Articles: brain-injuries.
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J Trauma Acute Care Surg · Jun 2014
Randomized Controlled Trial Multicenter StudyDo all trauma patients benefit from tranexamic acid?
This study tested the hypothesis that early routine use of tranexamic acid (TXA) reduces mortality in a subset of the most critically injured trauma intensive care unit patients. ⋯ Therapeutic study, level IV.
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Randomized Controlled Trial Multicenter Study
Long-term benefits of an early online problem-solving intervention for executive dysfunction after traumatic brain injury in children: a randomized clinical trial.
Executive dysfunction after traumatic brain injury (TBI) in children is common and leads to significant short- and long-term problems in functioning across multiple settings. We hypothesized that improvements in short-term executive function would be maintained to 24 months after injury and that improvements would increase over time in a counselor-assisted problem-solving (CAPS) intervention. ⋯ Delivery of the CAPS intervention early after TBI in older adolescents improves long-term executive function. This trial is, to our knowledge, one of the few large, randomized clinical treatment trials performed in pediatric TBI to demonstrate the efficacy of an intervention for management of executive dysfunction and long-term benefits of an intervention delivered soon after injury. Use of the CAPS intervention clinically should be considered; however, further research should explore ways to optimize delivery.
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Randomized Controlled Trial
Disseminating alcohol screening and brief intervention at trauma centers: a policy-relevant cluster randomized effectiveness trial.
In 2005 the American College of Surgeons passed a mandate requiring that level I trauma centers have mechanisms to identify and intervene with problem drinkers. The aim of this investigation was to determine if a multi-level trauma center intervention targeting both providers and patients would lead to higher-quality alcohol screening and brief intervention (SBI) when compared with trauma center mandate compliance without implementation enhancements. ⋯ Trauma center providers can be trained to deliver higher-quality alcohol screening and brief intervention (SBI) than untrained providers, which is associated with modest reductions in alcohol use problems, particularly among patients without TBI.
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Nan Fang Yi Ke Da Xue Xue Bao · May 2014
Randomized Controlled Trial[Comparison of 20% mannitol and 15% hypertonic saline in doses of similar osmotic burden for treatment of severe traumatic brain injury with intracranial hypertension].
To compare the effects of 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden for treatment of intracranial hypertension in patients with severe traumatic brain injury. ⋯ Treatment with 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden produces similar effects in management of increased ICP in patients with severe traumatic brain injury in terms of the time of action onset, maximum ICP reduction, and duration of action.
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J Head Trauma Rehabil · May 2014
Randomized Controlled Trial Multicenter StudyCounselor-assisted problem solving (CAPS) improves behavioral outcomes in older adolescents with complicated mild to severe TBI.
To test the efficacy of Counselor-Assisted Problem Solving (CAPS) versus an Internet resource comparison (IRC) condition in reducing behavior problems in adolescents following traumatic brain injury (TBI). ⋯ Online problem-solving therapy may be effective in reducing behavior problems in older adolescent survivors of moderate-severe TBI.