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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28230635/valproic-acid-modulates-platelet-and-coagulation-function-ex-vivo
#2
Ted Bambakidis, Simone E Dekker, Ihab Halaweish, Baoling Liu, Vahagn C Nikolian, Patrick E Georgoff, Patryk Piascik, Yongqing Li, Martin Sillesen, Hasan B Alam
Trauma-induced coagulopathy is associated with adverse patient outcome. Animal models demonstrate that histone deacetylase inhibitors, such as valproic acid (VPA), improve survival following injury. While in-vivo data suggest that improved survival may in part be because of an attenuation of coagulopathy, it remains unknown whether this is a direct effect of the drug, or the establishment of an overall prosurvival phenotype. We thus conducted an ex-vivo experiment to determine if VPA has an effect on coagulation and platelet function...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28228155/catecholamines-as-outcome-markers-in-isolated-traumatic-brain-injury-the-coma-tbi-study
#3
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/28227478/portable-video-oculography-device-for-implementation-in-sideline-concussion-assessments-a-prototype
#4
Joshua D Fischer, Dawie J van den Heever, Joshua D Fischer, Dawie J van den Heever, Dawie J Van den Heever, Joshua D Fischer
Concussion is currently a serious health problem and can lead to severe brain dysfunction. There is a definite need for sensitive and reliable tests to detect and evaluate the subtle changes in brain function caused by concussion. This study details the development of a low cost portable eye tracking device that can aid in the detection of concussions. The device evaluates ocular motor function and can be used on the sidelines of sporting events to give a quick indication of the severity of head trauma. It can further be used to evaluate and monitor mild Traumatic Brain Injuries and aid in the return to play decision making process...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28225527/neuro-trauma-or-med-surg-intensive-care-unit-does-it-matter-where-multiple-injuries-patients-with-traumatic-brain-injury-are-admitted-secondary-analysis-of-the-american-association-for-the-surgery-of-trauma-multi-institutional-trials-committee-decompressive
#5
Sarah Lombardo, Thomas Scalea, Jason Sperry, Raul Coimbra, Gary Vercruysse, Toby Enniss, Gregory J Jurkovich, Raminder Nirula
INTRODUCTION: Patients with nontraumatic acute intracranial pathology benefit from neurointensivist care. Similarly, trauma patients with and without traumatic brain injury (TBI) fare better when treated by a dedicated trauma team. No study has yet evaluated the role of specialized neurocritical (NICU) and trauma intensive care units (TICU) in the management of TBI patients, and it remains unclear which TBI patients are best served in NICU, TICU, or general (Med/Surg) ICU. METHODS: This study is a secondary analysis of The American Association for the Surgery of Trauma Multi-Institutional Trials Committee (AAST-MITC) decompressive craniectomy study...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28223249/predicted-unfavorable-neurological-outcome-is-overestimated-by-the-marshall-ct-score-crash-and-impact-models-in-severe-tbi-patients-management-with-early-decompressive-craniectomy
#6
Jose D Charry, Jorman H Tejada, Miguel A Pinzon, Wilson A Tejada, Juan D Ochoa, Manuel Falla, Jesus H Tovar, Ana M Cuellar-Bahamón, Juan P Solano
INTRODUCTION: Traumatic Brain Injury (TBI) is of public health interest and produces significant mortality and disability in Colombia. Calculators and prognostic models have been developed in order to establish neurologic outcome. We tested prognostic models (the Marshall CT score, IMPACT, and CRASH) for 14-day mortality, 6-month mortality, and 6-month outcome in TBI patients in a university Hospital in Colombia. METHODS: A 127 patients' cohort with TBI was treated in a regional trauma center in Colombia over 2 years and Bivariate and Multivariate analyses were used...
February 18, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28217583/profile-of-trauma-patients-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#7
Kundavaram Paul Prabhakar Abhilash, Nilanchal Chakraborthy, Gautham Raja Pandian, Vineet Subodh Dhanawade, Thomas Kurien Bhanu, Krishna Priya
BACKGROUND: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217503/pituitary-dysfunction-in-traumatic-brain-injury-is-evaluation-in-the-acute-phase-worthwhile
#8
Pradip P Dalwadi, Nikhil M Bhagwat, Parimal S Tayde, Ameya S Joshi, Premlata K Varthakavi
INTRODUCTION: Traumatic brain injury (TBI) is an under-recognized cause of hypopituitarism. According to recent data, it could be more frequent than previously known. However, there is a scarcity of data in Indian population. AIMS: The main aim of the study was to determine the prevalence of pituitary hormone deficiencies in the acute phase of TBI. The secondary objectives were to correlate the severity of trauma with basal hormone levels and to determine whether initial hormone deficiencies predict mortality...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#9
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28215129/longitudinal-changes-in-anthropometrics-and-impact-on-self-reported-physical-function-after-traumatic-brain-injury
#10
Lee-Anne S Chapple, Adam M Deane, Lauren T Williams, Richard Strickland, Chris Schultz, Kylie Lange, Daren K Heyland, Marianne J Chapman
BACKGROUND AND AIMS: Patients admitted to the ICU with a traumatic brain injury (TBI) are at risk of muscle wasting but this has not been quantified. Our aims were to describe longitudinal changes in anthropometrical data, compare the accuracy of non-invasive methodologies to the validated dual-energy x-ray absorptiometry (DXA), and assess the relationships between anthropometrical data and self-reported physical function. METHODS: In a prospective observational study, we recruited patients admitted to the ICU with a moderate-to-severe TBI over 12 months...
March 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28213195/blunt-traumatic-brain-injury-patients-a-role-for-ct-angiography-of-the-head-to-evaluate-non-traumatic-etiologies
#11
REVIEW
Ha Nguyen, Ninh Doan, Michael Gelsomino, Saman Shabani
BACKGROUND: In the setting of trauma, the etiology of intracranial hemorrhage (ICH) is frequently attributed to the physical, traumatic event. Caution should still be directed towards non-traumatic (or spontaneous) etiologies responsible for the trauma, such as hypertension, cerebral amyloid angiopathy, aneurysms, vascular malformation, and hemorrhagic infarcts. The role for immediate CT angiography (CTA) remains controversial to evaluate for non-traumatic etiologies. METHODS: A systematic review of the available literature in Medline PubMed database...
February 14, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28212955/health-state-preference-weights-for-the-glasgow-outcome-scale-following-traumatic-brain-injury-a-systematic-review-and-mapping-study
#12
Gordon Ward Fuller, Monica Hernandez, David Pallot, Fiona Lecky, Mathew Stevenson, Belinda Gabbe
BACKGROUND: Valid and relevant estimates of health state preference weights (HSPWs) for Glasgow Outcome Scale (GOS) categories are a key input of economic models evaluating treatments for traumatic brain injury (TBI). OBJECTIVES: To characterize existing HSPW estimates, and model the EuroQol five-dimensional questionnaire (EQ-5D) from the GOS, to inform parameterization of future economic models. METHODS: A systematic review of HSPWs for GOS categories following TBI was conducted using a highly sensitive search strategy implemented in an extensive range of information sources between 1975 and 2016...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28212927/patients-with-chronic-dizziness-following-traumatic-head-injury-typically-have-multiple-diagnoses-involving-combined-peripheral-and-central-vestibular-dysfunction
#13
Q Arshad, R E Roberts, H Ahmad, R Lobo, M Patel, T Ham, D J Sharp, B M Seemungal
OBJECTIVE: We hypothesised that chronic vestibular symptoms (CVS) of imbalance and dizziness post-traumatic head injury (THI) may relate to: (i) the occurrence of multiple simultaneous vestibular diagnoses including both peripheral and central vestibular dysfunction in individual patients increasing the chance of missed diagnoses and suboptimal treatment; (ii) an impaired response to vestibular rehabilitation since the central mechanisms that mediate rehabilitation related brain plasticity may themselves be disrupted...
February 7, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28211592/a-methodology-for-assessing-deployment-trauma-and-its-consequences-in-oef-oif-ond-veterans-the-tracts-longitudinal-prospective-cohort-study
#14
Regina E McGlinchey, William P Milberg, Jennifer R Fonda, Catherine Brawn Fortier
Many US veterans of Afghanistan and Iraq have multiple physical and psychiatric problems. A major focus of research has been on determining the effects of mild Traumatic Brain Injury (mTBI), but mTBI is rarely diagnosed in the absence of co-occurring conditions such as blast exposure, post-traumatic stress disorder (PTSD), depression, substance abuse, etc. These potentially interactive psychological and physical conditions produce complex patterns of cognitive, psychological, and physical symptoms that impede civilian reintegration and complicate efficient and effective treatment planning...
February 17, 2017: International Journal of Methods in Psychiatric Research
https://www.readbyqxmd.com/read/28209192/learning-from-2523-trauma-deaths-in-india-opportunities-to-prevent-in-hospital-deaths
#15
Nobhojit Roy, Deepa Kizhakke Veetil, Monty Uttam Khajanchi, Vineet Kumar, Harris Solomon, Jyoti Kamble, Debojit Basak, Göran Tomson, Johan von Schreeb
BACKGROUND: A systematic analysis of trauma deaths is a step towards trauma quality improvement in Indian hospitals. This study estimates the magnitude of preventable trauma deaths in five Indian hospitals, and uses a peer-review process to identify opportunities for improvement (OFI) in trauma care delivery. METHODS: All trauma deaths that occurred within 30 days of hospitalization in five urban university hospitals in India were retrospectively abstracted for demography, mechanism of injury, transfer status, injury description by clinical, investigation and operative findings...
February 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28195959/treatment-charges-for-traumatic-brain-injury-among-older-adults-at-a-trauma-center
#16
Jennifer S Albrecht, Julia F Slejko, Deborah M Stein, Gordon S Smith
OBJECTIVE: To provide charge estimates of treatment for traumatic brain injury (TBI), including both hospital and physician charges, among adults 65 years and older treated at a trauma center. METHODS: We identified older adults treated for TBI during 2008-2012 (n = 1843) at Maryland's Primary Adult Resource Center and obtained hospital and physician charges separately. Analyses were stratified by sex and all charges were inflated to 2012 dollars. Total TBI charges were modeled as a function of covariates using a generalized linear model...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28195956/group-based-trajectory-analysis-of-emotional-symptoms-among-survivors-after-severe-traumatic-brain-injury
#17
Dianxu Ren, Jun Fan, Ava M Puccio, David O Okonkwo, Sue R Beers, Yvette Conley
OBJECTIVES: Depressive symptoms and anxiety are fairly common emotional outcomes after severe traumatic brain injury (TBI). Life satisfaction is a main factor in the general construct of subjective well-being. However, there is limited literature available on the interrelationship between emotional outcomes and life satisfaction post-severe TBI over time. The purpose of this study was to characterize distinct patterns of change in depressive symptoms, anxiety, and life satisfaction over 24 months after severe TBI and evaluate the interrelationship of different trajectory groups among them as well as associated subject characteristics...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28195568/military-deployment-correlates-with-smaller-prefrontal-gray-matter-volume-and-psychological-symptoms-in-a-subclinical-population
#18
O Butler, J Adolf, T Gleich, G Willmund, P Zimmermann, U Lindenberger, J Gallinat, S Kühn
Research investigating the effects of trauma exposure on brain structure and function in adults has mainly focused on post-traumatic stress disorder (PTSD), whereas trauma-exposed individuals without a clinical diagnoses often serve as controls. However, this assumes a dichotomy between clinical and subclinical populations that may not be supported at the neural level. In the current study we investigate whether the effects of repeated or long-term stress exposure on brain structure in a subclinical sample are similar to previous PTSD neuroimaging findings...
February 14, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28192567/development-and-internal-validation-of-a-clinical-risk-score-for-treating-children-with-mild-head-trauma-and-intracranial-injury
#19
Jacob K Greenberg, Yan Yan, Christopher R Carpenter, Angela Lumba-Brown, Martin S Keller, Jose A Pineda, Ross C Brownson, David D Limbrick
Importance: The appropriate treatment of children with mild traumatic brain injury (mTBI) and intracranial injury (ICI) on computed tomographic imaging remains unclear. Evidence-based risk assessments may improve patient safety and reduce resource use. Objective: To derive a risk score predicting the need for intensive care unit observation in children with mTBI and ICI. Design, Setting, and Participants: This retrospective analysis of the prospective Pediatric Emergency Care Applied Research Network (PECARN) head injury cohort study included patients enrolled in 25 North American emergency departments from 2004 to 2006...
February 13, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28192386/spectrum-of-magnetic-resonance-imaging-features-in-unilateral-optic-tract-dysfunction
#20
Kristopher M Kowal, Francisco F Rivas Rodriguez, Ashok Srinivasan, Jonathan D Trobe
BACKGROUND: Optic tract dysfunction may be the predominant or only clinical manifestation of an intracranial disorder including mass legion, ischemic infarct, inflammatory disease, and trauma. Documentation of the neuroimaging features of these lesions is limited to reports mostly published before the availability of MRI. This study was undertaken to document the spectrum of MRI features in patients presenting with optic tract dysfunction. METHODS: A retrospective study from 2004 to 2015 at a single tertiary care neuro-ophthalmology service of 24 patients who had unilateral optic tract dysfunction defined by a homonymous hemianopia and a relative afferent pupil defect that could not be attributed to optic neuropathy or retinopathy...
March 2017: Journal of Neuro-ophthalmology: the Official Journal of the North American Neuro-Ophthalmology Society
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