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William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Seung Yoon Song, Sang Koo Lee, Ki Seong Eom
OBJECTIVE: The aims of the Korean Neuro-Trauma Data Bank System (KNTDBS) are to evaluate and improve treatment outcomes for brain trauma, prevent trauma, and provide data for research. Our purpose was to examine the mortality rates following traumatic brain injury (TBI) in a retrospective study and to investigate the sociodemographic variables, characteristics, and causes of TBI-related death based on data from the KNTDBS. METHODS: From 2010 to 2014, we analyzed the data of 2617 patients registered in the KNTDBS...
September 2016: Journal of Korean Neurosurgical Society
Maryse C Cnossen, Suzanne Polinder, Hester F Lingsma, Andrew I R Maas, David Menon, Ewout W Steyerberg
INTRODUCTION: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
2016: PloS One
Joanna L C Wheble, D K Menon
Each year, approximately 2.5 million people experience some form of traumatic brain injury (TBI) in Europe. One million of these are admitted to hospital and 75 000 will die. TBI represents a major cause of death and disability, particularly among those of working age. Substantial investments have been made in an effort to improve diagnosis, management and survival in TBI, but with little success. The Collaborative European Neuro-Trauma Effectiveness Research in TBI (CENTER-TBI) study promises to use the natural variability seen in the management of TBI across Europe with the application of Comparative Effectiveness Research (CER)...
April 2016: Journal of the Royal Army Medical Corps
Sandra C Yan, Timothy R Smith, Wenya Linda Bi, Ryan Brewster, William B Gormley, Ian F Dunn, Edward R Laws
Abraham Lincoln was the 16(th) President of the United States of America. On April 14, 1865, shortly after his re-election and the conclusion of the Civil War, Lincoln was shot and killed by John Wilkes Booth. Although numerous physicians tended to the President shortly after his injury, he passed away the next morning. Today, we recognize Lincoln as one of the greatest Presidents in American history. His assassination profoundly influenced the future of the United States, especially as the country was coming back together again following the Civil War...
November 2015: World Neurosurgery
Pierpaolo Terragni, Luciana Mascia, Chiara Faggiano, Tommaso Tenaglia, Emanuela Morello, Giovanni Succo, Marco Ranieri, Luca Brazzi
BACKGROUND: Ciaglia et al. originally proposed the percutaneous tracheostomy in 1985 as an alternative to the surgical approach. Several variants have been developed in the years with a convincing evidence that, compared to surgical tracheostomy, the percutaneous approach is more cost-effective without compromising safety. However the procedure is not immune from complications and requires procedural skills and adequate level of expertise with a steep learning curve. In this contest, to optimize safety and efficacy of percutaneous tracheostomy in different clinical scenarios, physicians should be familiar with the different available percutaneous techniques...
February 2016: Minerva Anestesiologica
Bernadette T Gillick, Wendy J Marshall, Wendy Rheault, Judy Stoecker
BACKGROUND AND PURPOSE: Few studies have explored optimal advancement and variation in mobility and length of stay (LOS) data with critically ill patients in the intensive care unit (ICU). The purpose of this study was to analyze the outcomes and LOS of critically ill patients in the neurotrauma ICU involved in rehabilitation. METHODS: A bidirectional case-control study of a total of 30 patients admitted to a level 1 trauma hospital in the metropolitan Chicago area with Glasgow Coma Score (GCS) of ≤12 (3-12) were studied...
October 2011: Neurohospitalist
Valerie D Johnson, John Whitcomb
INTRODUCTION: : This study compares the Full Outline of Unresponsiveness (FOUR) Score scale with the Glasgow Coma Scale (GCS) when evaluating a patient's level of responsiveness in the neuro/trauma intensive care unit of a large medical center. This new scoring tool evaluates 4 functional categories: eye response, motor response, brainstem reflexes, and respiratory pattern. AIMS AND METHODS: : A total of 57 patients 18 years or older were randomly selected as a convenience sample of those admitted to the neuro/trauma intensive care unit and were assessed using both the standard GCS and the FOUR Score scale...
July 2013: Dimensions of Critical Care Nursing: DCCN
Ashok Munivenkatappa, Dhaval P Shukla, Bhagavatula Indira Devi, Akhil Deepika Kumarsamy, Dhananjay I Bhat, Sampath Somanna
CONTEXT: Experience of animal-related neurotrauma at an apex institute, National Institute of Mental Health and Neurosciences, Bangalore, India. AIMS: The aim of this study is to review epidemiology, clinical findings, and outcome of animal-related traumatic brain injury (TBI) evaluated and treated at our institute. SETTINGS AND DESIGN: A retrospective study consisting of demographic data, clinical findings, radiological details, and outcomes...
January 2013: Journal of Neurosciences in Rural Practice
Susanne Muehlschlegel, Raphael Carandang, Cynthia Ouillette, Wiley Hall, Fred Anderson, Robert Goldberg
BACKGROUND: Known predictors of adverse outcomes in patients with moderate-severe TBI (msTBI) explain only a relatively small proportion of patient-related outcomes. The frequency and impact of intensive care unit complications (ICU-COMPL) on msTBI-associated outcomes are poorly understood. METHODS: In 213 consecutive msTBI patients admitted to a Level I Trauma Center neuro trauma ICU, twenty-eight ICU-COMPL (21 medical and 7 neurological) were prospectively collected and adjudicated by group consensus, using pre-defined criteria...
June 2013: Neurocritical Care
Deborah M Stein, Peter F Hu, Hegang H Chen, Shiming Yang, Lynn G Stansbury, Thomas M Scalea
BACKGROUND: We asked whether the advanced machine learning applications used in microarray gene profiling could assess critical thresholds in the massive databases generated by continuous electronic physiologic vital signs (VS) monitoring in the neuro-trauma intensive care unit. METHODS: We used Class Prediction Analysis to predict binary outcomes (life/death, good/bad Extended Glasgow Outcome Score, etc.) based on data accrued within 12, 24, 48, and 72 hours after admission to the neuro-trauma intensive care unit...
August 2012: Journal of Trauma and Acute Care Surgery
Tanweer Karim, Margaret Topno
Penetrating head injuries can be the result of numerous intentional or unintentional events, including missile wounds, stab wounds, and motor vehicle or occupational accidents (nails, screw-drivers). Penetrating head injuries in children constitute only a small part of the total number of traumatic head injuries seen in casualty. We report a case of neuro-trauma who was operated in our institution. Patient, 4 years male presented in casualty on 15/01/09 with a iron rod penetrating into the skull.
April 2010: Journal of Emergencies, Trauma, and Shock
Bipin Jose, Naveen Sankhyan, Ravindra Arya, Madhulika Kabra, Sheffali Gulati, R V Azad
Two infants with non-accidental inflicted neuro-trauma are reported. One presented with sudden onset lethargy, respiratory difficulty and unexplained seizures. There were bilateral retinal bleeds and extradural hemorrhage. Other was a well thriving child who had 2 seizures and was noted to lack visual fixation. Retinal hemorrhages and chronic subdural and intraparenchymal hemorrhages were subsequently discovered. We highlight the importance of suspecting child abuse in infants with sudden unexplained unresponsiveness, seizures or respiratory difficulty and the unusual occurrence of extradural hemorrhage...
March 2010: Indian Journal of Pediatrics
A H Akmal, M Hasan, A Mariam
UNLABELLED: Central venous catheter (CVC) placement in the intensive care unit (ICU) is a common practice and is being increasingly used also in general wards. Its use is associated with both mechanical and infectious complications. OBJECTIVE: To determine the infectious and mechanical complication rate of central venous catheterization in an ICU. DESIGN: A retrospective study about complications of 1319 central venous catheter placements...
April 2007: Annals of Thoracic Medicine
Akmal A Hameed, Hasan Mohamed, Mariam Al-Ansari
UNLABELLED: Tracheostomy is one of the most commonly performed procedures in critically ill patients. Over the past 15 years, many large university hospitals have reported their experience with percutaneous dilatational tracheostomy (PDT). We have described and compared our experience with 224 PDTs that we performed in the last four and a half years. We have also compared PDT performed with and without bronchoscopic guidance at our setting and PDT verses surgical tracheostomy. OBJECTIVE: The purposes of this study are to evaluate the safety of PDT in our hospital setting and to compare our results with those published in the literature...
January 2008: Annals of Thoracic Medicine
Houman Khosravani, Reza Shahpori, H Thomas Stelfox, Andrew W Kirkpatrick, Kevin B Laupland
INTRODUCTION: Hyperlactatemia is frequent in critically ill patients and is often used as a marker of adverse outcome. However, studies to date have focused on selected intensive care unit (ICU) populations. We sought to determine the occurrence and relation of hyperlactatemia with ICU mortality in all patients admitted to four ICUs in a large regional critical care system. METHODS: All adults ([greater than or equal to] 18 years) admitted to ICUs in the Calgary Health Region (population 1...
2009: Critical Care: the Official Journal of the Critical Care Forum
Daniel J Niven, Kevin B Laupland, Daniel B Gregson, Deirdre L Church et al.
PURPOSE: To determine the rate of Staphylococcus aureus nasal colonization at admission to intensive care units (ICU) and assess its effect on the development of an ICU-acquired S aureus infection. MATERIALS AND METHODS: We screened all ICU admissions for nasal colonization within the Calgary Health Region from October 2005 to September 2006 and followed up patients to hospital discharge or death or S aureus infection to 30 days. RESULTS: One thousand three hundred eight patients were admitted to ICU for more than 48 hours and screened for nasal colonization...
December 2009: Journal of Critical Care
R K J Murphy, L McEvoy, M O Kelleher, C Bolger, J Phillips
Motorcycles represent less than 2% of the licensed vehicles but motorcyclists account for 12% of road deaths in Ireland. The British Road Safety Authority has introduced the Sharp programme, which hopes to save 50 lives in the U.K. each year alone by helping riders to choose the best-fitting and safest helmets. We evaluated the pattern of head injuries sustained by motorcyclists referred to the two neurosurgical centres Beaumont Hospital and Cork University Hospital in Ireland and ascertained if the new SHARP guidelines could be of benefit in reducing the burden of motorcycle related neurotrauma and disability in Ireland...
April 2009: British Journal of Neurosurgery
Tuong A Mai-Phan, Bijendra Patel, Michael Walsh, Ajit T Abraham, Hemant M Kocher
BACKGROUND: Emergency admissions may account for over 50% of surgical admissions. The impact on service provision and implications for training are difficult to quantify. We performed a cohort study to analyse these workload patterns. METHODS: Data on emergency room (ER) surgical admissions over six months was collected including patient demographics, referral sources, diagnosis, operation and length of stay and analysed according to sub-speciality and age-groups...
2008: World Journal of Emergency Surgery: WJES
S Korfias, G Stranjalis, A Papadimitriou, C Psachoulia, G Daskalakis, A Antsaklis, D E Sakas
S-100 protein, described initially by Moore, constitutes a large family of at least 20 proteins with calcium binding ability. It is found as homo- or hetero-dimers of two different subunits (A and B). Types S-100AB and S-100BB are described as S-100B protein and are shown to be highly specific for nervous tissue. It is present in the cytosol of glial and Schwann cells, and also in adipocytes and chondrocytes, although in very low concentrations in the latter two. The role of protein S-100B is not yet fully understood...
2006: Current Medicinal Chemistry
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