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Latest & greatest articles for traumatic brain injury
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Use of a mild traumaticbraininjury guideline to reduce inpatient hospital imaging and charges Use of a mild traumaticbraininjury guideline to reduce inpatient hospital imaging and charges Use of a mild traumaticbraininjury guideline to reduce inpatient hospital imaging and charges Goldberg J, McClaine RJ, Cook B, Garcia VF, Brown RL, Crone K, Falcone RA 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 evaluated the impact of guidelines for the treatment of mild traumaticbraininjury in paediatric patients, in reducing hospital charges and computed tomography (CT) scans. The implementation of the guideline resulted in a significant reduction in CT scans, length of stay, and patient charges. There were
Mild traumaticbraininjury Mild traumaticbraininjury - Vos - 2012 - European Journal of Neurology - Wiley Online Library The full text of this article hosted at iucr.org is unavailable due to technical difficulties.
Multidisciplinary postacute rehabilitation for moderate to severe traumaticbraininjury in adults Multidisciplinary postacute rehabilitation for moderate to severe traumaticbraininjury in adults Multidisciplinary postacute rehabilitation for moderate to severe traumaticbraininjury in adults Brasure M, Lamberty GJ, Sayer NA, Nelson NW, MacDonald R, Ouellette J, Tacklind J, Grove M, Rutks IR, Butler ME, Kane RL, Wilt TJ 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 Brasure M, Lamberty GJ, Sayer NA, Nelson NW, MacDonald R, Ouellette J, Tacklind J, Grove M, Rutks IR, Butler ME, Kane RL, Wilt TJ. Multidisciplinary postacute rehabilitation for moderate to severe traumaticbraininjury in adults. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 72. 2012 Authors' objectives
Multidisciplinary Postacute Rehabilitation for Moderate to Severe TraumaticBrainInjury in Adults Multidisciplinary Postacute Rehabilitation for Moderate to Severe TraumaticBrainInjury in Adults Comparative Effectiveness Review Number 72Comparative Effectiveness Review Number 72 Multidisciplinary Postacute Rehabilitation for Moderate to Severe TraumaticBrainInjury in Adults Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither (...) to Severe TraumaticBrainInjury in Adults. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-2007-10064-I.) AHRQ Publication No. 12-EHC101-EF. Rockville, MD: Agency for Healthcare Research and Quality; June 2012. www.effectivehealthcare.ahrq.gov/reports/final.cfm. None of the investigators have any affiliations or financial involvement that conflicts with the material presented in this report. iii Preface The Agency for Healthcare Research and Quality (AHRQ) conducts
Effect of citicoline on functional and cognitive status among patients with traumaticbraininjury: Citicoline BrainInjury Treatment Trial (COBRIT). Traumaticbraininjury (TBI) is a serious public health problem in the United States, yet no treatment is currently available to improve outcome after TBI. Approved for use in TBI in 59 countries, citicoline is an endogenous substance offering potential neuroprotective properties as well as facilitated neurorepair post injury.To determine (...) ). At the 180-day evaluation, the citicoline and placebo groups did not differ significantly with respect to the primary outcome (global OR, 0.87 [95% CI, 0.72-1.04]).Among patients with traumaticbraininjury, the use of citicoline compared with placebo for 90 days did not result in improvement in functional and cognitive status.clinicaltrials.gov Identifier: NCT00545662.
A trial of intracranial-pressure monitoring in traumaticbraininjury. Intracranial-pressure monitoring is considered the standard of care for severe traumaticbraininjury and is used frequently, but the efficacy of treatment based on monitoring in improving the outcome has not been rigorously assessed.We conducted a multicenter, controlled trial in which 324 patients 13 years of age or older who had severe traumaticbraininjury and were being treated in intensive care units (ICUs) in Bolivia (...) was higher in the imaging-clinical examination group than in the pressure-monitoring group (4.8 vs. 3.4, P=0.002). The distribution of serious adverse events was similar in the two groups.For patients with severe traumaticbraininjury, care focused on maintaining monitored intracranial pressure at 20 mm Hg or less was not shown to be superior to care based on imaging and clinical examination. (Funded by the National Institutes of Health and others; ClinicalTrials.gov number, NCT01068522.).
Placebo-controlled trial of amantadine for severe traumaticbraininjury. Amantadine hydrochloride is one of the most commonly prescribed medications for patients with prolonged disorders of consciousness after traumaticbraininjury. Preliminary studies have suggested that amantadine may promote functional recovery.We enrolled 184 patients who were in a vegetative or minimally conscious state 4 to 16 weeks after traumaticbraininjury and who were receiving inpatient rehabilitation. Patients (...) (difference in slope, 0.30 points per week; P=0.02). The overall improvement in DRS scores between baseline and week 6 (2 weeks after treatment was discontinued) was similar in the two groups. There were no significant differences in the incidence of serious adverse events.Amantadine accelerated the pace of functional recovery during active treatment in patients with post-traumatic disorders of consciousness. (Funded by the National Institute on Disability and Rehabilitation Research; ClinicalTrials.gov
Effect on behavior problems of teen online problem-solving for adolescent traumaticbraininjury To report the results of a randomized clinical trial of teen online problem-solving (TOPS) meant to improve behavioral outcomes of adolescents with traumaticbraininjury (TBI).A randomized clinical trial was conducted to compare the efficacy of TOPS with access to Internet resources in teenagers with TBI in improving parent and self-reported behavior problems and parent-teen conflicts. Participants (...) included 41 adolescents aged 11 to 18 years (range: 11.47-17.90 years) who had sustained a moderate-to-severe TBI between 3 and 19 months earlier. Teens in the TOPS group received 10 to 14 online sessions that provided training in problem-solving, communication skills, and self-regulation. Outcomes were assessed before treatment and at a follow-up assessment an average of 8 months later. Groups were compared on follow-up scores after we controlled for pretreatment levels. Injury severity
and other injuries but no clinical diagnosis of traumaticbrain injury.Abnormalities revealed on DTI were consistent with traumatic axonal injury in many of the subjects with traumaticbraininjury. None had detectable intracranialinjury on computed tomography. As compared with DTI scans in controls, the scans in the subjects with traumaticbraininjury showed marked abnormalities in the middle cerebellar peduncles (P<0.001), in cingulum bundles (P=0.002), and in the right orbitofrontal white matter (P (...) Detection of blast-related traumaticbraininjury in U.S. military personnel. Blast-related traumaticbraininjuries have been common in the Iraq and Afghanistan wars, but fundamental questions about the nature of these injuries remain unanswered.We tested the hypothesis that blast-related traumaticbraininjury causes traumatic axonal injury, using diffusion tensor imaging (DTI), an advanced form of magnetic resonance imaging that is sensitive to axonal injury. The subjects were 63 U.S
Traumaticbraininjury and depression. Traumaticbraininjury and depression. Traumaticbraininjury and depression. Guillamondegui OD, Montgomery SA, Phibbs FT, McPheeters ML, Alexander PT, Jerome RN, McKoy JN, Seroogy JJ, Eicken JJ, Krishnaswami S, Salomon RM, Hartmann KE. 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 Guillamondegui (...) OD, Montgomery SA, Phibbs FT, McPheeters ML, Alexander PT, Jerome RN, McKoy JN, Seroogy JJ, Eicken JJ, Krishnaswami S, Salomon RM, Hartmann KE.. Traumaticbraininjury and depression. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 25. 2011 Authors' objectives The Vanderbilt Evidence-based Practice Center systematically reviewed evidence addressing key questions on depression after traumaticbraininjury, including prevalence, optimizing timing
Prehospital rapid sequence intubation improves functional outcome for patients with severe traumaticbraininjury: a randomized controlled trial To determine whether paramedic rapid sequence intubation in patients with severe traumaticbraininjury (TBI) improves neurologic outcomes at 6 months compared with intubation in the hospital.Severe TBI is associated with a high rate of mortality and long-term morbidity. Comatose patients with TBI routinely undergo endo-tracheal intubation to protect
: 20th January 2011 Status: Green (complete) Three Part Question In [patients with traumaticbraininjury (TBI) and signs of raised intracranial pressure (ICP)] are [hypertonic sodium solutions better than mannitol] at [reducing morbidity and mortality]? Clinical Scenario A 54 year old female pedestrian has been hit by a bus. She is brought into the ED by ambulance. Her GCS is 13 on arrival and examination reveals an isolated head injury with a haematoma over the left occiput. CT confirms a right (...) of 23.4% sodium chloride solution in reducing intracranial pressure in patients with traumaticbraininjury: A preliminary study Neurosurgery 2005 Oct. 57(4): 727-36 C Battison, PJD Andrews, C Graham, T Petty. Randomized, controlled trial on the effect of a 20% mannitol solution and a 7.5% saline/ 6% dextran solution on increased intracranial pressure after braininjury. Critical Care Medicine 2005 Jan. 33(1): 196-202 R Vialet, J Albanese, L Thomachot et al Isovolume hypertonic solutes (sodium
Is Progesterone Therapy Beneficial for Acute TraumaticBrainInjury? SystematicReviewSnapshot TAKE-HOME MESSAGE Progesterone therapy may improve mortality and neurologic disability in patients with traumaticbraininjury, but the current evidence is insuf?cient. A multicenter phase III trial sponsored by the National Institutes of Health will enhance the existing evidence. METHODS DATA SOURCES Data sources were Cochrane In- juries Group’s Specialized Regis- ter, MEDLINE, EMBASE, LILACS (...) measures assess- ing progesterone versus no pro- gesterone (or placebo) for the treatment of acute traumaticbraininjury were included. Only natural progesterone administered within 24 hours of the head injury in any dose, by any route, and for any duration was considered as a treatment. Is Progesterone Therapy Bene?cial for Acute TraumaticBrainInjury? EBEM Commentators John Pettey Sandifer, MD Alan E. Jones, MD Department of Emergency Medicine University of Mississippi Medical Center Jackson, MS
Guidelines for the prescription of a seated wheelchair or mobility scooter for people with a traumaticbraininjury or spinal cord injury Guidelines for the prescription of a seated wheelchair or mobility scooter for people with a traumaticbraininjury or spinal cord injury Guidelines for the prescription of a seated wheelchair or mobility scooter for people with a traumaticbraininjury or spinal cord injury 2 Guidelines for the prescription of a seated wheelchair or mobility scooter (...) for people with a traumaticbraininjury or spinal cord injury This publication is endorsed by Occupational Therapy (OT) Australia – NSW Division You may copy, distribute, display and otherwise freely deal with this work for any purpose, provided that you attribute the LTCSA and EnableNSW as the owners. However, you must obtain permission if you wish to (1) charge others for access to the work (other than at cost), (2) include the work in advertising or a product for sale, or (3) modify the work. ISBN
GFAP and S100B are biomarkers of traumaticbraininjury: an observational cohort study Biomarker levels in blood after traumaticbraininjury (TBI) may offer diagnostic and prognostic tools in addition to clinical indices. This study aims to validate glial fibrillary acidic protein (GFAP) and S100B concentrations in blood as outcome predictors of TBI using cutoff levels of 1.5 μg/L for GFAP and 1.13 μg/L for S100B from a previous study.In 79 patients with TBI (Glasgow Coma Scale score [GCS] ≤12 (...) ), serum, taken at hospital admission, was analyzed for GFAP and S100B. Data collected included injury mechanism, age, gender, mass lesion on CT, GCS, pupillary reactions, Injury Severity Score (ISS), presence of hypoxia, and hypotension. Outcome was assessed, using the Glasgow Outcome Scale Extended (dichotomized in death vs alive and unfavorable vs favorable), 6 months post injury.In patients who died compared to alive patients, median serum levels were increased: GFAP 33.4-fold and S100B 2.1-fold
Decompressive craniectomy in diffuse traumaticbraininjury. It is unclear whether decompressive craniectomy improves the functional outcome in patients with severe traumaticbraininjury and refractory raised intracranial pressure.From December 2002 through April 2010, we randomly assigned 155 adults with severe diffuse traumaticbraininjury and intracranial hypertension that was refractory to first-tier therapies to undergo either bifrontotemporoparietal decompressive craniectomy or standard (...) group (19%) and the standard-care group (18%).In adults with severe diffuse traumaticbraininjury and refractory intracranial hypertension, early bifrontotemporoparietal decompressive craniectomy decreased intracranial pressure and the length of stay in the ICU but was associated with more unfavorable outcomes. (Funded by the National Health and Medical Research Council of Australia and others; DECRA Australian Clinical Trials Registry number, ACTRN012605000009617.).