Articles: traumatic-brain-injuries.
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Comparative Study
Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome.
Stops at nontrauma centers for severely injured patients are thought to increase deaths and costs, potentially because of unnecessary imaging and indecisive/delayed care of traumatic brain injuries (TBIs). ⋯ Interhospital transfer does not affect the outcome of blunt trauma patients. However, the unnecessarily prolonged stay of low GCS patients in hospitals lacking neurosurgical care is inappropriate.
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This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS). ⋯ The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day.
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J Tradit Complement Med · Apr 2014
ReviewOmega-3 Fatty acids could alleviate the risks of traumatic brain injury - a mini review.
Traumatic brain injury (TBI) is an acquired brain trauma that occurs when any sudden trauma/injury causes damage to the brain. TBI is characterized by tissue damage and imbalance in the cerebral blood flow and metabolism. It has been established through laboratory experiments that the dietary supplementation of omega-3 fatty acids (FAs) could reduce the oxidative stress developed in brain due to TBI. ⋯ BDNF improves the synaptic transmission by regulating synapsin 1 and cyclic adenosine monophosphate (cAMP) response element binding protein. The brain tissue analysis of TBI models supplemented with omega-3 polyunsaturated fatty acids (PUFAs) showed significantly reduced lipid peroxidation, nucleic acid and protein oxidation, thereby promoting neuronal and glial cell survival. Thus, omega-3 FA intake could be considered as a therapeutic option to reduce the secondary neuronal damages initiated by TBI.
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Journal of critical care · Apr 2014
Case ReportsHypotensive resuscitation in a head-injured multi-trauma patient.
The concept of permissive hypotension is a controversial topic in trauma care. While driving blood pressure to "normal" levels with large volume crystalloid infusions is not appropriate, definitive data on the target blood pressure for hypotensive resuscitation are lacking. ⋯ The controversies highlighted herein call attention to the role of the intensivist in managing a continuing resuscitation while coordinating the care of other physicians whose therapies can run at cross-purposes to one another. The challenges of the practice of critical care in the 21st century are no more apparent than in the care of a complex trauma patient.
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Free Radic. Biol. Med. · Apr 2014
Neuroglobin expression and oxidant/antioxidant balance after graded traumatic brain injury in the rat.
Neuroglobin is a neuron-specific hexacoordinated globin capable of binding various ligands, including O2, NO, and CO, the biological function of which is still uncertain. Various studies seem to indicate that neuroglobin is a neuroprotective agent when overexpressed, acting as a potent inhibitor of oxidative and nitrosative stress. In this study, we evaluated the pathophysiological response of the neuroglobin gene and protein expression in the cerebral tissue of rats sustaining traumatic brain injury of differing severity, while simultaneously measuring the oxidant/antioxidant balance. ⋯ Results indicated that mild traumatic brain injury, although causing a reversible increase in oxidative/nitrosative stress (increase in malondialdehyde and nitrite + nitrate) and an imbalance in antioxidants (decrease in ascorbate and GSH), did not induce any change in neuroglobin. Conversely, severe traumatic brain injury caused an over nine- and a fivefold increase in neuroglobin gene and protein expression, respectively, as well as a remarkable increase in oxidative/nitrosative stress and depletion of antioxidants. The results of this study, showing a lack of effect in mild traumatic brain injury as well as asynchronous time course changes in neuroglobin expression, oxidative/nitrosative stress, and antioxidants in severe traumatic brain injury, do not seem to support the role of neuroglobin as an endogenous neuroprotective antioxidant agent, at least under pathophysiological conditions.