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https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#1
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
December 2, 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27913365/portable-mtbi-assessment-using-temporal-and-frequency-analysis-of-speech
#2
Louis Daudet, Nikhil Yadav, Matthew Perez, Christian Poellabauer, Sandra Schneider, Alan Huebner
This paper shows that extraction and analysis of various acoustic features from speech using mobile devices can allow the detection of patterns that could be indicative of neurological trauma. This may pave the way for new types of biomarkers and diagnostic tools. Toward this end, we created a mobile application designed to diagnose mild traumatic brain injuries (mTBI) such as concussions. Using this application, data was collected from youth athletes from 47 high schools and colleges in the the Midwestern United States...
December 1, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27911325/autonomic-nervous-system-dysfunctions-as-a-basis-for-a-predictive-model-of-risk-of%C3%A2-neurological-disorders-in-subjects-with%C3%A2-prior-history-of-traumatic-brain-injury-implications-in-alzheimer-s-disease
#3
Lap Ho, Marc Legere, Tongbin Li, Samara Levine, Ke Hao, Breanna Valcarcel, Giulio M Pasinetti
Autonomic dysfunction is very common in patients with dementia, and its presence might also help in differential diagnosis among dementia subtypes. Various central nervous system structures affected in Alzheimer's disease (AD) are also implicated in the central autonomic nervous system (ANS) regulation. For example, deficits in central cholinergic function in AD could likely lead to autonomic dysfunction. We recently developed a simple, readily applicable evaluation for monitoring ANS disturbances in response to traumatic brain injury (TBI)...
December 1, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27911066/-conservative-management-of-liver-trauma-and-its-complications-current-gold-standard
#4
R Gander, J A Molino, S Santiago, A Laín, G Guillén, C Giné, G Royo, S López, M Pérez, I Díez, S Cañadas, J Lloret, J Bueno
INTRODUCTION: The liver is the second most frequently involved organ in abdominal trauma in children. The aim of this study was to review the characteristics of liver traumas (LT) in children, its treatment and complications. MATERIAL AND METHODS: Retrospective study of patients with LT treated between 2010-2014. We analyzed data regarding diagnosis, conservative management (CM), complications and treatment. RESULTS: Twenty-four patients of LT with a mean age of 9...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27909098/reversible-disruption-of-neuronal-mitochondria-by-ischemic-and-traumatic-injury-revealed-by-quantitative-two-photon-imaging-in-the-neocortex-of-anesthetized-mice
#5
Mikhail Kislin, Jeremy Sword, Ioulia V Fomitcheva, Deborah Croom, Evgeny Pryazhnikov, Eero Lihavainen, Dmytro Toptunov, Heikki Rauvala, Andre S Ribeiro, Leonard Khiroug, Sergei A Kirov
: Mitochondria play a variety of functional roles in cortical neurons, from metabolic support and neuroprotection to the release of cytokines that trigger apoptosis. In dendrites, mitochondrial structure is closely linked to their function, and fragmentation (fission) of the normally elongated mitochondria indicates loss of their function under such pathological conditions as stroke and brain trauma. Using in vivo two-photon microscopy in mouse brain, we quantified mitochondrial fragmentation in a full spectrum of cortical injuries ranging from severe to mild...
December 1, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27907151/changes-in-galanin-systems-in-a-rat-model-of-post-traumatic-stress-disorder-ptsd
#6
Karen Barnabas, Lin Zhang, Huiying Wang, Gilbert Kirouac, Maria Vrontakis
Post-traumatic stress disorder (PTSD) is a chronic syndrome triggered by exposure to trauma and a failure to recover from a normal negative emotional reaction to traumatic stress. The neurobiology of PTSD and the participation of neuropeptides in the neural systems and circuits that control fear and anxiety are not fully understood. The long-term dysregulation of neuropeptide systems contributes to the development of anxiety disorders, including PTSD. The neuropeptide galanin (Gal) and its receptors participate in anxiety-like and depression-related behaviors via the modulation of neuroendocrine and monoaminergic systems...
2016: PloS One
https://www.readbyqxmd.com/read/27906870/effectiveness-of-low-molecular-weight-heparin-versus-unfractionated-heparin-to-prevent-pulmonary-embolism-following-major-trauma-a-propensity-matched-analysis
#7
James P Byrne, William Geerts, Stephanie A Mason, David Gomez, Christopher Hoeft, Ryan Murphy, Melanie Neal, Avery B Nathens
BACKGROUND: Pulmonary embolism (PE) is a leading cause of delayed mortality in patients with severe injury. While low molecular weight heparin (LMWH) is often favored over unfractionated heparin (UH) for thromboprophylaxis, evidence is lacking to demonstrate an effect on the occurrence of PE. This study compared the effectiveness of LMWH versus UH to prevent PE in patients following major trauma. METHODS: Data for adults with severe injury who received thromboprophylaxis with LMWH or UH were derived from the American College of Surgeons Trauma Quality Improvement Program (2012-2015)...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27906868/individual-clotting-factor-contributions-to-mortality-following-trauma
#8
Ryan C Kunitake, Benjamin M Howard, Lucy Z Kornblith, Sabrinah A Christie, Amanda S Conroy, Mitchell J Cohen, Rachael A Callcut
BACKGROUND: Acute traumatic coagulopathy (ATC) afflicts 20-30% of trauma patients, but the extensive collinearity of the coagulation cascade complicates attempts to clarify global clotting factor dysfunction. This study aims to characterize phenotypes of clotting factor dysfunction and their contributions to mortality after major trauma. METHODS: This prospective cohort study examines all adult trauma patients of the highest activation level presenting to San Francisco General Hospital between 2/2005 and 2/2015...
November 30, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27905046/in-hospital-mortality-with-use-of-percutaneous-endoscopic-gastrostomy-in-traumatic-brain-injury-patients-results-of-a-nationwide-population-based-study
#9
Rabail Chaudhry, Sachin Batra, Omar L Mancillas, Robert Wegner, Navneet Grewal, George W Williams
BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a frequently performed invasive procedure that has been associated with high short-term mortality. Its use of special interest in traumatic brain injury (TBI) patients as nutrition support constitutes important issues in intensive care of this group. We used a national database to determine the incidence of, and factors associated with, in-hospital mortality among TBI patients undergoing PEG. METHODS: We conducted a retrospective study using the US nationwide inpatient sample to analyze data from all hospitalizations in 2008 with International Classification of Diseases, Ninth Revision, diagnostic and procedure codes identifying patients with TBI and hemorrhagic stroke who received PEG...
November 30, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27901414/cognitive-deficits-and-inflammatory-response-resulting-from-mild-to-moderate-traumatic-brain-injury-in-rats-are-exacerbated-by-repeated-pre-exposure-to-an-innate-stress-stimulus
#10
Michaël Ogier, Amor Belmeguenai, Thomas Lieutaud, Béatrice Georges, Sandrine Bouvard, Emilie Carré, Frédéric Canini, Laurent Bezin
Traumatic brain injury (TBI) is common in both military and civilian populations, and often results in neurobehavioral sequelae that impair quality of life in both patients and their family. Although individuals who are chronically exposed to stress are more likely to experience TBI, it is still unknown whether pre-injury stress influences the outcome after TBI. The present study tested whether behavioral and cognitive long-term outcome after TBI in rats is affected by prior exposure to an innate stress stimulus...
November 30, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27899434/development-of-cgrp-dependent-pain-and-headache-related-behaviours-in-a-rat-model-of-concussion-implications-for-mechanisms-of-post-traumatic-headache
#11
Dara Bree, Dan Levy
BACKGROUND AND OBJECTIVE: Posttraumatic headache (PTH) is one of the most common, debilitating and difficult symptoms to manage after a mild traumatic brain injury, or concussion. However, the mechanisms underlying PTH remain elusive, in part due to the lack of a clinically relevant animal model. Here, we characterized for the first time, headache and pain-related behaviours in a rat model of concussion evoked by a mild closed head injury (mCHI) - the major type of military and civilian related trauma associated with PTH - and tested responses to current and novel headache therapies...
November 29, 2016: Cephalalgia: An International Journal of Headache
https://www.readbyqxmd.com/read/27899118/surgical-intervention-for-paediatric-liver-injuries-is-almost-history-a-12-year-cohort-from-a-major-scandinavian-trauma-centre
#12
Tomohide Koyama, Jorunn Skattum, Peder Engelsen, Torsten Eken, Christine Gaarder, Pål Aksel Naess
BACKGROUND: Although nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period. METHODS: Patients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed...
November 29, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27895358/paediatric-traumatic-brain-injury-presentation-prognostic-indicators-and-outcome-analysis-from-a-tertiary-care-center-in-a-developing-country
#13
Badar Ujjan, Muhammad Waqas, Muhammad Babar Khan, Saqib Kamran Bakhshi, Muhammad Ehsan Bari
Traumatic brain injury (TBI) is the leading cause of morbidity and mortality in children worldwide. This study was conducted to report the presentation, management, outcomes and prognostic indicators in a large series of patients from a tertiary care centre in a developing country. It is a review of prospectively collected data of paediatric patients with TBI admitted at our centre between July 2010 and December 2013. A total of 291 patients with a mean age of 7.2±5.0 years were dichotomised into survivors and non-survivors, and variables were compared between the two groups...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27894562/todd-s-paresis-in-acute-mild-head-trauma
#14
Alan Cowley, David Wright, Thomas Breen, Richard Lyon
We present the case of an adult male who sustained Todd's paresis after a traumatically induced seizure in a patient with an isolated facial injury. The precipitating event was head trauma from a golf club. The patient had no previous history of seizures and went on to make a complete neurologic recovery with no cerebral pathology noted. A literature review suggests that Todd's paresis after trauma is very rare as opposed to occurring in the medical or long-term brain injury settings. Although the authors acknowledge that it may occur in trauma, the awareness within the prehospital setting is sufficiently rare for this case report to be of interest to prehospital clinicians; it is important prehospital clinicians are aware of this condition...
November 2016: Air Medical Journal
https://www.readbyqxmd.com/read/27894286/the-family-experiences-of-in-hospital-care-questionnaire-in-severe-traumatic-brain-injury-fecq-tbi-a-validation-study
#15
Audny Anke, Unn Sollid Manskow, Oddgeir Friborg, Cecilie Røe, Cathrine Arntzen
BACKGROUND: Family members are important for support and care of their close relative after severe traumas, and their experiences are vital health care quality indicators. The objective was to describe the development of the Family Experiences of in-hospital Care Questionnaire for family members of patients with severe Traumatic Brain Injury (FECQ-TBI), and to evaluate its psychometric properties and validity. METHODS: The design of the study is a Norwegian multicentre study inviting 171 family members...
November 28, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27893148/osteopathic-manipulative-treatment-for-somatic-dysfunction-after-acute-severe-traumatic-brain-injury
#16
Adrienne McCallister, Christopher Brown, Michael Smith, Hugh Ettlinger, Gerard A Baltazar
Somatic dysfunction caused by traumatic brain injury (TBI) may be managed by osteopathic manipulative treatment (OMT). In this case report, the authors describe 2 patients with severe TBI who were each treated with OMT in a level-1 regional trauma center. Both patients received OMT beginning in the acute care phase of injury. Somatic dysfunction improved during the course of treatment, and no adverse effects of OMT were noted. More comprehensive research may clarify the efficacy and adverse effects of OMT as part of multimodal acute care of patients with severe TBI...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27890762/the-clinical-value-of-intraoperative-mobile-computed-tomography-in-managing-high-risk-surgical-patients-with-traumatic-brain-injury-a-single-tertiary-trauma-center-experience
#17
Ko-Ting Chen, Shih-Tseng Lee, Chieh-Tsai Wu
OBJECTS: A subset of surgically-treated traumatic brain injury (TBI) patients cannot be stabilized by initial surgery. Mobile computed tomography (mCT) provides real-time information for diagnosis in these TBI-surgically high risk (TBI-SHR) patients. The objective of this study was to analyze a 5-year series of TBI-SHR patients to evaluate the impact of intraoperative mCT (imCT) on prognosis. METHODS: Out of 1017 surgically-treated TBI patients retrospectively reviewed over a 5-year period (2009-2013), fifty-nine patients required second operations within 72 hours of their initial surgery due to progressive or delayed hematomas (TBI-SHR group)...
November 24, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27889010/neuropsychiatric-aspects-of-concussion
#18
REVIEW
Rajiv Radhakrishnan, Amir Garakani, Lawrence S Gross, Marcia K Goin, Janet Pine, Andrew E Slaby, Calvin R Sumner, David A Baron
Over the past decade, concussion has become the most widely discussed injury in contact sports. However, concussions also occur in several other settings, such as non-contact sports, elderly individuals, young children, military personnel, and victims of domestic violence. Concussion is frequently undiagnosed as a cause of psychiatric morbidity, especially when the patient has no history of loss of consciousness or direct head trauma. Almost all of the extant literature focuses on traumatic brain injury and assumes that concussion is merely a mild form of traumatic brain injury, which has resulted in a lack of understanding about what concussion is, and how to diagnose, monitor, and treat its varied neuropsychiatric symptoms...
December 2016: Lancet Psychiatry
https://www.readbyqxmd.com/read/27888550/mesenchymal-stem-stromal-cells-biology-and-preclinical-evidence-for-therapeutic-potential-for-organ-dysfunction-following-trauma-or-sepsis
#19
Michael A Matthay, Shibani Pati, Jae-Woo Lee
Several experimental studies have provided evidence that bone-marrow derived mesenchymal stem (stromal) cells (MSC) may be effective in treating critically ill surgical patients who develop traumatic brain injury, acute renal failure, or the acute respiratory distress syndrome. There is also preclinical evidence that MSC may be effective in treating sepsis-induced organ failure, including evidence that MSC have anti-microbial properties. This review considers preclinical studies with direct relevance to organ failure following trauma, sepsis or major infections that apply to critically ill patients...
November 26, 2016: Stem Cells
https://www.readbyqxmd.com/read/27886876/complications-in-the-management-of-patients-with-spine-trauma
#20
REVIEW
Geoffrey Stricsek, George Ghobrial, Jefferson Wilson, Thana Theofanis, James S Harrop
More than 50% of patients diagnosed with acute, traumatic spinal cord injury will experience at least 1 complication during their hospitalization. Age, severity of neurological injury, concurrent traumatic brain injury, comorbid illness, and mechanism of injury are all associated with increasing risk of complication. More than 75% of complications will occur within 2 weeks of injury. The complications associated with SCI carry a significant risk of morbidity and mortality; their early identification and management is critical in the care of the SCI patient...
January 2017: Neurosurgery Clinics of North America
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