Articles: brain-injuries.
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Journal of neurotrauma · Jan 2014
Randomized Controlled TrialInvestigating the Properties of the Hemodynamic Response Function Following Mild Traumatic Brain Injury.
Abstract Although several functional magnetic resonance imaging (fMRI) studies have been conducted in human models of mild traumatic brain injury (mTBI), to date no studies have explicitly examined how injury may differentially affect both the positive phase of the hemodynamic response function (HRF) as well as the post-stimulus undershoot (PSU). Animal models suggest that the acute and semi-acute stages of mTBI are associated with significant disruptions in metabolism and to the microvasculature, both of which could impact on the HRF. Therefore, fMRI data were collected on a cohort of 30 semi-acute patients with mTBI (16 males; 27.83±9.97 years old; 13.00±2.18 years of education) and 30 carefully matched healthy controls (HC; 16 males; 27.17±10.08 years old; 13.37±2.31 years of education) during a simple sensory-motor task. ⋯ The interaction was the result of an earlier time-to-peak and positive magnitude shift throughout the estimated HRF in patients with mTBI relative to HC. This difference in HRF shape combined with the greater volume of activated tissue may be indicative of a potential compensatory mechanism to injury. The current study demonstrates that direct examination and modeling of HRF characteristics beyond magnitude may provide additional information about underlying neuropathology that is not available with more standard fMRI analyses.
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Randomized Controlled Trial
Neurological injury after neonatal cardiac surgery: a randomized, controlled trial of 2 perfusion techniques.
Complex neonatal cardiac surgery is associated with cerebral injury. In particular, aortic arch repair, requiring either deep hypothermic circulatory arrest (DHCA) or antegrade cerebral perfusion (ACP), entails a high risk of perioperative injury. It is unknown whether ACP results in less cerebral injury than DHCA. ⋯ http://www.clinicaltrials.gov. Unique identifier: NCT01032876.
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Randomized Controlled Trial
Predicting six-month mortality of patients with traumatic brain injury: usefulness of common intensive care severity scores.
The aim of this study was to evaluate the usefulness of the APACHE II (Acute Physiology and Chronic Health Evaluation II), SAPS II (Simplified Acute Physiology Score II) and SOFA (Sequential Organ Failure Assessment) scores compared to simpler models based on age and Glasgow Coma Scale (GCS) in predicting long-term outcome of patients with moderate-to-severe traumatic brain injury (TBI) treated in the intensive care unit (ICU). ⋯ A simple prognostic model, based only on age and GCS, displayed a fairly good prognostic performance in predicting six-month mortality of ICU-treated patients with TBI. The use of the more complex scoring systems APACHE II, SAPS II and SOFA added little to the prognostic performance.
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Critical care medicine · Jan 2014
Randomized Controlled Trial Multicenter StudyEffect of Oropharyngeal Povidone-Iodine Preventive Oral Care on Ventilator-Associated Pneumonia in Severely Brain-Injured or Cerebral Hemorrhage Patients: A Multicenter, Randomized Controlled Trial.
To evaluate the efficacy and safety of oral care with povidone-iodine on the occurrence of ventilator-associated pneumonia in a high-risk population. ⋯ There is no evidence to recommend oral care with povidone-iodine to prevent ventilator-associated pneumonia in high-risk patients. Furthermore, this strategy seems to increase the rate of acute respiratory distress syndrome.
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The Journal of pediatrics · Jan 2014
Randomized Controlled Trial Multicenter Study Comparative StudyMood disorders after traumatic brain injury in adolescents and young adults: a nationwide population-based cohort study.
To delineate the relationship between traumatic brain injury (TBI) and mood disorders from population-based data in Taiwan. ⋯ Our findings show a higher likelihood of manifesting mood disorders in adolescents and young adults who sustained a prior TBI. Health professionals should carefully monitor both the physical and psychological impacts of head trauma.