or lateral fluid-percussion-induced TBI...
July 12, 2017: Epilepsy Research
https://www.readbyqxmd.com/read/28752349/citicoline-in-severe-traumatic-brain-injury-indications-for-improved-outcome-a%C3%A2-retrospective-matched-pair-analysis-from-14%C3%A2-austrian-trauma-centers
#11
Helmut Trimmel, Marek Majdan, Andrea Wodak, Guenther Herzer, Daniel Csomor, Alexandra Brazinova
Goal-oriented management of traumatic brain injury (TBI) can save the lives and/or improve the long-term outcome of millions of affected patients worldwide. Additionally, enhancing quality of life will save enormous socio-economic costs; however, promising TBI treatment strategies with neuroprotective agents, such as citicoline (CDP-choline), lacked evidence or produced contradictory results in clinical trials. During a prehospital TBI project to optimize early TBI care within 14 Austrian trauma centers, data on 778 TBI patients were prospectively collected...
July 27, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28748496/huperzine-a-alleviates-neuroinflammation-oxidative-stress-and-improves-cognitive-function-after-repetitive-traumatic-brain-injury
#12
Zhengrong Mei, Peiying Zheng, Xiangping Tan, Ying Wang, Bing Situ
Traumatic brain injury (TBI) may trigger secondary injury cascades including endoplasmic reticulum stress, oxidative stress, and neuroinflammation. Unfortunately, there are no effective treatments targeting either primary or secondary injuries that result in long-term detrimental consequences. Huperzine A (HupA) is a potent acetylcholinesterase inhibitor (AChEI) that has been used treatment of Alzheimer's disease (AD). This study aimed to explore the neuroprotective effects of HupA in TBI and its possible mechanisms...
July 26, 2017: Metabolic Brain Disease
https://www.readbyqxmd.com/read/28739248/the-protective-effect-of-hydrogen-sulfide-h2s-on-traumatic-brain-injury-tbi-induced-memory-deficits-in-rats
#13
Seyed Asaad Karimi, Narges Hosseinmardi, Mahyar Janahmadi, Mohammad Sayyah, Razieh Hajisoltani
Traumatic brain injury (TBI), as an expanding public health epidemic, is a common cause of death among youth. TBI is associated with cognitive deficits and memory impairment. Hydrogen sulfide (H2S), a novel gaseous mediator, has been recognized as an important neuromodulator and neuroprotective agent in the central nervous system. In the present study the potential neuroprotective role of sodium hydrosulfide (NaHS), an H2S donor on TBI induced memory deficit in a rat model of controlled cortical impact (CCI) injury was investigated...
July 22, 2017: Brain Research Bulletin
https://www.readbyqxmd.com/read/28738538/diosmin-improved-cognitive-deficit-and-amplified-brain-electrical-activity-in-the-rat-model-of-traumatic-brain-injury
#14
Mohammad Ali Mirshekar, Hamed Fanaei, Fereshteh Keikhaei, Fatemeh Sargolzaee Javan
OBJECTIVE: Traumatic brain injury (TBI) is one of the main causes of intellectual and cognitive disabilities in humans. Clinically, it is essential to limit the progress of cognitive impairment after TBI. It is reported that diosmin has a neuroprotective effect that can limit the progress of the impairment. The aim of this study was to evaluate the effects of diosmin on neurological score, memory, tumor necrosis factor-α (TNF-α) level and long-term potentiation in hippocampal dentate gyrus after the injury...
September 2017: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/28731871/online-family-problem-solving-for-pediatric-traumatic-brain-injury-influences-of-parental-marital-status-and-participation-on-adolescent-outcomes
#15
Stacey P Raj, Nanhua Zhang, Michael W Kirkwood, H Gerry Taylor, Terry Stancin, Tanya M Brown, Shari L Wade
OBJECTIVE: To examine the moderating effects of parent marital status and participation on efficacy of an online family problem-solving intervention for pediatric traumatic brain injury (TBI). METHODS: Participants were 132 adolescents (12-17 years) who had sustained a recent (<6 months) TBI and their parents. Participants were randomly assigned to the intervention (Counselor-Assisted Problem Solving, CAPS) or an Internet resource comparison (IRC) condition. CAPS was designed to support families in the initial phase following TBI, by teaching problem-solving skills and addressing common challenges...
July 20, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28731190/lutein-protects-against-severe-traumatic-brain-injury-through-anti%C3%A2-inflammation-and-antioxidative-effects-via-icam%C3%A2-1-nrf%C3%A2-2
#16
Dianhui Tan, Xiaoping Yu, Moran Chen, Junchen Chen, Jincheng Xu
Many studies have reported that lutein may exert its biological activities, including anti‑inflammation, anti‑oxidase and anti‑apoptosis, through effects on reactive oxygen species (ROS). Thus, lutein may prevent the damaging activities of ROS in cells. The current study investigated the effect of lutein against severe traumatic brain injury (STBI) and examined the mechanism of this protective effect. Sprague‑Dawley rats were randomly divided into 5 groups: Control group, STBI model group, 40 mg/kg lutein‑treated group, 80 mg/kg lutein‑treated group and 160 mg/kg lutein‑treated group...
July 20, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/28726590/a-method-of-managing-severe-traumatic-brain-injury-in-the-absence-of-intracranial-pressure-monitoring-the-ice-protocol
#17
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
#18
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
#19
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
#20
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
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