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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/28227478/portable-video-oculography-device-for-implementation-in-sideline-concussion-assessments-a-prototype
#2
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
#3
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
#4
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/28223179/biological-aspects-of-axonal-damage-in-glaucoma-a-brief-review
#5
REVIEW
Ernst R Tamm, C Ross Ethier, Claude Burgoyne, C Ross Ethier, Ernst R Tamm, Cheri Stowell, John E Dowling, Crawford Downs, Mark H Ellisman, Steven Fisher, Brad Fortune, Marcus Fruttiger, Tatjana Jakobs, Geoffrey Lewis, Claire H Mitchell, John Morrison, Sansar C Sharma, Ian Sigal, Michael Sofroniew, Lin Wang, Janey Wiggs, Samuel Wu, Richard H Masland
Intraocular pressure (IOP) is a critical risk factor in glaucoma, and the available evidence derived from experimental studies in primates and rodents strongly indicates that the site of IOP-induced axonal damage in glaucoma is at the optic nerve head (ONH). However, the mechanisms that cause IOP-induced damage at the ONH are far from understood. A possible sequence of events could originate with IOP-induced stress in the ONH connective tissue elements (peripapillary sclera, scleral canal and lamina cribrosa) that leads to an increase in biomechanical strain...
February 18, 2017: Experimental Eye Research
https://www.readbyqxmd.com/read/28220369/severe-head-injury-in-very-old-patients-to-treat-or-not-to-treat-results-of-an-online-questionnaire-for-neurosurgeons
#6
Claudia Unterhofer, Sebastian Hartmann, Christian F Freyschlag, Claudius Thomé, Martin Ortler
Due to the aging population, neurosurgeons are confronted with an increasing number of very old patients suffering from traumatic brain injury. Many of these patients present with an acute subdural hematoma. There is a lack of data on neurosurgical decision-making in elderly people. We investigated the importance of imaging criteria, patients' wishes, their surrogates' wishes, and patient demographics on treatment decisions chosen by neurosurgeons. An online questionnaire was sent to all German neurosurgical units via the German Society of Neurosurgery (DGNC)...
February 20, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28215267/a-community-based-study-of-risk-factors-for-probable-rapid-eye-movement-sleep-behavior-disorder
#7
Jian-Fang Ma, Yuan Qiao, Xiang Gao, Liang Liang, Xiao-Li Liu, Dun-Hui Li, Hui-Dong Tang, Sheng-Di Chen
OBJECTIVES: To cross-sectionally explore the potential risk factors for rapid eye movement (REM) sleep behavior disorder (RBD) in a community cohort in Shanghai. METHODS: Based on the validated RBD screening questionnaire (RBDSQ), we identified individuals with probable RBD (pRBD) in 3635 community-dwelling residents (≥50 years old) from an urban community of Shanghai. Potential risk factors of pRBD, including age, sex, smoking, socioeconomic status, obesity, consumption of tea (surrogate for caffeine intake) and alcohol, medications and chronic disease status, were assessed via questionnaire...
February 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28207508/concussion-mild-traumatic-brain-injury-related-chronic-pain-in-males-and-females-a-diagnostic-modelling-study
#8
Tatyana Mollayeva, J David Cassidy, Colin M Shapiro, Shirin Mollayeva, Angela Colantonio
Pain is an unpleasant, complex, and perceived experience that places a significant burden on patients and clinicians. Its severity may be mediated by emotion, attitude, and environmental influences, and pain may be expressed differently in males and females. Traumatic brain injury (TBI) is frequently associated with chronic pain. This diagnostic modeling study examined sex differences in the construct of chronic pain in patients with delayed recovery from concussion/mild traumatic brain injury (mTBI).Data were collected from standardized questionnaires, neuroimaging records, and comprehensive clinical assessments...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28206931/a-comprehensive-investigation-of-comorbidities-mechanisms-injury-patterns-and-outcomes-in-geriatric-blunt-trauma-patients
#9
Carlos V R Brown, Kevin Rix, Amanda L Klein, Brent Ford, Pedro G R Teixeira, Jayson Aydelotte, Ben Coopwood, Sadia Ali
The geriatric population is growing and trauma providers are often tasked with caring for injuries in the elderly. There is limited information regarding injury patterns in geriatric trauma patients stratified by mechanism of injury. This study intends to investigate the comorbidities, mechanisms, injury patterns, and outcomes in geriatric blunt trauma patients. A retrospective study of the 2012 National Trauma Databank was performed. Adult blunt trauma patients were identified; geriatric (>/=65) patients were compared with younger (<65) patients regarding admission demographics and vital signs, mechanism and severity of injury, and comorbidities...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28194508/open-reduction-and-internal-fixation-for-intraarticular-fracture-of-metacarpal-head
#10
Jun-Ku Lee, Yong-Gil Jo, Ji-Woong Kim, Yun Seong Choi, Soo-Hong Han
Intraarticular fracture of the metacarpophalangeal (MP) joint presents complex problems related to the sophisticated functional aspects of the hand. Injury to the metacarpal head may have a severe effect on hand function but few studies have investigated the management of this condition. In this study, we applied open reduction and internal fixation for the displaced fracture of the metacarpal head and report the clinical and radiographic outcomes of our experience. Thirteen patients (12 men, 1 woman; mean age 21 years) were included in this study, and medical records and radiographs were reviewed retrospectively...
February 13, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28194285/cerebral-salt-wasting-syndrome-caused-by-minor-head-injury
#11
Toshiki Fukuoka, Yuko Tsurumi, Arihito Tsurumi
A 34-year-old woman was admitted to hospital after sustaining a head injury in a motor vehicle accident (day 1). No signs of neurological deficit, skull fracture, brain contusion, or intracranial bleeding were evident. She was discharged without symptoms on day 4. However, headache and nausea worsened on day 8, at which time serum sodium level was noted to be 121 mEq/L. Treatment with sodium chloride was initiated, but serum sodium decreased to 116 mEq/L on day 9. Body weight decreased in proportion to the decrease in serum sodium...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28192452/increased-risk-of-dementia-in-patients-hospitalized-with-acute-kidney-injury-a-nationwide-population-based-cohort-study
#12
Hsin-Hsi Tsai, Ruoh-Fang Yen, Cheng-Li Lin, Chia-Hung Kao
PURPOSE: To determine whether acute kidney injury (AKI) is a risk factor for dementia. METHODS: This nationwide population-based cohort study was based on data from the Taiwan National Health Insurance Research Database for 2000-2011. The incidence and relative risk of dementia were assessed in 207788 patients hospitalized for AKI. The comparison control was selected using the propensity score based on age, sex, index year and comorbidities. RESULTS: During the 12-year follow-up, patients with AKI had a significantly higher incidence for developing dementia than did the controls (8...
2017: PloS One
https://www.readbyqxmd.com/read/28188728/trabeculectomy-bleb-associated-infections
#13
REVIEW
M Reza Razeghinejad, Shane J Havens, L Jay Katz
Trabeculectomy with antimetabolites is the most commonly performed surgery worldwide for glaucoma patients with progressive optic nerve head injury and visual field loss despite maximum pharmacologic intraocular pressure (IOP) lowering therapy. Trabeculectomy bleb-associated infections (BAI) remain one of the most feared early and long-term complications of trabeculectomy surgery because of their poor prognosis and variable response to antimicrobial therapy. Several studies have evaluated how surgical technique, conjunctival incision location, comorbid ocular pathology, concurrent medication use, and bleb morphology affect the risk of BAI...
February 7, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28188356/brain-trauma-foundation-guidelines-for-intracranial-pressure-monitoring-compliance-and-effect-on-outcome
#14
Alberto Aiolfi, Elizabeth Benjamin, Desmond Khor, Kenji Inaba, Lydia Lam, Demetrios Demetriades
BACKGROUND: Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring in patients who sustained severe traumatic brain injury (TBI). Compliance to BTF guidelines is variable, and the effect of ICP monitoring on outcomes remains a controversial issue. The purpose of this study was to assess guidelines compliance in patients who sustain a severe TBI and to analyze the effect of ICP monitoring on outcomes. METHODS: Trauma Quality Improvement Program database study, which included patients with isolated severe blunt head trauma (head Abbreviated Injury Scale ≥3 with Glasgow Coma Scale <9)...
February 10, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28188219/distinct-effects-of-mir-210-reduction-on-neurogenesis-increased-neuronal-survival-of-inflammation-but-reduced-proliferation-associated-with-mitochondrial-enhancement
#15
Ludmila A Voloboueva, Xiaoyun Sun, Lijun Xu, Yi-Bing Ouyang, Rona G Giffard
Neurogenesis is essential to brain development, and plays a central role in the response to brain injury. Stroke and head trauma stimulate proliferation of endogenous neural stem cells (NSC). However, the survival of young neurons is sharply reduced by post-injury inflammation. Cellular mitochondria are critical to successful neurogenesis and are a major target of inflammatory injury. Mitochondrial protection was shown to improve survival of young neurons. This study tested whether reducing cellular microRNA-210 (miR-210) would enhance mitochondrial function and improve survival of young murine neurons under inflammatory conditions...
February 10, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
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
#16
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/28183726/injury-region-and-risk-of-hospital-acquired-pneumonia-among-pediatric-trauma-patients
#17
Gretchen J Cutler, Anupam B Kharbanda, Jeffrey Nowak, Henry W Ortega
OBJECTIVE: To describe the relationship between injury region and risk of hospital-acquired pneumonia (HAP) in pediatric trauma patients. METHODS: Analyses included patients <19 years of age from the National Trauma Data Bank, during 2009-2011. Multivariable logistic regression was used to examine the association between injury region and odds of developing HAP stratified by age group. RESULTS: A total of 71 377 patients were eligible for analysis, and 1818 patients developed pneumonia...
February 9, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28180920/injury-mechanism-of-midfacial-fractures-in-football-causes-in-over-40-typical-neurological-symptoms-of-minor-brain-injuries
#18
Volker Krutsch, Markus Gesslein, Oliver Loose, Johannes Weber, Michael Nerlich, Axel Gaensslen, Viktor Bonkowsky, Werner Krutsch
PURPOSE: The injury mechanisms of midfacial fractures may be typical causes of concussion, but hardly any scientific data on midfacial injuries sustained in football are available. Head and brain trauma represent frequent injuries in athletes of different sports that require appropriate treatment by sports and trauma physicians. This study investigated the management of midfacial fractures in football and the association of such fractures with concomitant brain injury. METHODS: In a prospective cohort study lasting 24 months (2012 to 2013), midfacial injuries of football players were analysed with regard to the injury mechanisms, first aid procedures on the field, treatment and return-to-play...
February 8, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28180123/repetitive-traumatic-brain-injury-in-patients-from-kashan-iran
#19
Esmaeil Fakharian, Mahdi Mohammadzadeh, Shirin Behdadmehr, Hamid Reza Sabri, Azadeh Sadat Mirzadeh, Javad Mohammadzadeh
BACKGROUND: Traumatic brain injury (TBI) is a worldwide problem, especially in countries with high incidence of road traffic accidents such as Iran. Patients with a single occurrence of TBI have been shown to be at increased risk to sustain future TBI. OBJECTIVES: The aim of this study was to present the incidence and characteristics of repeated TBI (RTBI) in Iranian patients. PATIENTS AND METHODS: During one year, all admitted TBI patients with prior TBI history were enrolled into the study...
September 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
#20
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
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