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https://www.readbyqxmd.com/read/28432539/early-onset-ventilator-associated-pneumonia-in-patients-with-severe-traumatic-brain-injury-incidence-risk-factors-and-consequences-in-cerebral-oxygenation-and-outcome
#1
Pierre Esnault, Cédric Nguyen, Julien Bordes, Erwan D'Aranda, Ambroise Montcriol, Claire Contargyris, Jean Cotte, Philippe Goutorbe, Christophe Joubert, Arnaud Dagain, Henry Boret, Eric Meaudre
BACKGROUND: Early-onset ventilator-associated pneumonia (EOVAP) occurs frequently in severe traumatic brain-injured patients, but potential consequences on cerebral oxygenation and outcome have been poorly studied. The objective of this study was to describe the incidence, risk factors for, and consequences on cerebral oxygenation and outcome of EOVAP after severe traumatic brain injury (TBI). METHODS: We conducted a retrospective, observational study including all intubated TBI admitted in the trauma center...
April 21, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28430697/abusive-head-trauma-and-mortality-an-analysis-from-an-international-comparative-effectiveness-study-of-children-with-severe-traumatic-brain-injury
#2
Nikki Miller Ferguson, Ajit Sarnaik, Darryl Miles, Nadeem Shafi, Mark J Peters, Edward Truemper, Monica S Vavilala, Michael J Bell, Stephen R Wisniewski, James F Luther, Adam L Hartman, Patrick M Kochanek
OBJECTIVES: Small series have suggested that outcomes after abusive head trauma are less favorable than after other injury mechanisms. We sought to determine the impact of abusive head trauma on mortality and identify factors that differentiate children with abusive head trauma from those with traumatic brain injury from other mechanisms. DESIGN: First 200 subjects from the Approaches and Decisions in Acute Pediatric Traumatic Brain Injury Trial-a comparative effectiveness study using an observational, cohort study design...
April 20, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28429407/spinal-cord-injury-induces-widespread-chronic-changes-in-cerebral-white-matter
#3
Tero Ilvesmäki, Eerika Koskinen, Antti Brander, Teemu Luoto, Juha Öhman, Hannu Eskola
Traumatic spinal cord injuries (SCIs) lead to axonal damage at the trauma site, as well as disconnections within the central nervous system. While the exact mechanisms of the long-term pathophysiological consequences of SCIs are not fully understood, it is known that neuronal damage and degeneration are not limited to the direct proximity of the trauma. Instead, the effects can be detected even in the cerebrum. We examined SCI-induced chronic brain changes with a case-control design using 32 patients and 70 control subjects...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28429381/the-structural-connectome-of-children-with-traumatic-brain-injury
#4
Marsh Königs, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan, Petra J W Pouwels
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+) , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28429236/the-course-of-headache-in-patients-with-moderate-to-severe-headache-due-to-mild-traumatic-brain-injury-a-retrospective-cross-sectional-study
#5
Chang-Ki Hong, Jin-Yang Joo, Yu Shik Shim, Sook Young Sim, Min A Kwon, Yong Bae Kim, Joonho Chung
BACKGROUND: Little is known about the long-term course of headache in patients with moderate-to-severe headache due to traumatic brain injury (TBI). We evaluated the course of headache in patients with moderate-to-severe headache due to mild TBI. METHODS: Since September 2009, patients with TBI prospectively rated their headache using a numeric rating scale (NRS). From the database containing 935 patients with TBI between September 2009 and December 2013, 259 patients were included according to following criteria: (1) newly onset moderate-to-severe headache (NRS ≥ 4) due to head trauma; (2) age ≥ 15 years; (3) Glasgow Coma Scale ≥ 13; (4) transient loss of consciousness ≤ 30 min; and (5) radiographic evaluation, such as computed tomography or magnetic resonance image...
December 2017: Journal of Headache and Pain
https://www.readbyqxmd.com/read/28422895/diffusion-tensor-tractography-for-detection-of-concomitant-traumatic-brain-injury-in-patients-with-traumatic-spinal-cord-injury
#6
Sung Ho Jang, Sang Ho Ahn, Yun Woo Cho, Ji Woon Lim, Ik Tae Cho
OBJECTIVES: We investigated concomitant traumatic brain injury in patients with traumatic spinal cord injury (TSCI) who had head trauma history, using diffusion tensor tractography (DTT). DESIGN: Retrospective survey. PARTICIPANTS: We recruited 14 consecutive patients with TSCI and coexisting head trauma history at the time of TSCI and 30 control subjects. METHODS: The corticospinal tract (CST), corticoreticulospinal tract (CRT), cingulum, and fornix were reconstructed using DTT, and DTT parameters (fractional anisotropy and fiber volume) and configuration were estimated...
January 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#7
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28419114/h-fabp-a-new-biomarker-to-differentiate-between-ct-positive-and-ct-negative-patients-with-mild-traumatic-brain-injury
#8
Linnéa Lagerstedt, Juan José Egea-Guerrero, Alejandro Bustamante, Joan Montaner, Ana Rodríguez-Rodríguez, Amir El Rahal, Natacha Turck, Manuel Quintana, Roser García-Armengol, Carmen Melinda Prica, Elisabeth Andereggen, Lara Rinaldi, Asita Sarrafzadeh, Karl Schaller, Jean-Charles Sanchez
The majority of patients with mild traumatic brain injury (mTBI) will have normal Glasgow coma scale (GCS) of 15. Furthermore, only 5%-8% of them will be CT-positive for an mTBI. Having a useful biomarker would help clinicians evaluate a patient's risk of developing intracranial lesions. The S100B protein is currently the most studied and promising biomarker for this purpose. Heart fatty-acid binding protein (H-FABP) has been highlighted in brain injury models and investigated as a biomarker for stroke and severe TBI, for example...
2017: PloS One
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#9
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28416561/requirements-for-and-current-provision-of-rehabilitation-services-for-children-after-severe-acquired-brain-injury-in-the-uk-a-population-based-study
#10
Louise Hayes, Simon Shaw, Mark S Pearce, Rob J Forsyth
OBJECTIVES: Survival with brain injury is an outcome of severe illness that may be becoming more common. Provision for children in this situation has received little attention. We sought to estimate rates of severe paediatric acquired brain injury (ABI) requiring rehabilitation and to describe current provision of services for these children in the UK. METHODS: This study conducted an analysis of Hospital Episode Statistics data between April 2003 and March 2012, supplemented by a UK provider survey completed in 2015...
April 17, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28408294/resilience-and-cross-network-connectivity-a-neural-model-for-post-trauma-survival
#11
Marcella Brunetti, Laura Marzetti, Gianna Sepede, Filippo Zappasodi, Vittorio Pizzella, Fabiola Sarchione, Federica Vellante, Giovanni Martinotti, Massimo Di Giannantonio
Literature on the neurobiological bases of Post-Traumatic Stress Disorder (PTSD) considers medial Prefrontal cortex (mPFC), a core region of the Default Mode Network (DMN), as a region involved in response regulation to stressors. Disrupted functioning of the DMN has been recognized at the basis of the pathophysiology of a number of mental disorders. Furthermore, in the evaluation of the protective factors to trauma consequence, an important role has been assigned to resilience. Our aim was to investigate the specific relation of resilience and PTSD symptoms severity with resting state brain connectivity in a traumatized population using magnetoencephalography (MEG), a non-invasive imaging technique with high temporal resolution and documented advantages in clinical applications...
April 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28406438/u-s-trends-of-ed-visits-for-pediatric-traumatic-brain-injuries-implications-for-clinical-trials
#12
Cheng Chen, Junxin Shi, Rachel M Stanley, Eric A Sribnick, Jonathan I Groner, Henry Xiang
Our goal in this paper was to use the 2006-2013 Nationwide Emergency Department Sample (NEDS) database to describe trends of annual patient number, patient demographics and hospital characteristics of pediatric traumatic brain injuries (TBI) treated in U.S. emergency departments (EDs); and to use the same database to estimate the available sample sizes for various clinical trials of pediatric TBI cases. National estimates of patient demographics and hospital characteristics were calculated for pediatric TBI...
April 13, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28400228/keen-s-point-for-external-ventricular-drainage-in-traumatic-brain-injury-patients-an-uncommon-indication-for-an-old-technique
#13
Kevin T Huang, Vamsidhar Chavakula, William B Gormley
BACKGROUND: In cases of severe traumatic brain injury (TBI), cerebrospinal fluid (CSF) diversion though an external ventricular drain (EVD) is a proven method to assist in the control of elevated intracranial pressure (ICP). Under normal circumstances, the EVD is placed in a frontal location. However, in cases of multifocal intracranial injury and swelling, collapse of the frontal horns of the lateral ventricles leads to frequent failure of frontal CSF drainage. In this series we describe the utility of the Keen's point EVD as a safe alternative to maintain continuous CSF diversion for patients in whom frontal drainage is not feasible...
April 8, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28398926/early-systolic-dysfunction-following-traumatic-brain-injury-a-cohort-study
#14
Vijay Krishnamoorthy, Ali Rowhani-Rahbar, Edward F Gibbons, Frederick P Rivara, Nancy R Temkin, Crystal Pontius, Kevin Luk, Morgan Graves, Danielle Lozier, Nophanan Chaikittisilpa, Taniga Kiatchai, Monica S Vavilala
OBJECTIVE: Prior studies have suggested that traumatic brain injury may affect cardiac function. Our study aims were to determine the frequency, longitudinal course, and admission risk factors for systolic dysfunction in patients with moderate-severe traumatic brain injury. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. MEASUREMENTS: Transthoracic echocardiogram within 1 day and over the first week after moderate-severe traumatic brain injury; transthoracic echocardiogram within 1 day after mild traumatic brain injury (comparison group)...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28396009/molecular-mechanisms-of-brain-derived-neurotrophic-factor-in-neuro-protection-recent-developments
#15
REVIEW
Hailin Zhao, Azeem Alam, Chun-Yin San, Shiori Eguchi, Qian Chen, Qingquan Lian, Daqing Ma
Neuronal cell injury, as a consequence of acute or chronic neurological trauma, is a significant cause of mortality around the world. On a molecular level, the condition is characterized by widespread cell death and poor regeneration, which can result in severe morbidity in survivors. Potential therapeutics are of major interest, with a promising candidate being brain-derived neurotrophic factor (BDNF), a ubiquitous agent in the brain which has been associated with neural development and may facilitate protective and regenerative effects following injury...
April 7, 2017: Brain Research
https://www.readbyqxmd.com/read/28393708/minor-head-trauma-in-the-pediatric-emergency-department-decision-making-nodes
#16
Mario Mastrangelo, Fabio Midulla
BACKGROUND: Minor head trauma is one of the leading cause of access to pediatric emergency departments with only a limited quote of patients resulting in clinically relevant brain injuries. OBJECTIVES: The aim of this review is to guide physicians involved in the management of pediatric head trauma towards a correct clinical approach. METHODS: A Pubmed/Medline search was realized through different entries including "minor head trauma" or "mild head trauma", "minor head injury" or "mild head injury", "acute head trauma"...
April 4, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/28389734/-intensive-care-treatment-of-traumatic-brain-injury-in-multiple-trauma-patients-decision-making-for-complex-pathophysiology
#17
H Trimmel, G Herzer, H Schöchl, W G Voelckel
Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients...
April 7, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28389109/problem-solving-following-traumatic-brain-injury-in-adolescence-associations-with-functional-outcomes
#18
Shari L Wade, Amy E Cassedy, Lauren E Fulks, H Gerry Taylor, Terry Stancin, Michael W Kirkwood, Keith O Yeates, Brad G Kurowski
OBJECTIVE: To examine the association of problem solving with functioning in youth with traumatic brain injury (TBI). DESIGN: Cross-sectional evaluation of pre-treatment data from a randomized clinical trial. SETTING: Four children's hospitals and one general hospital, with level 1 trauma units. PARTICIPANTS: Youth, ages 11 to 18, who sustained moderate or severe TBI in the past 18 months (n = 133). MAIN OUTCOME AND MEASURES: Problem-solving skills were assessed using the Social Problem Solving Inventory (SPSI) and the Dodge Social Information Processing Short Stories (SIP-SR)...
April 4, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28387644/medical-necessity-of-routine-admission-of-children-with-mild-traumatic-brain-injury-to-the-intensive-care-unit
#19
Jared D Ament, Krista N Greenan, Patrick Tertulien, Joseph M Galante, Daniel K Nishijima, Marike Zwienenberg
OBJECTIVE Approximately 475,000 children are treated for traumatic brain injury (TBI) in the US each year; most are classified as mild TBI (Glasgow Coma Scale [GCS] Score 13-15). Patients with positive findings on head CT, defined as either intracranial hemorrhage or skull fracture, regardless of severity, are often transferred to tertiary care centers for intensive care unit (ICU) monitoring. This practice creates a significant burden on the health care system. The purpose of this investigation was to derive a clinical decision rule (CDR) to determine which children can safely avoid ICU care...
April 7, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28385926/critical-care-air-transport-team-severe-traumatic-brain-injury-short-term-outcomes-during-flight-for-operation-iraqi-freedom-operation-enduring-freedom
#20
L Renee Boyd, J Borawski, J Lairet, A T Limkakeng
INTRODUCTION: Our understanding of the expertise and equipment required to air transport injured soldiers with severe traumatic brain injuries (TBIs) continue to evolve. METHODS: We conducted a retrospective chart review of characteristics, interventions required and short-term outcomes of patients with severe TBI managed by the US Air Force Critical Care Air Transport Teams (CCATTs) deployed in support of Operation Iraqi Freedom and Operation Enduring Freedom between 1 June 2007 and 31 August 2010...
April 6, 2017: Journal of the Royal Army Medical Corps
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