Articles: brain-injuries.
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Randomized Controlled Trial
A pilot randomized controlled trial of an early multidisciplinary model to prevent disability following traumatic injury.
Chronic pain, posttraumatic stress disorder (PTSD), and depression are common outcomes following traumatic injury. Yet, screening and early intervention to prevent the onset of these disorders do not occur routinely in acute trauma settings. This pilot study examined the clinical utility of screening and early multidisciplinary intervention for reducing disability following traumatic injury. ⋯ Early findings point to the value of early screening to identify patients at risk of treatable pain, physical, and psychological impairments. Moreover, early multidisciplinary intervention models following traumatic injury show promise for protecting against the onset of posttraumatic psychological disorders.
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Zhonghua yi xue za zhi · Jun 2013
Randomized Controlled Trial[Guiding value of brain tissue oxygenation plus intracranial pressure monitoring in severe traumatic brain injury patients].
To elucidate the effectiveness of brain tissue oxygenation (PbtO2) plus intracranial pressure (ICP) monitoring and targeted therapy in patients of severe traumatic brain injury (TBI). ⋯ The combined use of both ICP and PbtO2 may be associated with reduced mortality and improved outcome in patients with severe TBI.
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Randomized Controlled Trial Multicenter Study Comparative Study
Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial.
On the basis of mixed results from previous trials, we assessed whether therapeutic hypothermia for 48-72 h with slow rewarming improved mortality in children after brain injury. ⋯ National Institute of Neurological Disorders and Stroke and National Institutes of Health.
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Randomized Controlled Trial Multicenter Study Comparative Study
Temperature management in patients with acute neurological lesions: an Australian and New Zealand point prevalence study.
Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. ⋯ Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
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Journal of neurosurgery · Jun 2013
Randomized Controlled TrialA prospective, randomized Phase II clinical trial to evaluate the effect of combined hyperbaric and normobaric hyperoxia on cerebral metabolism, intracranial pressure, oxygen toxicity, and clinical outcome in severe traumatic brain injury.
Preclinical and clinical investigations indicate that the positive effect of hyperbaric oxygen (HBO2) for severe traumatic brain injury (TBI) occurs after rather than during treatment. The brain appears better able to use baseline O2 levels following HBO2 treatments. In this study, the authors evaluate the combination of HBO2 and normobaric hyperoxia (NBH) as a single treatment. ⋯ In this Phase II clinical trial, in comparison with standard care (control treatment) combined HBO2/NBH treatments significantly improved markers of oxidative metabolism in relatively uninjured brain as well as pericontusional tissue, reduced intracranial hypertension, and demonstrated improvement in markers of cerebral toxicity. There was significant reduction in mortality and improved favorable outcome as measured by GOS. The combination of HBO2 and NBH therapy appears to have potential therapeutic efficacy as compared with the 2 treatments in isolation. CLINICAL TRIAL REGISTRATION NO.: NCT00170352 (ClinicalTrials.gov).