Articles: traumatic-brain-injuries.
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Recently, increasing evidence has shown that cell cycle activation is a key factor of neuronal death and neurological dysfunction after traumatic brain injury (TBI). This study aims to investigate the effects of Honokiol, a cell cycle inhibitor, on attenuating the neuronal damage and facilitating functional recovery after TBI in rats, in an attempt to unveil its underlying molecular mechanisms in TBI. This study suggested that delayed intravenous administration of Honokiol could effectively ameliorate TBI-induced sensorimotor and cognitive dysfunctions. ⋯ Furthermore, the expression of some of the key cell cycle proteins such as cyclin D1 and E2F1 and the associated apoptosis in neurons were both remarkably attenuated by Honokiol treatment. These results show that delayed intravenous administration of Honokiol could effectively improve the functional recovery and attenuate the neuronal cell death, which is probably, at least in part, attributed to its role as a cell cycle inhibitior. This might give clues to developing attractive therapies for future clinical trials.
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Journal of neurotrauma · Oct 2014
Comparative StudyPredicting outcome after traumatic brain injury: development of prognostic scores based on the IMPACT and the APACHE II.
Prediction models are important tools for heterogeneity adjustment in clinical trials and for the evaluation of quality of delivered care to patients with traumatic brain injury (TBI). We sought to improve the predictive performance of the IMPACT (International Mission for Prognosis and Analysis of Clinical Trials) prognostic model by combining it with the APACHE II (Acute Physiology and Chronic Health Evaluation II) for 6-month outcome prediction in patients with TBI treated in the intensive care unit. A total of 890 patients with TBI admitted to a large urban level 1 trauma center in 2009-2012 comprised the study population. ⋯ Internal validation using split-sample and resample bootstrap techniques yielded equivalent results, indicating low grade of overestimation. Our findings show that by combining the APACHE II with the IMPACT, improved 6-month outcome predictive performance is achieved. This may be applicable for heterogeneity adjustment in forthcoming TBI studies.
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Journal of neurotrauma · Oct 2014
The Parkland Protocol's Modified Berne-Norwood Criteria Predict Two Tiers of Risk for TBI Progression.
As a basis for venous thromboembolism (VTE) prophylaxis after traumatic brain injury (TBI), we have previously published an algorithm known as the Parkland Protocol. Patients are classified by risk for spontaneous progression of hemorrhage with chemoprophylaxis regimens tailored to each tier. We sought to validate this schema. ⋯ Tukey's post-hoc test showed the low-risk progression rate to be significantly different than both the moderate- and high-risk arms; no difference was noted between the moderate- and high-risk arms themselves. These criteria are a valid tool for classifying TBI patients into two categories of risk for spontaneous progression. This supports tailored chemoprophylaxis regimens for each arm.