Brainstem auditory evoked potential with increased stimulus rate in minor head trauma

AbstractFifteen Minor Head Trauma patients were investigated by Brainstem Auditory Evoked Potentials at 10/s and 55/s stimulus rate. The results were compared with those of the same patients at a second examination, two months later, as well as with a matched normal control group. Increasing the stimulus rate in MHT patients caused a significant but reversible delay in the central conduction time. No significant difference was found regarding the interpeak latency differences at a 10/s stimulus rate. The present study suggests that the primary lesion in MHT is ischaemic, affecting synaptic efficiency, and not axonal damage. These findings may be informative on the as yet obscure pathophysiological mechanism of minor head trauma.

Download Full-text

The Influence of Sex and Pre-Traumatic Headache on the Incidence and Severity of Headache After Head Injury

Cephalalgia ◽

10.1046/j.1468-2982.1990.1006285.x ◽

1990 ◽

Vol 10 (6) ◽

pp. 285-293 ◽

Cited By ~ 54

Author(s):

Ole Kudsk Jensen ◽

Frank Farsø Nielsen

Keyword(s):

At Risk ◽

Relative Risk ◽

Head Injury ◽

Head Trauma ◽

Control Group ◽

Trauma Patients ◽

Significant Difference ◽

Post Traumatic ◽

Headache Patients

Pre- and post-traumatic headache of 168 individuals aged 18–60 years was registered 9–12 months after a head trauma. Headache before the trauma was reported by 39.9%, women being in the majority. After the trauma 64.3% were suffering from headache. Post-traumatic headache was reported by 64 patients (38.1%), of whom 22 patients experienced an increase of already existing headache and 42 patients complained of new headache. Patients suffering from headache before the trauma were not more at risk of having post-traumatic headache than patients who did not suffer from headache before the trauma. Patients who experienced an increase of already-existing pre-traumatic headache used more analgesics than patients first suffering from headache after the trauma. Post-traumatic headache was reported by more women than men ( p < 0.02), the corresponding relative risk being 1.6. Both the use of analgesics and the frequency of headache showed a significant increase for patients with post-traumatic headache when compared with a “control group” of 41 patients with unchanged headache and when compared with all patients with headache before the trauma. There was no significant difference in the location of pain between the groups analysed.

Download Full-text

RISK PREDICTION FOR ARRHYTHMIA IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Wiadomości Lekarskie ◽

10.36740/wlek202110214 ◽

2021 ◽

Vol 74 (10) ◽

pp. 2605-2609

Author(s):

Tetyana M. Ternushchak ◽

Marianna I. Tovt-Korshynska

Keyword(s):

P Wave ◽

Doppler Imaging ◽

Control Group ◽

Chronic Obstructive ◽

Conduction Time ◽

Electromechanical Delay ◽

P Wave Dispersion ◽

Atrial Electromechanical Delay ◽

Copd Patients ◽

Significant Difference

The aim: To evaluate P-wave dispersion (PwD), as an independent predictor of atrial fibrillation, corrected QT interval dispersion (cQTD), the noninvasive marker of ventricular arrhythmia and sudden cardiac death, investigate the atrial electromechanical delay in patients with COPD and assess their relation with the severity of the disease. Materials and methods: We prospectively enrolled consecutive patients with newly diagnosed COPD (n = 53, age 41.2 ± 6.8 years), compared with an age-matched healthy control group (n = 51, age 40.9 ± 6.5 years). A standard 12-lead electrocardiogram of each patient was analyzed for PwD and сQTD. Atrial electromechanical delay was analyzed by echocardiographic tissue Doppler imaging. The difference between PAs-PAl, PAs-PAt, and PAl-PAt were defined as left intra-atrial, right intra-atrial, and interatrial electromechanical delays (EMD), respectively. Results: PwD was higher in COPD patients than in control subjects (39.47 ± 3.12 ms vs. 30.29 ± 3.17 ms, p < 0.05). In comparison between control group and COPD subgroups (mild, moderate and severe), there was a statistically significant difference among these free groups in terms of PwD. Subgroup analyses showed that this difference was mainly due to patients with severe COPD. Regarding cQTD, there was a statistically significant increase in COPD patients 57.92 ± 3.43 ms vs 41.03 ± 5.21 ms, p < 0.05 respectively. PAs, PAl and PAt durations, right intra-atrial and interatrial EMD were also significantly longer in COPD patients (p < 0.05). Furthermore, there were significant negative correlations between FEV1 and PwD (r = – 0.46, p < 0.05), right intra-atrial (r = – 0.39 ms, p < 0.05), interatrial EMD ( r = – 0.35 ms, p < 0.05) and cQTD (r = – 0.32, p < 0.05). Conclusions: Atrial conduction time, such as inter- and intra-atrial EMD intervals, PwD and cQTD were longer than in healthy controls and correlated with the severity of COPD. These parameters offer a non-invasive and cost-effective assessment method for detecting patients at high risk of arrhythmia. Nevertheless, further prospective investigations on this issue are required.

Download Full-text

Efficacy of Amflow®, a Real-Time-Portable Feedback Device for Delivering Appropriate Ventilation in Critically Ill Patients: A Randomised, Controlled, Cross-Over Simulation Study

Emergency Medicine International ◽

10.1155/2020/5296519 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Jong Won Kim ◽

Sang O Park ◽

Kyeong Ryong Lee ◽

Dae Young Hong ◽

Kwang Je Baek

Keyword(s):

Head Trauma ◽

Simulation Study ◽

Gas Flow ◽

Distress Syndrome ◽

Trauma Patients ◽

Feedback Group ◽

Clinical Scenarios ◽

Significant Difference ◽

Adult Head ◽

Randomised Controlled

Objective. The aim of this study was to test whether Amflow® (a newly designed portable ventilation feedback device) can assist rescuers in delivering target tidal volume (VT) and respiration rate (RR) during self-inflating bag (SB) ventilations in various clinical scenarios. Method. This was a simulation study with a prospective cross-over design. A total of 40 trained participants who underwent training for SB ventilation were recruited. Using a SB with or without Amflow® alternately, participants delivered ventilations to test lungs connected to a gas flow analyser in each of three different scenarios: acute respiratory distress syndrome (ARDS; 315–385 ml ranges for 350 ml target VT, with 20 breaths/min); cardiopulmonary resuscitation (CPR; 450–550 ml ranges for 500 ml target VT with 10 breaths/min); and adult head trauma (630–770 ml ranges for 700 ml target VT with 15 breaths/min). Results. The feedback group (SB with Amflow®) demonstrated a significantly higher percentage of delivering the appropriate VT ranges than the no-feedback group for both ARDS (58.6% versus 23.5%, respectively) and CPR (85.4% versus 41.0%, respectively) (all p<0.05). However, there was no significant difference between the two groups in the percentage of delivering the appropriate VT ranges in head trauma patients (65.9% versus 68.3%, respectively; p=0.092). In all three scenarios, a higher percentage of target RR delivered was achieved in the feedback group (88.3%, 99.2%, and 96.3%, respectively) compared with the no-feedback group (5.8%, 12.5%, and 10.0%, respectively) (all p<0.05). Conclusion. The Amflow® device could be useful for rescuers in delivering SB ventilation with appropriate VT and RR simultaneously in various critical situations, except for clinical cases that demand greater delivered VT.

Download Full-text

Acoustic Change Complex (ACC) using Speech and Non-Speech Stimuli in Normal Hearing Children

QJM ◽

10.1093/qjmed/hcaa047.008 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

W A Elkholy ◽

D M Hassan ◽

N A Shafik ◽

Y E K Eltoukhy

Keyword(s):

Auditory Evoked Potentials ◽

Temporal Frequency ◽

Normal Hearing ◽

Auditory Discrimination ◽

Auditory Evoked Potential ◽

Frequency Change ◽

Spectral Change ◽

Speech Stimuli ◽

Significant Difference ◽

Hearing Children

Abstract Background Cortical auditory evoked potentials (CAEPs) are brain responses evoked by sound and are processed in or near the auditory cortex. ACC is a cortical auditory evoked potential (P1-N1-P2) elicited by a change within an ongoing sound stimulus. Objective To reach the best stimuli that can elicit ACC and act as an objective tool for assessment of cortical auditory discrimination in normal hearing children. Patients and Methods The present study was originally designed to standardize ACC evoked response in 41 children aged from 2 to 10 years. The mean age in our study group was 6.2 years with no significant difference between males and females. Stimuli used in this study were specifically designed to be used by AEP equipment that is capable of uploading short duration stimuli (500 msec.), thus can be used in a regular AEP lab. ACC was elicited by three groups of stimuli. Gap-in-tones stimuli represent temporal change (6, 10, 30 and 50 msec. gap introduced to 1000 Hz tone separately), frequency pairs stimuli represent frequency change (2%, 4%, 10% and 25% change from base freq. 1000 Hz) and vowel pairs stimuli represent spectral change (/i-u/, /u-i/, /i-a/. /a-i/, /u-a/, /a-u/). ACC response parameters were compared when using the different stimuli as regards percent detectability, morphology, latency and amplitude. Results Gap-in-tones at 6 msec. and 4% frequency change could elicit ACC response in 100% of subjects. For spectral change, /u-i/ was the highest in eliciting ACC (78%) followed by /i-u/ (68.2%) then /a-i/ (58.5%). ACC had the same morphology of the onset response in the majority of subjects, with longer latency and smaller amplitude. ACC amplitude is a better indicator of cortical discrimination compared to latency because it is consistently affected by magnitude of change. Conclusion ACC is a good electrophysiological tool for cortical auditory discrimination for temporal, frequency and spectral change.

Download Full-text

The Effect of Learning English on P300 in Children

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1710304 ◽

2020 ◽

Author(s):

Pâmela Mariel Marques ◽

Ângela Leusin Mattiazzi ◽

Laís Ferreira ◽

Sheila Jacques Oppitz ◽

Eliara Pinto Vieira Biaggio

Keyword(s):

Second Language ◽

Cognitive Activity ◽

Auditory Pathway ◽

Auditory Evoked Potential ◽

Control Group ◽

P300 Latency ◽

Cross Sectional ◽

English Classes ◽

Significant Difference ◽

Learning English

Abstract Introduction Learning a second language is an essential task in today's world, and is experienced by many children. The cognitive auditory-evoked potential (P300) is related to cognitive activity, attention and concentration, enabling the investigation of the effect of a second language on the central auditory pathway. Objective To analyze the effects of learning English on P300 latency and amplitude in children and to correlate them with age, time of exposure to English, and time in class. Method An observational, descriptive, cross-sectional and quantitative study, in which 33 children, aged between 5 and 9 years and 11 months, of both genders participated, 14 of them in the process of learning English (study group) and 19 without this experience (control group). All subjects had their P300 evaluated using the Intelligent Hearing Systems (IHS, Miami, FL, US) Smart EP equipment. A total of 300 binaural stimuli were used in 75 dBnHL, as well as 240 frequent and 60 rare stimuli, using the pairs /ba/ and /di/ respectively. Results There was a statistically significant difference regarding P300 latency between the groups, and children exposed to English classes had lower latency in this component. No statistical difference was found between P300 amplitudes. No correlation was observed regarding age, time of exposure to English, time in class, and electrophysiological responses. Conclusion The Children exposed to English classes had the most stimulating auditory pathway, because their P300 had lower latency, being a resource for the speech therapy clinic.

Download Full-text

Prediction of Chronic Subdural Hematoma in Minor Head Trauma Patients

Korean Journal of Neurotrauma ◽

10.13004/kjnt.2014.10.2.106 ◽

2014 ◽

Vol 10 (2) ◽

pp. 106 ◽

Cited By ~ 7

Author(s):

Sang-Beom Han ◽

Seung-Won Choi ◽

Shi-Hun Song ◽

Jin-Young Youm ◽

Hyeon-Song Koh ◽

...

Keyword(s):

Head Trauma ◽

Subdural Hematoma ◽

Chronic Subdural Hematoma ◽

Trauma Patients ◽

Minor Head Trauma

Download Full-text

Rates of Intracranial Hemorrhage in Mild Head Trauma Patients Presenting to Emergency Department and Their Management: A Comparison of Direct Oral Anticoagulant Drugs with Vitamin K Antagonists

Medicina ◽

10.3390/medicina56060308 ◽

2020 ◽

Vol 56 (6) ◽

pp. 308 ◽

Cited By ~ 1

Author(s):

Gabriele Savioli ◽

Iride Francesca Ceresa ◽

Sabino Luzzi ◽

Cristian Gragnaniello ◽

Alice Giotta Lucifero ◽

...

Keyword(s):

Emergency Department ◽

Head Trauma ◽

Intracranial Hemorrhage ◽

Vitamin K ◽

Vitamin K Antagonists ◽

Mortality Rates ◽

Control Group ◽

Number Of Patients ◽

Blunt Head Trauma ◽

Significant Difference

Background and objectives: Anticoagulants are thought to increase the risks of traumatic intracranial injury and poor clinical outcomes after blunt head trauma. The safety of using direct oral anticoagulants (DOACs) compared to vitamin K antagonists (VKAs) after intracranial hemorrhage (ICH) is unclear. This study aims to compare the incidence of post-traumatic ICH following mild head injury (MHI) and to assess the need for surgery, mortality rates, emergency department (ED) revisit rates, and the volume of ICH. Materials and Methods: This is a retrospective, single-center observational study on all patients admitted to our emergency department for mild head trauma from 1 January 2016, to 31 December 2018. We enrolled 234 anticoagulated patients, of which 156 were on VKAs and 78 on DOACs. Patients underwent computed tomography (CT) scans on arrival (T0) and after 24 h (T24). The control group consisted of patients not taking anticoagulants, had no clotting disorders, and who reported an MHI in the same period. About 54% in the control group had CTs performed. Results: The anticoagulated groups were comparable in baseline parameters. Patients on VKA developed ICH more frequently than patients on DOACs and the control group at 17%, 5.13%, and 7.5%, respectively. No significant difference between the two groups was noted in terms of surgery, intrahospital mortality rates, ED revisit rates, and the volume of ICH. Conclusions: Patients with mild head trauma on DOAC therapy had a similar prevalence of ICH to that of the control group. Meanwhile, patients on VKA therapy had about twice the ICH prevalence than that on the control group or patients on DOAC, which remained after correcting for age. No significant difference in the need for surgery was determined; however, this result must take into account the very small number of patients needing surgery.

Download Full-text

EARLY PROBIOTICS IN PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA AFTER MULTIPLE TRAUMA

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2020.v13i10.38114 ◽

2020 ◽

pp. 83-85

Author(s):

TAMER HABIB ◽

AMIRA B KASSEM ◽

ISLAM AHMED

Keyword(s):

Multiple Trauma ◽

University Hospital ◽

Control Group ◽

Trauma Patients ◽

Ventilator Associated Pneumonia ◽

Mechanically Ventilated ◽

Significant Difference ◽

Multiple Trauma Patients ◽

And Control

Objective: Using probiotics in preventing ventilator-associated pneumonia (VAP) remain controversial due to different intensive care unit (ICU) populations included in such studies. The aim of this study is to evaluate the role of probiotics in prophylaxis of VAP after multiple trauma. Methods: Sixty-five adult multiple trauma patients on mechanical ventilator (expected ≥48 h) after admission to the Critical Care Medicine Department, Alexandria Main University Hospital from June to November 2018. Patients were randomly assigned using computer sheet into two groups; probiotics group (32 patients received one Lacteol Forte® sachet through orogastric/nasogastric tube 3 times daily during their ICU stay) and control group (33 patients received similar regimen of placebo sachets). All patients were followed up and subjected to all possible strategies of the diagnosis of microbiologically confirmed VAP. Results: Sixty-five patients were enrolled with a mean of age (39.48±7.692) years, 80% of them were male. Regarding the incidence of VAP, it was 18.46% of all patients without statistically significant difference between probiotics group (15.63%) and control group (21.21%) (p=0.751). Conclusion: Routine use of early probiotics in mechanically ventilated multiple trauma patients was not associated with lower incidence of VAP, duration of MV, or ICU mortality.

Download Full-text

Audiological findings following head trauma

The Journal of Laryngology & Otology ◽

10.1017/s0022215100114410 ◽

1990 ◽

Vol 104 (12) ◽

pp. 927-936 ◽

Cited By ~ 16

Author(s):

M. R. Abd Al-Hady ◽

O. Shehata ◽

M. El-Mously ◽

F. S. Sallam

Keyword(s):

Hearing Loss ◽

Head Injury ◽

Head Trauma ◽

Repetition Rate ◽

Control Group ◽

Traumatic Head Injury ◽

Auditory Brain Stem Response ◽

Auditory Brain Stem ◽

Significant Difference ◽

Traumatic Head

AbstractTraumatic head injury is the principal cause of death and serious physical disability in adolescents and young adult. Hearing loss is a common sequela of head trauma. The results of pure tone and auditory brain-stem response (ABR) assessment of minor head injury revealed that 20 per cent of these cases showed impairment of hearing including both conductive and sensorineural heaing loss mostly in the high frequencies loss.ABR findings showed a significant difference of absolute wave V latency and interwave (III-V) latencies at repetition rate 11.1 click/sec., and a highly significant difference at a repetition rate of 51.1 click/sec., compared with the control group.In severe head injury, conductive hearing loss was found in only one case, in which a longitudinal fracture of the temporal bone was identified radiologically. No ABR could be recorded at a repetition rate of 11.1 click/sec. in either ear of this case; this patient died a few days later.Three cases were found with a mixed sensorineural hearing loss; one of them showed a longitudinal fracture radiologically. ABR findings in two cases showed prolongation of wave V and I–V interwave latencies, and the third case showed absence of ABR recording.In comatose patients, an ABR grading system is a more sensitive index of brainstem dysfunction than the simple division of normal versus abnormal ABR waves and interwave latencies. Presence or prolongation of wave V and interwave latency I–V even in one ear is of good prognostic value in the comatosed patient.

Download Full-text