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https://www.readbyqxmd.com/read/29166203/temporal-profile-of-care-following-mild-traumatic-brain-injury-predictors-of-hospital-admission-follow-up-referral-and-six-month-outcome
#1
John K Yue, Ethan A Winkler, Sourabh Sharma, Mary J Vassar, Jonathan J Ratcliff, Frederick K Korley, Seth A Seabury, Adam R Ferguson, Hester F Lingsma, Sacha Meeuws, Opeolu M Adeoye, Jonathan W Rick, Caitlin K Robinson, Siena M Duarte, Esther L Yuh, Pratik Mukherjee, Sureyya S Dikmen, Thomas W McAllister, Ramon Diaz-Arrastia, Alex B Valadka, Wayne A Gordon, David O Okonkwo, Geoffrey T Manley
OBJECTIVE: To investigate the clinical management and medical follow-up of patients with mild traumatic brain injury (mTBI) presenting to emergency departments (EDs). METHODS: Overall, 168 adult patients with mTBI from the prospective, multicentre Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) Pilot study with Glasgow Coma Scale (GCS) 13-15, no polytrauma and alive at six months were included. Predictors for hospital admission, three-month follow-up referral and six-month functional disability (Glasgow Outcome Scale-Extended (GOSE) ≤ 6) were analysed using multivariable regression...
2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29165784/interventions-for-managing-skeletal-muscle-spasticity-following-traumatic-brain-injury
#2
REVIEW
Anneliese Synnot, Marisa Chau, Veronica Pitt, Denise O'Connor, Russell L Gruen, Jason Wasiak, Ornella Clavisi, Loyal Pattuwage, Kate Phillips
BACKGROUND: Skeletal muscle spasticity is a major physical complication resulting from traumatic brain injury (TBI), which can lead to muscle contracture, joint stiffness, reduced range of movement, broken skin and pain. Treatments for spasticity include a range of pharmacological and non-pharmacological interventions, often used in combination. Management of spasticity following TBI varies from other clinical populations because of the added complexity of behavioural and cognitive issues associated with TBI...
November 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29165777/the-use-of-crystalloids-in-traumatic-brain-injury
#3
Wojciech Dąbrowski, Tom Woodcock, Ziemowit Rzecki, Manu L N G Malbrain
Fluid therapy is one of the most important treatments in patients with traumatic brain injury (TBI) as both hypo- and hypervolaemia can cause harm. The main goals of fluid therapy for patients with TBI are to optimize cerebral perfusion and to maintain adequate cerebral oxygenation. The avoidance of cerebral oedema is clearly essential. The current weight of evidence in the published literature suggests that albumin therapy is harmful and plasma substitutes have failed to demonstrate superiority over crystalloids solutions...
November 22, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29165744/hypothermia-therapy-after-traumatic-brain-injury-a-systematic-review-and-meta-analysis
#4
Lige Leng
The purpose of this article was mainly focus on in patients with TBI, does or not hypothermia improved mortality and/or chance of good neurologic outcome compared with standard of care alone. We performed a comprehensive search strategy. Articles were eliminated in a stepwise fashion. Data from each study was entered in Review Manager (RevMan) software version 5.0 when reported. 7 studies, including 1331 patients confirmed to all selection criteria and were identified. This meta-analysis got all data of 7 articles together to come to a conclusion, besides that, it also carried on a detailed analysis of different classification, trying to outline the possible mechanism...
October 29, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/29165556/resumption-of-oral-anticoagulation-following-traumatic-injury-and-risk-of-stroke-and-bleeding-in-patients-with-atrial-fibrillation-a-nationwide-cohort-study
#5
Laila Staerk, Emil Loldrup Fosbøl, Morten Lamberts, Anders Nissen Bonde, Kasper Gadsbøll, Caroline Sindet-Pedersen, Ellen A Holm, Thomas Alexander Gerds, Brice Ozenne, Gregory Y H Lip, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Jonas Bjerring Olesen
Aims: We examined the risks of all-cause mortality, stroke, major bleeding, and recurrent traumatic injury associated with resumption of vitamin K antagonists (VKAs) and non-VKAs oral anticoagulants (NOACs) following traumatic injury in atrial fibrillation (AF) patients. Methods and results: This was a Danish nationwide registry-based study (2005-16), including 4541 oral anticoagulant (OAC)-treated AF patients experiencing traumatic injury (defined as traumatic brain injury, hip fracture, or traumatic torso or abdominal injury)...
November 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29163337/disrupted-gamma-synchrony-after-mild-traumatic-brain-injury-and-its-correlation-with-white-matter-abnormality
#6
Chao Wang, Michelle E Costanzo, Paul E Rapp, David Darmon, Dominic E Nathan, Kylee Bashirelahi, Dzung L Pham, Michael J Roy, David O Keyser
Mild traumatic brain injury (mTBI) has been firmly associated with disrupted white matter integrity due to induced white matter damage and degeneration. However, comparatively less is known about the changes of the intrinsic functional connectivity mediated via neural synchronization in the brain after mTBI. Moreover, despite the presumed link between structural and functional connectivity, no existing studies in mTBI have demonstrated clear association between the structural abnormality of white matter axons and the disruption of neural synchronization...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29163326/systematic-review-of-traumatic-brain-injuries-in-baseball-and-softball-a-framework-for-prevention
#7
Michael D Cusimano, Alice Zhu
Background: Traumatic brain injuries (TBIs) are an important public health challenge. The classification of baseball and softball as low contact sports and their association with extremity injuries cause individuals to overlook the risk of TBI in baseball and softball. Purpose: To summarize our knowledge of the epidemiology and risk factors of TBIs associated with baseball and softball with an aim to better design and implement preventive strategies. Methods: A search algorithm containing keywords that were synonymous to the terms "TBI," "baseball" was applied to the following nine databases: MEDLINE, Scopus, PubMed, EMBASE, CINAHL, Healthstar, PsychINFO, AMED, Cochrane library...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29163104/transcranial-random-noise-stimulation-does-not-improve-behavioral-and-neurophysiological-measures-in-patients-with-subacute-vegetative-unresponsive-wakefulness-state-vs-uws
#8
Mauro Mancuso, Laura Abbruzzese, Stefania Canova, Giulia Landi, Simone Rossi, Emiliano Santarnecchi
Background: The absence of efficient treatments capable to promote central nervous system recovery in patients in vegetative state (VS) due to a severe acquired brain injury highlights the need of exploring alternative neuromodulatory treatments that can lead to neurobehavioral gains. Some encouraging preliminary observations suggest that transcranial direct current stimulation could be effective in disorders of consciousness (DoC) patients, especially when applied on the dorsolateral prefrontal cortex (DLPFC) in patients with minimally conscious state (MCS) but not in those with VS...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/29162596/lactadherin-promotes-microvesicle-clearance-to-prevent-coagulopathy-and-improves-survival-of-severe-tbi-mice
#9
Yuan Zhou, Wei Cai, Zilong Zhao, Tristan Hilton, Min Wang, Jason Yeon, Wei Liu, Fangyi Zhang, Fu-Dong Shi, Xiaoping Wu, Perumal Thiagarajan, Min Li, Jianning Zhang, Jing-Fei Dong
Coagulopathy is common in patients with traumatic brain injury (TBI) and predicts poor clinical outcomes. We have shown that brain-derived extracellular microvesicles, including extracellular mitochondria, play a key role in the development of TBI-induced coagulopathy. Here, we further show in mouse models that the apoptotic cell-scavenging factor lactadherin, given at a single dose of 400 µg/kg 30 min before (preconditioning) or 30 min after cerebral fluid percussion injury, prevented coagulopathy as defined by clotting time, fibrinolysis, intravascular fibrin deposition, and microvascular bleeding of the lungs...
November 21, 2017: Blood
https://www.readbyqxmd.com/read/29162266/plasma-free-carnitine-in-severe-trauma-influence-of-the-association-with-traumatic-brain-injury
#10
Fanny Vardon Bounes, Géraldine Faure, Antoine Rouget, Jean-Marie Conil, Bernard Georges, Thomas Geeraerts, Olivier Fourcade, Vincent Minville, Clément Delmas
BACKGROUND: Metabolic response to severe trauma requires early nutritional resuscitation. Carnitine is essential for lipolysis, the energy source during this hypercatabolic phase. However l-carnitine is not present in nutritional replacement solutions. Furthermore, free carnitine depletion, defined as carnitine plasma level under 36μmol/L, was not adequately reported in adult patients with severe trauma. The aim of this study was to assess plasma free carnitine levels and factors of variation in severe trauma...
November 15, 2017: Injury
https://www.readbyqxmd.com/read/29162086/tribes-and-tribulations-interdisciplinary-ehealth-in-providing-services-for-people-with-a-traumatic-brain-injury-tbi
#11
M Hines, M Brunner, S Poon, M Lam, V Tran, D Yu, L Togher, T Shaw, E Power
BACKGROUND: eHealth has potential for supporting interdisciplinary care in contemporary traumatic brain injury (TBI) rehabilitation practice, yet little is known about whether this potential is being realised, or what needs to be done to further support its implementation. The purpose of this study was to explore health professionals' experiences of, and attitudes towards eHealth technologies to support interdisciplinary practice within rehabilitation for people after TBI. METHODS: A qualitative study using narrative analysis was conducted...
November 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29162023/pentobarbital-removal-during-continuous-venovenous-hemofiltration-case-report-and-review-of-the-literature
#12
David M Hensler, Deepika P McConnell, Kimberly E Levasseur-Franklin, Kasey M Greathouse
BACKGROUND: Renal replacement therapy may enhance the elimination of barbiturates. Pentobarbital clearance during continuous venovenous hemofiltration (CVVH) has not been described previously. We report a patient case involving the measurement of serial pentobarbital levels during CVVH and review relevant literature characterizing extracorporeal pentobarbital elimination. METHODS: The following is a retrospective report of a previously healthy 26-year-old woman who sustained a severe traumatic brain injury (TBI) and required administration of pentobarbital on hospital day 0 for intracranial pressure (ICP) control...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29161339/astrocyte-specific-deletion-of-sox2-promotes-functional-recovery-after-traumatic-brain-injury
#13
Chunhai Chen, Xiaoling Zhong, Derek K Smith, Wenjiao Tai, Jianjing Yang, Yuhua Zou, Lei-Lei Wang, Jiahong Sun, Song Qin, Chun-Li Zhang
Injury to the adult brain induces activation of local astrocytes, which serves as a compensatory response that modulates tissue damage and recovery. However, the mechanism governing astrocyte activation during brain injury remains largely unknown. Here we provide in vivo evidence that SOX2, a transcription factor critical for stem cells and brain development, is also required for injury-induced activation of adult cortical astrocytes. Genome-wide chromatin immunoprecipitation-seq analysis of mouse cortical tissues reveals that SOX2 binds to regulatory regions of genes associated with signaling pathways that control glial cell activation, such as Nr2e1, Mmd2, Wnt7a, and Akt2...
November 17, 2017: Cerebral Cortex
https://www.readbyqxmd.com/read/29161151/an-index-of-decline-or-recovery-following-nonimpact-and-impact-mtbi
#14
James Ernest Sweeney, Andrew M Johnson
This study investigated the degree to which litigants/insurance claimants sustaining Nonimpact mild traumatic brain injury (mTBI) in motor vehicle accidents differed from compensation-seeking motor vehicle accident victims that suffered Impact mTBI in terms of neuropsychological decline/recovery, using as a control litigants/insurance claimants that did not experience mTBI in motor vehicle accidents. A clinical index (C-Voc) was employed as the dependent measure for decline/recovery, consisting of T-score algebraic differences between a highly sensitive neurocognitive measure (Category Test) and a relatively insensitive "hold" measure (Wechsler Adult Intelligence Scale Vocabulary subtest)...
November 21, 2017: Applied Neuropsychology. Adult
https://www.readbyqxmd.com/read/29160926/electro-mechanical-response-of-a-3d-nerve-bundle-model-to-mechanical-loads-leading-to-axonal-injury
#15
I Cinelli, M Destrade, M Duffy, P McHugh
OBJECTIVE: Traumatic brain injuries and damage are major causes of death and disability. We propose a 3D fully coupled electro-mechanical model of a nerve bundle to investigate the electrophysiological impairments due to trauma at the cellular level. METHODS: The coupling is based on a thermal analogy of the neural electrical activity by using the finite element software Abaqus CAE 6.13-3. The model includes a real-time coupling, modulated threshold for spiking activation and independent alteration of the electrical properties for each 3-layer fibre within a nerve bundle as a function of strain...
November 21, 2017: International Journal for Numerical Methods in Biomedical Engineering
https://www.readbyqxmd.com/read/29160735/up-regulation-of-wnt-%C3%AE-catenin-expression-is-accompanied-with-vascular-repair-after-traumatic-brain-injury
#16
Arjang Salehi, Amandine Jullienne, Mohsen Baghchechi, Mary Hamer, Mark Walsworth, Virginia Donovan, Jiping Tang, John H Zhang, William J Pearce, Andre Obenaus
Recent data suggest that repairing the cerebral vasculature after traumatic brain injury (TBI) may help to improve functional recovery. The Wnt/β-catenin signaling pathway promotes blood vessel formation during vascular development, but its role in vascular repair after TBI remains elusive. In this study, we examined how the cerebral vasculature responds to TBI and the role of Wnt/β-catenin signaling in vascular repair. We induced a moderate controlled cortical impact in adult mice and performed vessel painting to visualize the vascular alterations in the brain...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29160141/effects-of-mild-blast-traumatic-brain-injury-on-cerebral-vascular-histopathological-and-behavioral-outcomes-in-rats
#17
Uylissa A Rodriguez, Yaping Zeng, Donald James Deyo, Margaret O Parsley, Bridget E Hawkins, Donald S Prough, Douglas DeWitt
To determine the effects of mild blast-induced traumatic brain injury (bTBI), several groups of rats were subjected to blast injury or sham injury in a compressed air-driven shock tube. The effects of bTBI on relative cerebral perfusion (laser Doppler flowmetry, LDF), mean arterial blood pressure (MAP) cerebral vascular resistance were measured for two hrs post-bTBI. Dilator responses to reduced intravascular pressure were measured in isolated middle cerebral arterial (MCA) segments, ex vivo, 30 and 60 min post-bTBI...
November 21, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#18
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159715/does-the-administration-of-melatonin-during-post-traumatic-brain-injury-affect-cytokine-levels
#19
Fatemeh Dehghan, Nader Shahrokhi, Mohammad Khaksari, Zahra Soltani, Gholamreza Asadikorom, Ali Najafi, Nava Shahrokhi
Increased levels of inflammatory cytokines after traumatic brain injury (TBI) can lead to brain edema and neuronal death. In this study, the effect of melatonin on pro-inflammatory (IL-1ß, IL-6, and TNF-α) and anti-inflammatory (IL-10) cytokines following TBI was investigated considering anti-inflammatory effect of melatonin. Male Wistar rats were divided into five groups: Sham, TBI, TBI + VEH (vehicle), TBI + 5 mg dose of melatonin (MEL5), TBI + 20 mg dose of melatonin (MEL20). Diffuse TBI was induced by Marmarou method...
November 20, 2017: Inflammopharmacology
https://www.readbyqxmd.com/read/29159600/early-seizure-prophylaxis-in-traumatic-brain-injuries-revisited-a-prospective-observational-study
#20
Desmond Khor, Jinglan Wu, Quanqiu Hong, Elizabeth Benjamin, Shuiming Xiao, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Pharmacological prophylaxis for early seizures following traumatic brain injury (TBI) is a recommendation in the Brain Trauma Foundation Guidelines. However, several studies have challenged the efficacy and safety of this practice, resulting in varied practice across centers around the world. The purpose of the present study was to compare the incidence of early clinical seizures following TBI, between two large centers, a US Center that practises routine seizure prophylaxis and a Chinese Center that does not use seizure prophylaxis following TBI...
November 20, 2017: World Journal of Surgery
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