Articles: traumatic-brain-injuries.
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Epidemiologic studies have identified differences in concussion incidence between the sexes. However, few authors to date have updated injury rates (IRs) and time loss between male and female concussed athletes. ⋯ Female athletes sustained a higher rate of concussion and, in all sports except lacrosse, had greater time loss from concussion than male athletes. Additional research is needed on sex differences in time loss after concussions.
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Clin Neurol Neurosurg · Mar 2016
TBI prognosis calculator: A mobile application to estimate mortality and morbidity following traumatic brain injury.
Traumatic Brain Injury (TBI) is a significant public health problem and a leading cause of worldwide mortality and morbidity. Although effective evidence-based guidelines are available to help with management, the first question clinicians and family face is whether or not it is appropriate to intervene at all. To facilitate prognostic assessment and family counseling, we developed mobile application integrating validated TBI prognostic models. ⋯ Prompt and accurate prognosis estimation in TBI is promising. Mobile applications have the potential to enable easier and quicker point-of-care access to validated models, providing additional information to improve management and family counseling. We anticipate that clinicians will find "TBI Prognosis Calculator" useful as an adjunct in their prognostic assessment and family counseling.
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Review Meta Analysis
Hypertonic saline in severe traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.
Hypertonic saline solutions are increasingly used to treat increased intracranial pressure following severe traumatic brain injury. However, whether hypertonic saline provides superior management of intracranial pressure and improves outcome is unclear. We thus conducted a systematic review to evaluate the effect of hypertonic saline in patients with severe traumatic brain injury. ⋯ We observed no mortality benefit or effect on the control of intracranial pressure with the use of hypertonic saline when compared to other solutions. Based on the current level of evidence pertaining to mortality or control of intracranial pressure, hypertonic saline could thus not be recommended as a first-line agent for managing patients with severe traumatic brain injury.
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J Head Trauma Rehabil · Mar 2016
Time to Follow Commands and Duration of Posttraumatic Amnesia Predict GOS-E Peds Scores 1 to 2 Years After TBI in Children Requiring Inpatient Rehabilitation.
To evaluate the utility of time to follow commands (TFC) in predicting functional outcome after pediatric traumatic brain injury (TBI), as assessed by an outcome measure sensitive to the range of outcomes observed after pediatric TBI, the Glasgow Outcome Scale-Extended, Pediatric Revision (GOS-E Peds). ⋯ Above and beyond the influence of GCS, TFC, PTA, and TFC + PTA are important predictors of later outcome after TBI.
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Providing current, reliable and evidence based information for clinicians and researchers in a synthesised and summarised way can be challenging particularly in the area of traumatic brain injury where a vast number of reviews exists. These reviews vary in their methodological quality and are scattered across varying sources. In this paper, we present an overview of systematic reviews that evaluate the pharmacological interventions in traumatic brain injury (TBI). By doing this, we aim to evaluate the existing evidence for improved outcomes in TBI with pharmacological interventions, and to identify gaps in the literature to inform future research. ⋯ The evidence from high quality systematic reviews show that there is currently insufficient evidence for the use of magnesium, monoaminergic and dopamine agonists, progesterone, aminosteroids, excitatory amino acid inhibitors, haemostatic and antifibrinolytic drugs in TBI. Anti-convulsants are only effective in reducing early seizures with no significant difference between phenytoin and leviteracetam. There is no difference between propofol and midazolam for sedation in TBI patients and ketamine may not cause increased ICP. Overviews of systematic review provide informative and powerful summaries of evidence based research.