Articles: traumatic-brain-injuries.
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Observational Study
The impact of COVID-19 on home, social, and productivity integration of people with chronic traumatic brain injury or stroke living in the community.
Compare community integration of people with stroke or traumatic brain injury (TBI) living in the community before and during the coronavirus severe acute respiratory syndrome coronavirus 2 disease (COVID-19) when stratifying by injury: participants with stroke (G1) and with TBI (G2); by functional independence in activities of daily living: independent (G3) and dependent (G4); by age: participants younger than 54 (G5) and older than 54 (G6); and by gender: female (G7) and male (G8) participants. Prospective observational cohort studyIn-person follow-up visits (before COVID-19 outbreak) to a rehabilitation hospital in Spain and on-line during COVID-19. Community dwelling adults (≥18 years) with chronic stroke or TBI. ⋯ In home-CIQ only G6 (d = -0.229) significantly decreased, no significant differences were observed in any of the other groups. The largest effect sizes were observed in total-CIQ for G3, in productivity-CIQ for G6, in social-CIQ for G3 and in home-CIQ for G6 (medium effect sizes). Stratifying participants by injury, functionality, age or gender allowed identifying specific CIQ subtotals where remote support may be provided addressing them.
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Randomized Controlled Trial
Early complementary acupuncture improves the clinical prognosis of traumatic brain edema: A randomized controlled trial.
Traumatic brain edema occurs commonly brain injury, and most manifests as pericontusional edema of brain contusions. On the basis of evidence-based medicine, apart from recommending craniotomy and mannitol, there are few particularly effective measures to prevent and treat traumatic brain edema. It is uncertain whether an early complementary acupuncture treatment would improve long-term outcomes of patients with traumatic brain edema. The aim of this study is to assess the efficacy and the safety of early complementary acupuncture for patients with traumatic brain edema. ⋯ This study will provide data regarding the efficacy of early complementary acupuncture for traumatic brain edema. If the study yields positive results, its findings may offer insights into a valuable complementary option of acupuncture for traumatic brain edema that could provide pilot evidence for large, randomized, controlled trials.Trial registration: This trial has been published in the Chinese Clinical Trial Register, http://www.chictr.org.cn/edit.aspx?pid=141208&htm=4 (Identifier: ChiCTR2100053794, registered on December 3, 2021).
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Brain multimodal monitoring including intracranial pressure (ICP) and brain tissue oxygen pressure (PbtO2) is more accurate than ICP alone in detecting cerebral hypoperfusion after traumatic brain injury (TBI). No data are available for the predictive role of a dynamic hyperoxia test in brain-injured patients from diverse etiology. ⋯ The combination of ICP and PbtO2 monitoring provides a better detection of cerebral hypoperfusion than ICP alone in patients with acute brain injury. The use of dynamic hyperoxia test could not significantly increase the diagnostic accuracy.
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Traumatic brain injury (TBI) as well as Attention Deficit Disorder with or without hyperactivity (ADHD) are very common problems that affect children. It is known that patients who suffer a traumatic brain injury may present symptoms of ADHD, which often go unnoticed in the acute period, especially when there are more serious injuries that hide them and are only evident when the patient returns to their regular cognitive activity after discharge. Symptoms can vary depending on the mechanism of injury, the location in the brain where the trauma or its effects occur, complications, and the severity of the injury. ⋯ We describe some clinical scenarios in this article in which there is an interaction between these two processes that are explained in part because both can affect similar nerve conduction pathways and neurotransmitters. The clinician must recognize attention problems in patients with TBI and other presentations and offer appropriate and timely treatment when symptoms interfere with the patient's functioning. Treatment of ADHD in patients with TBI uses accommodations and medications similar to those used in patients who only have ADHD, but depending on the severity, they can vary in duration.
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Review Meta Analysis
Can serum biomarkers be used to rule out significant intracranial pathology in emergency department patients with mild traumatic brain injury? A Systemic Review & Meta-Analysis.
Interest has mounted into the use of objective clinical biomarkers for traumatic brain injury (TBI). This systematic review and meta-analysis aimed to synthesise the existing evidence investigating the use of serum & plasma biomarkers to exclude significant intracranial injuries seen on CT head scans in patients that present to ED with TBI. ⋯ The overall quality of evidence regarding the diagnostic accuracy of single biomarkers as a rule out for significant intracranial injury seen on CT head scans in ED patients with TBI is low. Based on current evidence, S100B is the only single biomarker with a validated clinical platform, pre-determined cut off threshold and moderate quality evidence; at this stage making it the biomarker of choice. More robust clinical outcome and economic impact data is required to support its incorporation into clinical decision tools.