scholarly journals A Comparison of Patients from Argentina and Germany to Assess Factors Impacting Brachial Plexus and Brain Injury

2019 ◽  
Vol 14 (01) ◽  
pp. e39-e46
Author(s):  
Mariano Socolovsky ◽  
Gregor Antoniadis ◽  
Ana Lovaglio ◽  
Gregor Durner ◽  
Gonzalo Bonilla ◽  
...  
Keyword(s):  
Brain Injury ◽  
Brachial Plexus ◽  
Brain Injuries ◽  
Injury Severity ◽  
Pearson Correlation ◽  
Young Patients ◽  
Correlation Coefficients ◽  
Case Control Studies ◽  
Level Of Evidence ◽  
Two Populations

Background Traumatic brachial plexus injuries (BPIs) represent a major cause of disability in young patients. The purpose of this study was to compare two populations (from Argentina and Germany) who suffered a traumatic BPI after a motorcycle accident to identify predictors of BPI and brain injury severity. Methods Univariate and multivariable intergroup comparisons were conducted, and odds ratios were calculated to assess the associations between the different demographic, morphometric, and trauma-related variables, and the type and severity of patients' injuries. Pearson correlation coefficients were generated to identify statistically significant correlations. Results A total of 187 patients were analyzed, 139 from Argentina and 48 from Germany. The two countries differed significantly in age and several morphometric and trauma-related variables. The clinical presentation was also convincingly different in the two countries. The following three variables remained as statistically significant predictors of a complete (vs. partial) BPI: living in Argentina (p < 0.001), presenting prior to 2015 (p = 0.004), and greater estimated speed at the time of impact (p = 0.074). As for BPIs, a disproportionate percentage (85.6%) of more severe brain injuries occurred in Argentinian patients (p < 0.001) and among those whose accident involved striking a stationary vertical object. Conclusions This study identified several factors that might be considered when planning governmental policies and education initiatives to reduce BPI and brain injuries related to motorcycle use. Level of evidence II-2 (evidence obtained from case–control studies).

scholarly journals Study of Traumatic Brain Injury Due To Recent Earthquake in Manipal Teaching Hospital

2016 ◽  
Vol 12 (2) ◽  
pp. 63-66
Author(s):  
Bal G Karmacharya ◽  
Brijesh Sathian
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Teaching Hospital ◽  
Brain Injuries ◽  
Injury Severity ◽  
Traumatic Brain Injuries ◽  
The Body ◽  
Mild Head Injury ◽  
Associated Injuries

The objective of this study was to review the demographics, causes injury, severity, treatment and outcome of traumatic brain injuries in victims of the April 2015 earthquake who were admitted in Manipal Teaching Hospital, Pokhara. A total of 37 patients was admitted under Neurosurgery Services. Collapse of buildings was the commonest cause of head injury. The majority of them had mild head injury. Associated injuries to other parts of the body were present in 40.54% patients.Nepal Journal of Neuroscience 12:63-66, 2015

scholarly journals Correspondence of the Boston Assessment of Traumatic Brain Injury-Lifetime and In-Theater Department of Defense Medical Records

2021 ◽  
Author(s):  
Sahra Kim ◽  
Alyssa Currao ◽  
Jennifer R. Fonda ◽  
Brigitta Beck ◽  
Alexandra Kenna ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Department Of Defense ◽  
Medical Records ◽  
Brain Injuries ◽  
Injury Severity ◽  
Assessment Tools ◽  
System Level ◽  
Chi Square ◽  
Convenience Sample

Abstract Background: Since 2006, efforts have been made to increase the identification of traumatic brain injuries (TBIs) in post-9/11 military personnel. The BAT-L is the first validated instrument to diagnose TBIs throughout the lifespan in post-9/11 Veterans. The objective is to investigate the correspondence of the Boston Assessment of TBI-Lifetime (BAT-L) diagnostic prevalence and injury severity of traumatic brain injury with in-theater medical records from Department of Defense (DoD). Methods: A convenience sample of 153 Veterans deployed in 2011 enrolled in the TRACTS longitudinal cohort study was examined. Retrospective review of DoD online medical records to determine diagnostic prevalence and injury severity for all head injury cases during deployment were compared with diagnostic prevalence and injury severity from the BAT-L clinical interview using Chi-square analyses.Results: There was moderate correspondence for TBI diagnosis between the BAT-L and DoD records (κ = 0.42). Sensitivity was 72.7% and specificity was 82.8%. Comparison of injury severity also had moderate correspondence (κ = 0.41). Missing TBI diagnostic data from DoD records was frequent; 43% percent of TBIs reported on the BAT-L did not have any documentation of mTBI assessment or diagnosis in DoD records while 83% did not have in-theater documentation.Conclusions: Diagnosis of TBI via the BAT-L retrospective interview was both sensitive and specific when compared to DoD medical records. However, diagnostic correspondence was only moderate. This lack of diagnostic agreement was related to multiple factors including lack of documentation of injury, differences in assessment tools and goals, and other combat-related motivational factors associated with failure to report injuries while deployed. Several policies were implemented to address underreporting and under-documentation of TBI, yet challenges remain. Findings suggest changes at both individual-level (e.g. service members) and system-level (e.g. DoD/military branches) are needed to adequately diagnose and document all TBI during deployment.

scholarly journals Population differences in morphological and anatomical traits of Pinus mugo Turra needles from the Polish part of the Tatra Mountains

2017 ◽  
Vol 78 (1) ◽  
pp. 67-76
Author(s):  
Ewa M. Pawlaczyk ◽  
Alina Bączkiewicz ◽  
Piotr Wawrzyniak ◽  
Magdalena Czołpińska ◽  
Patrycja Gonera ◽  
...  
Keyword(s):  
Natural Variation ◽  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Principal Component ◽  
Pinus Mugo ◽  
Tatra Mountains ◽  
Tatra Mts ◽  
The Tatra Mountains ◽  
The Relationship ◽  
Two Populations

Abstract The main aim of this study was to describe the variation between the populations of the dwarf mountain pine Pinus mugo Turra based on the morphological and anatomical traits of their needles, and to investigate the relationship between the observed variation and environmental conditions (altitude and substrate). Two-year-old needles were collected from 180 individuals of six populations of P. mugo growing in the Tatra Mts. Two populations were classified as dense, located at 1360–1450 m altitude, and the remaining four formed loose clusters and were situated at 1500–1650 m altitude. Four of the populations are growing on granite and two on a limestone substrate. The natural variation of 10 morpho-anatomical and 3 synthetic needle traits was measured. In addition to descriptive statistics, the analyses of variance (ANOVA) with a Tukey test and principal component analysis were computed. We also estimated Pearson correlation coefficients for the examined needle traits and altitude as well as substrate. Our results indicate that the P. mugo populations differ significantly with regard to the investigated traits for which the Trzydniowiański Wierch population was the most distinct. The observed pattern of variability is largely caused by differences in stomatal traits and these features are positive correlated with altitude. Additionally, populations growing on granite have larger values for most of the examined traits compared to populations growing on limestone.

scholarly journals Role of Cisternal Drainage in Patients with Traumatic Brain Injury Undergoing Decompressive Craniectomy

2019 ◽  
Vol 15 (3) ◽  
pp. 14-20
Author(s):  
Amit Thapa ◽  
Rupendra Bahadur Adhikari ◽  
Bidur KC ◽  
Bikram Shakya
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Decompressive Craniectomy ◽  
Brain Injuries ◽  
Injury Severity ◽  
Absolute Risk ◽  
Group 2 ◽  
Cisternal Drainage ◽  
Group 1

The effect of decompressive craniectomy (DC) on survival and functional outcome in traumatic brain injuries (TBI) is far from satisfactory. Additional modalities including cisternal drainage (CD) that provides good control of refractory intracranial pressure (ICP) intraoperatively need careful scrutiny. Two centre retrospective superiority study with one centre offering only standard decompressive craniectomy (DC) i.e. Group 1 and the other centre supplementing cisternal drainage (CD) to standard DC i.e. Group 2 was conducted. Consecutive patients with traumatic brain injury with signs of brain herniation or CT scan showing mass lesion or diffuse brain edema or midline shift or with GCS less than 9 or rapid fall in GCS over 2 points with persistently raised ICP of 25 mmHg over 15 minutes between August 2012 and July 2017 were included. The primary outcome was rating on Glasgow Outcome Scale (GOS) at 6 months post operatively, with GOS (1-3) categorized as ‘Unfavorable’ and GOS (4,5) as ‘Favorable’. Patients either received DC alone (Group 1=73 patients, 48.7%) or DC with CD (Group 2=77 patients, 51.3%). 107 (71.3%) severe, 36 (24%) moderate, and 7 (4.7%) mild head injuries cases received 72 unilateral and 78 bilateral DC. GOS 1 was observed in 32 DC only group (43.8%) and 22 DC plus CD group (28.6%) (p=0.052), an absolute risk reduction of 15.2% was found. Outcome (favorable sun favorable) against all strata of head injury severity, predominant radiological feature, laterality of surgery, and patient characteristics across the two groups were statistically not significant, however the groups were statistically significantly different on age and GCS at presentation (p=0.016 & 0.034 consecutively). Distinct survival benefit in patients with traumatic brain injury receiving cisternal drainage during decompressive craniectomy did not translate to better functional outcome.

Midterm Functional Outcome of the Linked Semiconstrained Distal Radioulnar Joint Prosthesis

2021 ◽  
Author(s):  
Jaak Warlop ◽  
Maarten Van Nuffel ◽  
Luc De Smet ◽  
Ilse Degreef
Keyword(s):  
Pearson Correlation ◽  
Correlation Coefficients ◽  
Visual Analog Scale Score ◽  
Distal Radioulnar Joint ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Radioulnar Joint ◽  
Therapeutic Study ◽  
And Function

Abstract Background A painful unstable distal radioulnar joint (DRUJ) can seriously compromise hand and wrist function. The semiconstrained prosthesis was developed to restore DRUJ function. To date, most outcome reports are coauthored by the designer. Questions Does independent reporting confirm the promising results of the semiconstrained DRUJ prosthesis? Are complication and failure rates acceptable? Patients and Methods We evaluated patients with the semiconstrained DRUJ implant and a minimum follow-up of 2 years. We monitored patient satisfaction and function with functionality questionnaires and measured wrist range of motion, grip, and key pinch strength. Statistical analysis was done using descriptive statistics, Pearson correlation coefficients, linear and logistic regression. Results We included 41 patients with 42 implants. Mean follow-up was 46 months (range: 24–102 months). Eighty percent of wrist had undergone previous surgery. We found a mean pronation of 83 degrees (0–90 degrees), supination of 70 degrees (0–90 degrees), flexion of 42 degrees (0–90 degrees), extension of 49 degrees (0–90 degrees), ulnar deviation of 24 degrees (0–60 degrees), and radial deviation of 14 degrees (0–40 degrees). Grip and key pinch strength were 20.1 (1–50 kg) and 6 kg (1–12 kg), respectively. Average patient-rated wrist and hand evaluation score was 42.7 (0–95), disabilities of the arm, shoulder and hand score was 38 (0–88), and visual analog scale score was 3.6 (0–8). We found a 43% complication rate (mostly minor: ulnar or radial tendinopathy, temporary hypoesthesia) with 24% reoperation and 92% prosthesis survival rate. Conclusion The linked semiconstrained DRUJ prosthesis has its value in the surgical treatment of DRUJ failure. Currently, most implants are used in secondary surgery and multioperated wrists. More research is required to assess the value of the DRUJ prosthesis as a primary procedure. Level of evidence This is a level IV, therapeutic study.

Predictors of 1-Month and 1-Year Neurocognitive Functioning from the UCLA Longitudinal Mild, Uncomplicated, Pediatric Traumatic Brain Injury Study

2012 ◽  
Vol 19 (2) ◽  
pp. 145-154 ◽  
Author(s):  
Talin Babikian ◽  
David McArthur ◽  
Robert F. Asarnow
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Parental Education ◽  
Brain Injuries ◽  
Injury Severity ◽  
School Achievement ◽  
Body Part ◽  
Neurocognitive Deficits ◽  
Post Injury ◽  
Neurocognitive Impairments

AbstractAlthough more severe brain injuries have long been associated with persisting neurocognitive deficits, an increasing body of literature has shown that children/adolescents with single, uncomplicated mild traumatic brain injury (mTBI) do not exhibit long-lasting neurocognitive impairments. Nonetheless, clinical experience and our previous report (Babikian, 2011) showed that a minority of children/adolescents exhibit persistent cognitive problems using performance based measures following what appear to be relatively mild injuries. Predictors of poor neurocognitive outcomes were evaluated in 76 mTBI and 79 Other Injury subjects to determine the relative contributions of indices of injury severity, clinical symptomatology, demographic factors, and premorbid functioning in predicting 1-month and 12-month neurocognitive impairment on computerized or paper and pencil measures. Injury severity indicators or type of injury (head vs. other body part) did not predict either 1-month or 12-month cognitive impairment status. Rather, premorbid variables that antedated the injury (parental education, premorbid behavior and/or learning problems, and school achievement) predicted cognitive impairments. When post-injury neurocognitive impairments are observed in survivors of mild injuries (head or other body part), a sound understanding of their etiology is critical in designing appropriate intervention plans. Clinical and research implications are discussed. (JINS, 2012, 18, 1–10)

scholarly journals Red Blood Cell Transfusion in Animal Models of Acute Brain Injuries: A Systematic Review Protocol

2020 ◽  
Author(s):  
Mathieu Laflamme ◽  
Hourmazd Haghbayan ◽  
Manoj M Lalu ◽  
Ryan Zarychanski ◽  
Francois Lauzier ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Animal Models ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Brain Injuries ◽  
Random Effect ◽  
Red Blood Cell Transfusion ◽  
Level Of Evidence ◽  
The Impact

Abstract Background: Anemia is common in neurocritically ill patients. Considering the limited clinical evidence in this population, preclinical data may provide some understanding of the potential impact of anemia and of red blood cell transfusion in these patients. We aim to estimate the association between different transfusion strategies and neurobehavioral outcome in animal models.Methods: We will conduct a systematic review of comparative studies of red blood cell transfusion strategies using animal models of traumatic brain injury, ischemic stroke or cerebral hemorrhage. We will search MEDLINE, EMBASE and Web of Science databases for eligible studies. Two independent reviewers will perform study selection and data extraction. We will report our results in a descriptive synthesis focusing on characteristics of included studies, reported outcomes, risk of bias and construct validity. If appropriate, we will also perform a quantitative synthesis and pool results using random-effect models. Heterogeneity will be expressed with I2 statistics. Subgroup analyses are planned according to animal model characteristics, co-interventions and risks of bias.Discussion: Our study is aligned with the efforts to better understand the level of evidence on the impact of red blood cell transfusion strategies from preclinical studies in animal models of acute brain injury and the potential translation of information from the preclinical to the clinical research field.Systematic review registration: PROSPERO CRD42018086662

The Youth Throwing Score: Validating Injury Assessment in Young Baseball Players

2016 ◽  
Vol 45 (2) ◽  
pp. 317-324 ◽  
Author(s):  
Christopher S. Ahmad ◽  
Ajay S. Padaki ◽  
Manish S. Noticewala ◽  
Eric C. Makhni ◽  
Charles A. Popkin
Keyword(s):  
Upper Extremity ◽  
Assessment Tool ◽  
Pearson Correlation ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Importance Rating ◽  
Extremity Injury ◽  
Level Of Evidence ◽  
Baseball Players ◽  
Upper Extremity Injury

Background: Epidemic levels of shoulder and elbow injuries have been reported recently in youth and adolescent baseball players. Despite the concerning frequency of these injuries, no instrument has been validated to assess upper extremity injury in this patient population. Purpose/Hypothesis: The purpose of this study was to validate an upper extremity assessment tool specifically designed for young baseball players. We hypothesized that this tool will be both reliable and valid. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: The Youth Throwing Score (YTS) was constructed by an interdisciplinary team of providers and coaches as a tool to assess upper extremity injury in youth and adolescent baseball players (age range, 10-18 years). The psychometric properties of the test were then determined. Results: A total of 223 players completed the final survey. The players’ mean age was 14.3 ± 2.7 years. Pilot analysis showed that none of the 14 questions received a mean athlete importance rating less than 3 of 5, and the final survey read at a Flesch-Kincaid level of 4.1, which is appropriate for patients aged 9 years and older. The players self-assigned their injury status, resulting in a mean instrument score of 59.7 ± 8.4 for the 148 players “playing without pain,” 42.0 ± 11.5 for the 60 players “playing with pain,” and 40.4 ± 10.5 for the 15 players “not playing due to pain.” Players playing without pain scored significantly higher than those playing with pain and those not playing due to pain ( P < .001). Psychometric analysis showed a test-retest intraclass correlation coefficient of 0.90 and a Cronbach alpha intra-item reliability coefficient of 0.93, indicating excellent reliability and internal consistency. Pearson correlation coefficients of 0.65, 0.62, and 0.31 were calculated between the YTS and the Pediatric Outcomes Data Collection Instrument sports/physical functioning module, the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow score, and the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, respectively. Injured players scored a mean of 9.4 points higher after treatment ( P < .001), and players who improved in their self-assigned pain categorization scored 16.5 points higher ( P < .001). Conclusion: The YTS is the first valid and reliable instrument for assessing young baseball players’ upper extremity health.

scholarly journals Respect your elders: effects of ageing on intracranial pressure monitor use in traumatic brain injury

2019 ◽  
Vol 4 (1) ◽  
pp. e000306 ◽  
Author(s):  
Alexander J Schupper ◽  
Allison E Berndtson ◽  
Alan Smith ◽  
Laura Godat ◽  
Todd W Costantini
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Injury Severity ◽  
Demographic Data ◽  
Multivariable Analysis ◽  
Brain Trauma ◽  
Hospital Length Of Stay ◽  
Level Of Evidence ◽  
Brain Trauma Foundation

BackgroundThe Brain Trauma Foundation recommends intracranial pressure (ICP) monitor placement for patients with severe traumatic brain injury (TBI). Adherence with these guidelines in elderly patients is unknown. We hypothesized that disparities in ICP monitor placement would exist based on patient age.MethodsUsing the National Trauma Data Bank (2010–2014), we identified patients admitted for blunt TBI with admission Glasgow Coma Scale (GCS) scores of 3–8. Patients were excluded if they had a non-Head Abbreviated Injury Scale (AIS) score ≥3, hospital length of stay <24 hours or were discharged from the emergency department. Demographic data, ICP monitor placement, GCS, AIS-Head, Injury Severity Score, and outcome measures were collected. Propensity score matching between ICP monitor and non-ICP monitor patients was used for logistic regression and Cox multivariate regression analyses.ResultsOf the 30 710 patients with blunt TBI with GCS scores of 3–8 included in our study, 4093 were treated with an ICP monitor. ICP monitor placement rates significantly decreased with increasing age. Multivariable analysis demonstrated that patients treated with an ICP monitor were more likely to be younger, male, have private/commercial insurance, and receive care at an institution with three or more neurosurgeons.ConclusionPatients ≥65 years of age with severe blunt TBI are less likely to be treated with an ICP monitor than younger patients. Age disparities in adherence to Brain Trauma Foundation guidelines may alter the outcomes for patients with severe TBI.Level of evidenceLevel IV.

scholarly journals Epidemiology of Pediatric Traumatic Brain Injury at Sylvanus Olympio University Hospital of Lomé in Togo

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Pilakimwe Egbohou ◽  
Tabana Mouzou ◽  
Pikabalo Tchetike ◽  
Hamza Doles Sama ◽  
Sarakawabalo Assenouwe ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Traffic Accidents ◽  
Brain Injuries ◽  
Injury Severity ◽  
Road Traffic ◽  
Skull Fracture ◽  
University Hospital ◽  
Pediatric Traumatic Brain Injury ◽  
The Mean

Introduction. Severe pediatric traumatic brain injury (pTBI) is a leading cause of disability and death in children worldwide. Children victims of pTBI are admitted to the Sylvanus Olympio University Hospital (SOUH) at the multipurpose Intensive Care Unit (ICU). We aimed in this study to describe the epidemiologic characteristics and outcomes of pTBI patients admitted in this ICU. Patients and Methods. This study was conducted at the ICU of SOUH of Lome. It was a retrospective study based on patients’ records from 0 to 15 years old admitted during the period from 1 January 2012 to 30 June 2018 (5 years and 6 months). Results. We recorded 91 pTBI included in the study. The mean age was 7.7 ± 4.3 years. The male predominated with 67.0%. Road traffic accidents were the most common cause (79.1%), followed by falls (19.8%). The average pediatric Glasgow Coma Scale (pGCS) was 6.6 ± 1.4, with a mean Injury Severity Score (ISS) of 23.1 ± 8.4. The most common brain injuries found in the CT scan were brain edema (72.9%), skull fracture (69.5%), and brain contusion (55.9%). The average duration under mechanical ventilation was 2.1 ± 2.9 days, and the mean ICU stay was 4.9 ± 4.4 days. Overall mortality was 31.9% (29 cases). Factors significantly associated (p<0.05) with death were hypotension (51.7%), anemia (43.1%), hyperthermia (46.7%), GCS < 6 (64%), and ISS > 20 (48.9%). Conclusion. pTBI mortality remains high in SOUH ICU. Factors associated with mortality were secondary systemic insults, worse GCS < 6, and ISS > 20.

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