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Latest & greatest articles for traumatic brain injury
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Predictors of extended rehabilitation length of stay after traumaticbraininjury 20875505 2010 09 29 2010 10 19 2010 09 29 1532-821X 91 10 2010 Oct Archives of physical medicine and rehabilitation Arch Phys Med Rehabil Predictors of extended rehabilitation length of stay after traumaticbraininjury. 1495-504 10.1016/j.apmr.2010.07.010 To develop a prediction rule for acutely identifying patients at risk for extended rehabilitation length of stay (LOS) after traumaticbraininjury (TBI (...) ) by using demographic and injury characteristics. Retrospective cohort study. TraumaticBrainInjury Model Systems. Sample of TBI survivors (N=7284) with injuries occurring between 1999 and 2009. Not applicable. Extended rehabilitation LOS defined as 67 days or longer. A multivariable model was built containing FIM motor and cognitive scores at admission, preinjury level of education, cause of injury, punctate/petechial hemorrhage, acute-care LOS, and primary payor source. The model had good calibration
Therapeutic hypothermia for paediatric traumaticbraininjury BestBets: Therapeutic hypothermia for paediatric traumaticbraininjury within 8 hr Therapeutic hypothermia for paediatric traumaticbraininjury within 8 hr Report By: Gabriel Cade - Emergency Medicine Physician Search checked by Venkatesh Gattu - Senior Emergency Medicine Trainee Institution: Baystate Medical Center aSpringfield, MA 01199, USA nd Manchester Royal Infirmary, Manchester, UK Date Submitted: 12th December 2009 Date (...) Completed: 9th July 2010 Last Modified: 9th July 2010 Status: Green (complete) Three Part Question In [paediatric patients presenting within 8 h of traumaticbraininjury (TBI)] are [therapeutic hypothermia regimens better than normothermic care] in [improving patient survival]? Clinical Scenario An 8-year old child presents to the Emergency Department within six hours of an unclear incident at home which left nonspecific bruising and acute change in mental status. Fundoscopic exam reveals retinal
Intensive insulin therapy in severe traumaticbraininjury: a randomized trial 20032790 2010 04 13 2010 05 06 2011 11 17 1529-8809 68 4 2010 Apr The Journal of trauma J Trauma Intensive insulin therapy in severe traumaticbraininjury: a randomized trial. 904-11 10.1097/TA.0b013e3181c9afc2 Intensive insulin therapy (IIT) has been shown to reduce morbidity and mortality in critically ill patients. Little investigation has been done to find out whether it improves the prognosis of patients (...) with severe traumaticbraininjury (STBI). We conducted a prospective controlled study where adult patients with blunt STBI, with Glasgow Coma Scale
Rates of major depressive disorder and clinical outcomes following traumaticbraininjury. CONTEXT: Uncertainties exist about the rates, predictors, and outcomes of major depressive disorder (MDD) among individuals with traumaticbraininjury (TBI). OBJECTIVE: To describe MDD-related rates, predictors, outcomes, and treatment during the first year after TBI. DESIGN: Cohort from June 2001 through March 2005 followed up by structured telephone interviews at months 1 through 6, 8, 10, and 12 (data (...) once in the follow-up period. Point prevalences ranged between 31% at 1 month and 21% at 6 months. In a multivariate model, risk of MDD after TBI was associated with MDD at the time of injury (risk ratio [RR], 1.62; 95% confidence interval [CI], 1.37-1.91), history of MDD prior to injury (but not at the time of injury) (RR, 1.54; 95% CI, 1.31-1.82), age (RR, 0.61; 95% CI, 0.44-0.83 for > or = 60 years vs 18-29 years), and lifetime alcohol dependence (RR, 1.34; 95% CI, 1.14-1.57). Those with MDD
Haemostatic drugs for traumaticbraininjury. BACKGROUND: Traumaticbraininjury (TBI) is a leading cause of death and disability. Intracranial bleeding is a common complication of TBI, and intracranial bleeding can develop or worsen after hospital admission. Haemostatic drugs may reduce the occurrence or size of intracranial bleeds and consequently lower the morbidity and mortality associated with TBI. OBJECTIVES: To assess the effects of haemostatic drugs on mortality, disability (...) and thrombotic complications in patients with traumaticbraininjury. SEARCH STRATEGY: We searched the electronic databases: Cochrane Injuries Group Specialised Register (3 February 2009), CENTRAL (The Cochrane Library 2009, Issue 1), MEDLINE (1950 to Week 3 2009), PubMed (searched 3 February 2009 (last 180 days)), EMBASE (1980 to Week 4 2009), CINAHL (1982 to January 2009), ISI Web of Science: Science Citation Index Expanded (SCI-EXPANDED) (1970 to January 2009), ISI Web of Science: Conference Proceedings
Prophylactic hypothermia for traumaticbraininjury: a quantitative systematic review Prophylactic hypothermia for traumaticbraininjury: a quantitative systematic review Prophylactic hypothermia for traumaticbraininjury: a quantitative systematic review Fox JL, Vu EN, Doyle-Waters M, Brubacher JR, Abu-Laban R, Hu Z CRD summary The review found that early prophylactic mild to moderate hypothermia improved mortality and functional outcomes after severe traumaticbraininjury, especially when (...) a long-term or goal-directed cooling strategy was used. In view of limitations in the review, including poor quality studies and possible publication bias (both acknowledged by the authors), some caution may be required in interpreting the findings. Authors' objectives To evaluate the use of prophylactic hypothermia for traumaticbraininjury. Searching MEDLINE, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, PapersFirst
Hyperbaric oxygen therapy for traumaticbraininjury (TBI) and post traumatic stress disorder (PTSD) Hyperbaric oxygen therapy for traumaticbraininjury (TBI) and post traumatic stress disorder (PTSD) Hyperbaric oxygen therapy for traumaticbraininjury (TBI) and post traumatic stress disorder (PTSD) Adams E Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA (...) database. Citation Adams E. Hyperbaric oxygen therapy for traumaticbraininjury (TBI) and post traumatic stress disorder (PTSD) Boston: VA Technology Assessment Program (VATAP). 2010 Authors' conclusions Conclusions: Traumaticbraininjury. The systematic reviews by McDonagh (2003) and Bennett (2004) provide the most rigorous and current information on the status of the clinical research for the use of HBO2 in TBI. Subsequent reviews identified these two reviews as the primary basis
Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumaticbraininjury Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumaticbraininjury Cost-effectiveness analysis of intravenous levetiracetam versus intravenous phenytoin for early onset seizure prophylaxis after neurosurgery and traumaticbrain (...) after neurosurgery or traumaticbraininjury, in the intensive care unit setting. The authors concluded that, from the perspective of the hospital, levetiracetam could be cost-effective compared with phenytoin. The methods were valid and the study was generally well presented. The authors’ conclusions seem robust. Type of economic evaluation Cost-effectiveness analysis Study objective This study examined the cost-effectiveness of intravenous levetiracetam, compared with conventional intravenous
The Cognitive Effects of Mild TraumaticBrainInjury and Resulting Postconcussion Syndrome in High Risk Patients "The Cognitive Effects of Mild TraumaticBrainInjury and Resulting Pos" by Terrance Hartmann < > > > > > Title Author Date of Award 8-14-2010 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies First Advisor Dr. Mark Pedemonte, MD Second Advisor Annjanette Sommers MS, PAC Third Advisor Rob Rosenow PharmD, OD Rights . Abstract Background: Mild (...) traumaticbraininjury with postconcussion syndromes may be correlated with long term cognitive deficits. While 1.7 million traumaticbraininjuries are reported each year, this number does not account for the many mild traumaticbraininjuries that are not reported each year. Methods: Exhaustive search of available medical literature using the search engines: OVID, CINAHL, Entrez, and UpToDate. Keywords used were Mild TraumaticBrainInjury, Cognitive Disorders, Psychological Disorders, Neurological
Out-of-hospital hypertonic resuscitation following severe traumaticbraininjury: a randomized controlled trial. 20924011 2010 10 06 2010 10 08 2016 12 15 1538-3598 304 13 2010 Oct 06 JAMA JAMA Out-of-hospital hypertonic resuscitation following severe traumaticbraininjury: a randomized controlled trial. 1455-64 10.1001/jama.2010.1405 Hypertonic fluids restore cerebral perfusion with reduced cerebral edema and modulate inflammatory response to reduce subsequent neuronal injury and thus have (...) potential benefit in resuscitation of patients with traumaticbraininjury (TBI). To determine whether out-of-hospital administration of hypertonic fluids improves neurologic outcome following severe TBI. Multicenter, double-blind, randomized, placebo-controlled clinical trial involving 114 North American emergency medical services agencies within the Resuscitation Outcomes Consortium, conducted between May 2006 and May 2009 among patients 15 years or older with blunt trauma and a prehospital Glasgow
Nursing management of adults with severe traumaticbraininjury. Nursing management of adults with severe traumaticbraininjury. | National Guideline Clearinghouse Search Sign In Username or Email * Password * Remember Me Don't have an account? Guideline Summary NGC:006948 This guideline summary has been withdrawn from NGC. Please update your bookmarks. View all withdrawn summaries in the . About NGC Guideline Summaries NGC's guidelines summaries contain information systematically derived from
Brain tissue oxygen and outcome after severe traumaticbraininjury: a systematic review 19384213 2009 05 18 2009 06 08 2013 11 21 1530-0293 37 6 2009 Jun Critical care medicine Crit. Care Med. Brain tissue oxygen and outcome after severe traumaticbraininjury: a systematic review. 2057-63 10.1097/CCM.0b013e3181a009f8 In this study, available medical literature were reviewed to determine whether brain hypoxia as measured by brain tissue oxygen (Bto2) levels is associated with increased risk (...) of poor outcome after traumaticbraininjury (TBI). A secondary objective was to examine the safety profile of a direct BtO2 probe. DATA SOURCE AND EXTRACTION: Clinical studies published between 1993 and 2008 were identified from electronic databases, Index Medicus, bibliographies of pertinent articles, and expert consultation. The following inclusion criteria were applied for outcome analysis: 1) more than 10 patients described, 2) use of a direct Bto2 monitor, 3) brain hypoxia defined as Bto2 <10 mm
Interventions for apathy after traumaticbraininjury. BACKGROUND: Apathy is a deficiency in overt behavioural, emotional and cognitive components of goal-directed behaviour. It is a common occurrence after traumaticbraininjury (TBI), with widespread impact. We have systematically reviewed studies examining the effectiveness of interventions for apathy in the TBI population. OBJECTIVES: To investigate the effectiveness of interventions for apathy in adults who have sustained a TBI (...) . This was evaluated by changes in behavioural, cognitive and emotional measures of apathy. SEARCH STRATEGY: We searched the following databases up to January 2008: CENTRAL (The Cochrane Library 2008, Issue 1), Database of Abstracts of Reviews of Effects, ACP Journal Club, MEDLINE (1950 to Jan 2008), EMBASE (1980 to Jan 2008), PsycINFO (1806 to Jan 2008), CINAHL (1982 Jan 2008), PsycBITE, AMED (1985 to Jan 2008), www.controlled-trials.com, www.clinicaltrials.gov and www.actr.org.au.The Cochrane Injuries Group's
Longitudinal trajectories of postconcussive symptoms in children with mild traumaticbraininjuries and their relationship to acute clinical status 19254996 2009 03 03 2009 03 30 2017 02 20 1098-4275 123 3 2009 Mar Pediatrics Pediatrics Longitudinal trajectories of postconcussive symptoms in children with mild traumaticbraininjuries and their relationship to acute clinical status. 735-43 10.1542/peds.2008-1056 We examined whether mild traumaticbraininjuries in children and adolescents (...) , especially when associated with acute clinical features reflecting more severe injury, result in different postinjury trajectories of postconcussive symptoms compared with mild orthopedic injuries. Participants in this prospective and longitudinal cohort study were 8- to 15-year-old children, 186 with mild traumaticbraininjuries and 99 with mild orthopedic injuries, who were recruited from consecutive admissions to emergency departments in 2 large children's hospitals. Parents rated current
A critical comparison of clinical decision instruments for computed tomographic scanning in mild closed traumaticbraininjury in adolescents and adults 18339447 2009 01 26 2009 02 10 2016 11 24 1097-6760 53 2 2009 Feb Annals of emergency medicine Ann Emerg Med A critical comparison of clinical decision instruments for computed tomographic scanning in mild closed traumaticbraininjury in adolescents and adults. 180-8 10.1016/j.annemergmed.2008.01.002 A number of clinical decision aids have (...) been introduced to limit unnecessary computed tomographic scans in patients with mild traumaticbraininjury. These aids differ in the risk factors they use to recommend a scan. We compare the instruments according to their sensitivity and specificity and recommend ones based on incremental benefit of correctly classifying patients as having surgical, nonsurgical, or no intracranial lesions. We performed a secondary analysis of prospectively collected database from 7,955 patients aged 10 years
Long-term risk of epilepsy after traumaticbraininjury in children and young adults: a population-based cohort study. BACKGROUND: The risk of epilepsy shortly after traumaticbraininjury is high, but how long this high risk lasts is unknown. We aimed to assess the risk of epilepsy up to 10 years or longer after traumaticbraininjury, taking into account sex, age, severity, and family history. METHODS: We identified 1 605 216 people born in Denmark (1977-2002) from the Civil Registration (...) System. We obtained information on traumaticbraininjury and epilepsy from the National Hospital Register and estimated relative risks (RR) with Poisson analyses. FINDINGS: Risk of epilepsy was increased after a mild braininjury (RR 2.22, 95% CI 2.07-2.38), severe braininjury (7.40, 6.16-8.89), and skull fracture (2.17, 1.73-2.71). The risk was increased more than 10 years after mild braininjury (1.51, 1.24-1.85), severe braininjury (4.29, 2.04-9.00), and skull fracture (2.06, 1.37-3.11). RR
The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumaticbraininjury The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumaticbraininjury The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumaticbraininjury Ruan S, Noyes K, Bazarian JJ Record Status (...) This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary This study estimated the cost reduction associated with serum-100B testing to determine whether a computed tomography (CT) scan was required for adults with an isolated mild traumaticbraininjury. The authors
Systematic review of the literature on pain in patients with polytrauma including traumaticbraininjury Systematic review of the literature on pain in patients with polytrauma including traumaticbraininjury Systematic review of the literature on pain in patients with polytrauma including traumaticbraininjury Dobscha SK, Clark ME, Morasco BJ, Freeman M, Campbell R, Helfand M CRD summary This review evaluated the assessment and management of pain in patients with polytraumatic injuries (...) , including traumaticbraininjury and blast-related headache. The authors concluded that there was little evidence to guide pain assessment and treatment approaches. This conclusion reflects the evidence presented, but a cautious interpretation of reliability might be necessary due to potential biases in the review process. Authors' objectives To evaluate the assessment and management of pain in patients with polytraumatic injuries, including traumaticbraininjury and blast-related headache. The review