Scoping review of the risk factors and time frame for development of post-traumatic hydrocephalus

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Emily M. Hannah ◽  
Stephanie Zyck ◽  
Ali Hazama ◽  
Satish Krishnamurthy
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Brain Injuries ◽  
Significant Risk ◽  
Time Frame ◽  
Subsequent Treatment ◽  
Exclusion Criteria ◽  
Neurologic Outcomes ◽  
Post Traumatic ◽  
Diagnostic Criterion

Abstract Post-traumatic hydrocephalus (PTH) following traumatic brain injury (TBI) may develop within or beyond the acute phase of recovery. Recognition and subsequent treatment of this condition leads to improved neurologic outcomes. In this scoping review, we identify statistically significant demographic, clinical, radiographic, and surgical risk factors as well as a predictive time frame for the onset of PTH in order to facilitate timely diagnosis. Two researchers independently performed a scoping review of the PubMed and Cochrane databases for articles relevant to risk factors for PTH. Articles that met inclusion and exclusion criteria underwent qualitative analysis. Twenty-seven articles were reviewed for statistically significant risk factors and a proposed time frame for the onset of PTH. Variables that could serve as proxies for severe brain injuries were identified as risk factors. The most commonly identified risk factors included either very young or old age, intracranial hemorrhage including intraventricular hemorrhage, hygroma, and need for decompressive craniectomy. Although the timeframe for diagnosis of PTH varied widely from within one week to 31.5 months after injury, the first 50 days were more likely. Established risk factors and timeframe for PTH development may assist clinicians in the early diagnosis of PTH after TBI. Increased consistency in diagnostic criterion and reporting of PTH may improve recognition with early treatment of this condition in order to improve outcomes.

325 Thrombocytosis as a Predictor of Outcome In Severe TBI

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 271-271
Author(s):  
William J Ares ◽  
Joshua S Bauer ◽  
David O Okonkwo
Keyword(s):  
Platelet Count ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Secondary Outcome ◽  
Exclusion Criteria ◽  
Platelet Counts ◽  
Trauma Population ◽  
Severe Tbi ◽  
Hospital Stays ◽  
Post Traumatic

Abstract INTRODUCTION Post-traumatic development of thrombocytosis is felt to be secondary to a reactive process associated with cytokine release during the global inflammatory state and has been demonstrated in a general trauma population to be associated with decreased mortality. This has not been investigated in patients with severe traumatic brain injuries. METHODS This study included 120 consecutive patients with severe TBI (GCS<8) presenting to our institution between 6/2010 and 9/2012. Clinical data was retrospectively collected; clinical outcomes were part of a prospective registry. Exclusion criteria included non-survival to hospital discharge and lack of follow up data. Thrombocytosis was defined as peak platelet count greater than 600 × 103/mm3. Primary outcome was Glascow Outcome Score at 6 months. Secondary outcome was mortality at 6 months. RESULTS >Forty-four patients were available for analysis after applying exclusion criteria. All patients demonstrated an increase in platelet counts when compared to admission levels. Twenty-one (47%) patients developed thrombocytosis during their hospital stay with an average platelet count of 752 × 103/mm3 and an average time to peak of 17 days. Patients who developed thrombocytosis had a trend towards decreased GOS at 6 months (3.3 vs 3.8, p = .08) and towards longer hospital stays (37.5 vs 21.5, p = .08). Six-month mortality was unchanged between the two groups (4% vs 4%, P = 1). Additionally, patients with peak platelet counts that were greater than 200% of admission baseline had lower GOS at 6 months when compared to those that remained below 200% of baseline (3.4 vs 4.1, p = .03). CONCLUSION The development of post-traumatic thrombocytosis, while associated with lower mortality in the overall trauma population, may be associated with worse outcomes and longer hospital stays in patients with severe traumatic brain injuries. Relative reactive thrombocytosis greater than 200% of baseline may be more predictive of poor outcome than strictly defined laboratory cutoffs.

scholarly journals A Systematic Scoping Review of New Attention Problems Following Traumatic Brain Injury in Children

2021 ◽  
Vol 12 ◽  
Author(s):  
Sonja Stojanovski ◽  
Shannon E. Scratch ◽  
Benjamin T. Dunkley ◽  
Russell Schachar ◽  
Anne L. Wheeler
Keyword(s):  
Risk Factors ◽  
Brain Injury ◽  
Scoping Review ◽  
Brain Injuries ◽  
Attention Problems ◽  
Future Research ◽  
Original Research ◽  
Neural Basis ◽  
Adhd Diagnosis ◽  
Wide Range

Objective: To summarize existing knowledge about the characteristics of attention problems secondary to traumatic brain injuries (TBI) of all severities in children.Methods: Computerized databases PubMed and PsychINFO and gray literature sources were used to identify relevant studies. Search terms were selected to identify original research examining new ADHD diagnosis or attention problems after TBI in children. Studies were included if they investigated any severity of TBI, assessed attention or ADHD after brain injury, investigated children as a primary or sub-analysis, and controlled for or excluded participants with preinjury ADHD or attention problems.Results: Thirty-nine studies were included in the review. Studies examined the prevalence of and risk factors for new attention problems and ADHD following TBI in children as well as behavioral and neuropsychological factors associated with these attention problems. Studies report a wide range of prevalence rates of new ADHD diagnosis or attention problems after TBI. Evidence indicates that more severe injury, injury in early childhood, or preinjury adaptive functioning problems, increases the risk for new ADHD and attention problems after TBI and both sexes appear to be equally vulnerable. Further, literature suggests that cases of new ADHD often co-occurs with neuropsychiatric impairment in other domains. Identified gaps in our understanding of new attention problems and ADHD include if mild TBI, the most common type of injury, increases risk and what brain abnormalities are associated with the emergence of these problems.Conclusion: This scoping review describes existing studies of new attention problems and ADHD following TBI in children and highlights important risk factors and comorbidities. Important future research directions are identified that will inform the extent of this outcome across TBI severities, its neural basis and points of intervention to minimize its impact.

Soil-transmitted helminth (STH) infections in Malaysia : A scoping review protocol (Preprint)

2022 ◽  
Author(s):  
MUHAMMAD HISHAM ◽  
Fazila Haryati Ahmag ◽  
Hasmah Mohamed Haris ◽  
Noor Aliza Lodz ◽  
Norzawati Yoep ◽  
...  
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Neglected Tropical Diseases ◽  
Data Extraction ◽  
Significant Risk ◽  
Research Activity ◽  
Data Extraction Form ◽  
Review Protocol ◽  
The Government ◽  
Meta Analyses

BACKGROUND Soil-transmitted helminth (STH) infection is one of the 13 notable Neglected Tropical Diseases (NTDs) according to the CDC and WHO. In 2010, it is estimated that 1.73 billion people are infected with STH globally of which 70% of cases occur in Asia. To date, there is a dearth of published literature on the prevalence of STH infection throughout Malaysia. OBJECTIVE The objectives of this study are to review research activity on STH infection in Malaysia, to estimate the prevalence of STH infection among Malaysian, and to identify significant risk factors associated with the infection. METHODS We will conduct a scoping review based on the 6-stages structured framework of Arksey and O’Malley’s (2005) methodology. A comprehensive search strategy focusing on STH infection will be executed using electronic databases (Scopus, PubMed, Web of Science and EMBASE). A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Review (PRISMA-ScR). Mendeley software and Microsoft Excel programmes will be used to manage the references and to remove duplicates. Relevant data from selected articles will be extracted using a standardized data extraction form using the Google Form application. Results will be summarized descriptively in tabular form including types of interventions, study design, settings, tools used, and the outcomes of each study. RESULTS We would like to provide further evidence on the prevalence of STH in terms of parasite species that predominately cause the infection and the intensity of the infection. Finally, we will present the significant risk factors that contribute to STH infection and discuss prevention taken by considering the government or private sectors involvement towards curbing this issue. CONCLUSIONS We hope that the findings of this scoping review will provide information for policymakers and strengthen policy guidelines to eradicate STH infection, and for researchers to further study and investigate any STH-related issue in Malaysia.

scholarly journals Risk factors and outcomes of post-traumatic endophthalmitis: a retrospective single-center study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nawat Watanachai ◽  
Janejit Choovuthayakorn ◽  
Susama Chokesuwattanaskul ◽  
Chaipot Photcharapongsakul ◽  
Praelada Wongsirimeteekul ◽  
...  
Keyword(s):  
Risk Factors ◽  
High Velocity ◽  
Significant Risk ◽  
Risk Groups ◽  
Main Body ◽  
Delayed Presentation ◽  
Visual Outcomes ◽  
Open Globe ◽  
Post Traumatic ◽  
Potential Risks

Abstract Background To describe the epidemiology, characteristics, risk factors, and outcomes of post-traumatic endophthalmitis. Main body Medical records of consecutive open globe injury patients admitted and primarily treated between January 2006 and December 2016 were retrospectively reviewed. Patients were defined as having or not having associated endophthalmitis. Data of demographics, injury characteristics, clinical presentations, and visual outcomes were collected. The potential risks and significant factors for visual outcomes of post-traumatic endophthalmitis were determined. There were 591 patients included in this study. Among these, 118 patients were clinically diagnosed as having accompanied endophthalmitis. Higher proportions of intraocular foreign body (IOFB) (55.1% vs. 27.3%) and injury related to high-velocity objects (55.9% vs. 32.6%) were noted in patients with endophthalmitis compared to patients without endophthalmitis. Anterior wound location (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.1 to 3.7; P = 0.020), presence of IOFB (OR, 1.9; 95% CI 1.2 to 3.0; P = 0.005), and delayed presentation of > 24 h (OR, 3.9; 95% CI 2.3 to 6.4; P < 0.001) were significant risk factors for associated endophthalmitis. Final visual acuity (VA) of the overall population improved significantly from 2.4 (0.6) logMAR to 1.4 (0.1) logMAR, P < 0.001, however, patients in the endophthalmitis group achieved a worse final VA than the non-endophthalmitis group (66.1% vs. 43.5%, P < 0.001). Conclusion High proportions of post-traumatic endophthalmitis patients had subsequent poor visual outcomes. Therefore, safety and protective measurements, especially when performing activities related to high-velocity objects, and the institution of prophylactic antibiotics in high-risk groups should be promptly considered to reduce the incidence.

scholarly journals Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review

2021 ◽  
Author(s):  
Gregory Harris ◽  
Brooke Hatchell ◽  
Davelin Woodard ◽  
Dwayne Accardo
Keyword(s):  
Risk Factors ◽  
Scoping Review ◽  
Elderly Population ◽  
Postoperative Delirium ◽  
Significant Risk ◽  
The Elderly ◽  
Current Evidence ◽  
Opioid Use ◽  
Significant Difference ◽  
Opioid Administration

Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.

scholarly journals Post-Traumatic Stress Disorder Is a Significant Risk Factor for Central Serous Chorioretinopathy in Male Veterans

2021 ◽  
Vol 15 (5) ◽  
pp. 155798832110349
Author(s):  
Bradley S. Gundlach ◽  
Irena Tsui
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Risk Factor ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Central Serous Chorioretinopathy ◽  
Stress Disorder ◽  
Significant Risk ◽  
Post Traumatic Stress ◽  
Post Traumatic

The primary aim of this study was to determine whether psychosocial factors, such as post-traumatic stress disorder (PTSD) and anxiety, are independently associated with the development of central serous chorioretinopathy (CSCR), a predominantly male eye disorder. A secondary aim was to verify previously determined risk factors in a veteran population. All CSCR subjects seen in one year at a veteran eye clinic were included. Chart review was performed to identify general health information as well as eye history. Univariate and multivariate analysis was performed to identify factors that were independently associated with the development of CSCR. Fifty-one cases of CSCR were identified and an additional 51 age-matched controls with healthy eyes were used for analysis. Multivariate analysis revealed that history of PTSD was strongly associated with the development of CSCR (OR = 9.43, p = .002), even more so than previously reported risk factors. Anxiety was significant at the univariate level (OR = 6.48, p = .001) but lost significance at the multivariate level. At the multivariate level, several existing risk factors were confirmed including sleep apnea (OR = 5.76, p = .004), heart disease (OR = 7.06, p = .004), smoking (OR = 5.52, p = .003) and steroid use (OR = 4.55, p = .005). PTSD was strongly associated with the development of CSCR in the veteran population studied and may represent an important modifiable risk factor.

scholarly journals Prevalence, Risk Factors and Primary Prevention of Osteoarthritis in Asia: A Scoping Review

2019 ◽  
Author(s):  
Nur Aimi Asyrani Zamri ◽  
Sakinah Harith ◽  
Noor Aini Mohd Yusoff ◽  
Nurulhuda Mat Hassan ◽  
Ying Qian Ong
Keyword(s):  
Risk Factors ◽  
Primary Prevention ◽  
Scoping Review ◽  
Lifestyle Modification ◽  
Mass Density ◽  
Significant Risk ◽  
Cost Effective ◽  
Asian Countries ◽  
Knee Oa ◽  
Asian Populations

Introduction: Osteoarthritis (OA) is estimated to be the eleventh leading cause of disability worldwide. In Asian countries, OA is much less well-known than in the caucasian population and strongly associated with aging. Therefore, this article focuses comprehensively on the prevalence, risk factors and primary prevention for OA identified in Asian countries.   Methods: This scoping review used the methodological framework by Arksey and O'Malley (2005). Pertaining to this topic, a comprehensive search on academic journals published from 2008 to 2018 (English) was conducted.   Results: A total of 30 studies were selected in this review from 221,510 studies screened from electronic databases. The overall prevalence of OA is in a range of 20.5% to 68.0%. Most of the Asian populations reported to have knee OA in a range of 13.1% to 71.1% in various Asian countries. Risk factors that have been associated with OA are advanced age, being the female and obesity. Osteoporosis, higher body mass density, low level of education, family history of OA, smoking and environmental factors appeared as significant risk factors for OA. A strategic method of primary prevention for OA through lifestyle modification is reducing obesity and treating concomitant cardiovascular disease. Conclusion: Determining OA prevalence and risk factors will provide important information for planning future cost-effective preventive strategies.

scholarly journals The frequency of post-partum urinary retention (PPUR) and factors contributing PPUR after vaginal delivery.

2020 ◽  
Vol 27 (11) ◽  
pp. 2463-2468
Author(s):  
Hafiza Khatoon ◽  
Ambreen Naz ◽  
Nousheen Mushtaq ◽  
Farzana . ◽  
Kanta Aahuja ◽  
...  
Keyword(s):  
Risk Factors ◽  
Epidural Analgesia ◽  
Urinary Retention ◽  
Vaginal Delivery ◽  
Post Partum ◽  
Significant Risk ◽  
Medical Sciences ◽  
Exclusion Criteria ◽  
Postpartum Urinary Retention ◽  
Study Setting

Objective: To determine the frequency and factors contributing to post-partum urinary retention (PPUR) after vaginal delivery. Study Design: Observational study. Setting: Department of Obstetrics and Gynecology, Gambat Institute of Medical Sciences Gambat, Khairpur Sindh. Period: 1st November 2018 to 30th June 2019. Material & Methods: Out of 114 patients delivered vaginaly at Gambat Institute of Medical Sciences Gambat, Khairpur Sindh, postnatal patients who do not urinate within 6 hours after normal viginal delivery, label as a case of PPUR following the inclusion and exclusion criteria. Results: Frequency of postpartum urinary retention (PPUR) after vaginal delivery was observed in 6.14% (7/114). Significant risk Factors contributing to post-partum urinary retention (PPUR) were Prolong labor and epidural analgesia. Conclusion: We concluded that statistically significant risk factors for postpartum urinary retention were epidural analgesia and prolong labor. So attention to bladder care during labor and vigilance in the early detection.

scholarly journals GFAP positivity in neurons following traumatic brain injuries

2021 ◽  
Author(s):  
Johann Zwirner ◽  
Julia Lier ◽  
Heike Franke ◽  
Niels Hammer ◽  
Jakob Matschke ◽  
...  
Keyword(s):  
Survival Time ◽  
Outcome Prediction ◽  
Brain Injuries ◽  
Traumatic Brain Injuries ◽  
Exclusion Criteria ◽  
Post Mortem Interval ◽  
Regional Brain ◽  
Post Traumatic ◽  
Contralateral Cortex ◽  
Negative Controls

AbstractGlial fibrillary acidic protein (GFAP) is a well-established astrocytic biomarker for the diagnosis, monitoring and outcome prediction of traumatic brain injury (TBI). Few studies stated an accumulation of neuronal GFAP that was observed in various brain pathologies, including traumatic brain injuries. As the neuronal immunopositivity for GFAP in Alzheimer patients was shown to cross-react with non-GFAP epitopes, the neuronal immunopositivity for GFAP in TBI patients should be challenged. In this study, cerebral and cerebellar tissues of 52 TBI fatalities and 17 controls were screened for immunopositivity for GFAP in neurons by means of immunohistochemistry and immunofluorescence. The results revealed that neuronal immunopositivity for GFAP is most likely a staining artefact as negative controls also revealed neuronal GFAP staining. However, the phenomenon was twice as frequent for TBI fatalities compared to non-TBI control cases (12 vs. 6%). Neuronal GFAP staining was observed in the pericontusional zone and the ipsilateral hippocampus, but was absent in the contralateral cortex of TBI cases. Immunopositivity for GFAP was significantly correlated with the survival time (r = 0.306, P = 0.015), but no correlations were found with age at death, sex nor the post-mortem interval in TBI fatalities. This study provides evidence that the TBI-associated neuronal immunopositivity for GFAP is indeed a staining artefact. However, an absence post-traumatic neuronal GFAP cannot readily be assumed. Regardless of the particular mechanism, this study revealed that the artefact/potential neuronal immunopositivity for GFAP is a global, rather than a regional brain phenomenon and might be useful for minimum TBI survival time determinations, if certain exclusion criteria are strictly respected.

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