Articles: brain.
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Critical care medicine · Jan 2025
Transfusion Practices in Traumatic Brain Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Balancing oxygen requirements, neurologic outcomes, and systemic complications from transfusions in traumatic brain injury (TBI) patients is challenging. This review compares liberal and restrictive transfusion strategies in TBI patients. ⋯ Our findings suggest that a liberal transfusion strategy results in better neurologic outcomes than a restrictive approach. Future research should examine the complication profile and the effects of using a 9 g/dL threshold. We advocate for revising current guidelines to establish 9 g/dL as the standard threshold for transfusions in TBI patients.
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Environmental hypothermia increases mortality in patients with major trauma, however the impact of exposure hypothermia on outcomes in isolated traumatic brain injury (TBI) is under-explored in literature. The aim of this study is to determine the relationship between environmental hypothermia and survival in patients with isolated blunt TBI. ⋯ Environmental hypothermia is associated with increased mortality at 24 hours and at hospital discharge in patients with isolated blunt TBI. Further investigation is needed to identify optimal treatment strategies for TBI patients with hypothermia and to determine whether hypothermia prevention decreases mortality.
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Concussions are a common form of mild traumatic brain injury characterized by a transient alteration of cerebral function leading to a range of physical, cognitive, and emotional symptoms. Postconcussive symptoms (PCSs) usually resolve in about a week but can persist in 10% to 15% of patients. If left untreated, PCS can profoundly affect a patient's life. ⋯ The OMT techniques applied during treatment included balanced ligamentous tension, myofascial release, and osteopathy in the cranial field techniques. OMT is a nonpharmacological, noninvasive treatment that can benefit patients suffering with PCS. The authors would like to increase the awareness of clinicians and researchers for OMT's potential positive outcomes for PCS, as part of a multifactorial approach to care.
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Obstructive sleep apnea (OSA) is linked to brain alterations, but the specific regions affected and the causal associations between these changes remain unclear. ⋯ Nerve fiber damage and imbalances in neuronal activity across multiple brain regions caused by hypoxia, particularly the frontal lobe, underlie the structural and the functional connectivity impairments in OSA.
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Loneliness is intricately connected to social cognition, yet the precise brain mechanisms that underscore their relationship need further exploration. The present study employed a theory of mind processing task that engaged participants in assessing the trajectories of geometric shapes while undergoing fMRI scans. The comprehensive data pool encompassed loneliness assessments and brain imaging data from a cohort of 157 participants. ⋯ Furthermore, functional connectivity among the social network, the default mode network, and somatomotor networks emerged as crucial factors in prediction. Brain regions contributed strongly in prediction are involved in a variety of social cognitive processes, including intention inference, empathy, and information integration. The results illuminate the association between brain functional connectivity induced by social cognition and loneliness, which enhance the comprehensive understanding of this complex emotional state and may have implications for its diagnosis and intervention.