Symptom Experience and Emotional Distress After Traumatic Brain Injury

2006 ◽  
Vol 7 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Esther Bay ◽  
Karen Bergman

Traumatic brain injury (TBI) is unexpected and affects nearly 1.5 million Americans annually. Many with seemingly minor injuries incur long-lasting symptoms without clear explanation. This study examined the symptom experience and emotional response of persons with mild-to-moderate TBI and was guided by the University of California San Francisco (UCSF) symptom management model. Using a cross-sectional design with persons recruited from outpatient rehabilitation settings, we found a positive and significant relationship between postinjury symptom frequency and tension/anxiety, anger/hostility and perceived chronic stress, implying a need to understand these relationships over time in order to implement symptom management strategies.

2015 ◽  
Vol 33 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Viviana Marycel Céspedes Cuevas

<p><strong>Objective:</strong> To identify subgroups of women with Acute Coronary Syndrome according to symptom experience: perception, evaluation and response, based on the Symptom Management Conceptual Model.</p><p><strong>Methodology:</strong> Quantitative, descriptive, exploratory, cross-sectional study. The sample was made of 380 women positively diagnosed with Acute Coronary Syndrome, hospitalized in two institutions in Bogotá, Colombia. A measurement instrument was designed and validated.</p><p><strong>Results:</strong> Final instrument was made of 37 items that reported content validity, scale validity, discriminant validity, and construct validity. A Cronbach’s Alpha coefficient of 0,76 was obtained, which guarantees homogeneity in the measurement<br />according to the Maximum Validity-Maximum Reliability Model.<br />A total of 11 subgroups of women with Acute Coronary Syndrome were identified, those were characterized by atypical coronary heart disease symptomatology, evaluation processes<br />related to extra-cardiac causes and inadequate symptom management strategies. It was possible to demonstrate that psychosocial factors, previous coronary heart disease and delays were variables making a significant influence on the components of symptom experience.</p><p><strong>Conclusions:</strong> Women with Acute Coronary Syndrome, belonging to the 11 subgroups that were identified<br />and studied, showed atypical symptoms. The instrument designed features a proven psychometric quality; it was valid, reliable, and useful for clinical research and practice.</p>


2018 ◽  
Vol 18 (2) ◽  
pp. 80-85
Author(s):  
Suherman Suherman ◽  
Ipak Nistriana ◽  
Muhammad Rizky

Abstrak. Latar Belakang Cedera kepala traumatik masih menjadi penyebab utama kecacatan dan kematian di dunia. Sebagian besar terjadi pada usia produktif. Efek sekunder dari cedera kepala adalah gangguan fungsi kognitif berupa fungsi memori, visuospasial, perhatian dan konsentrasi, bahasa, kalkulasi, dan orientasi. Masih sedikitnya penelitian tentang penilaian fungsi memori pada pasien cedera kepala di Indonesia. Tujuan Memaparkan gambaran penurunan fungsi kognitif terutama fungsi memori pada pasien cedera kepala derajat sedang dengan edema serebri.Metode Studi deskriptif dengan desain potong-lintang menggunakan kuesioner MMSE dan MoCA-INA sebagai modalitas penilaian.Hasil Dari 30 pasien cedera kepala traumatik derajat sedang didapatkan rerata skor MMSE adalah 27.1±2.13 (interval 20-29). Rerata skor MoCA-INA adalah 24.4±2.99 (interval 16-28). Kedua skor menunjukkan bahwa MoCA-INA memiliki rerata yang lebih rendah dan rentang skor yang lebih luas. Domain yang paling banyak terganggu adalah fungsi memori recall (98%)Kesimpulan Secara keseluruhan pasien dengan cedera kepala traumatik dengan edema serebri mengalami gangguan fungsi memori terutama area memori eksplisit berupa fungsi recall. Tatalaksana kuratif dan rehabilitatif secara adekuat dan berkelanjutan diperlukan untuk mempercepat proses penyembuhanKata Kunci Cedera Kepala Traumatik Derajat Sedang, Fungsi Memori, MMSE, MoCA-INAAbstract. Background Traumatic brain injury is still a major cause of disability and death. Most occur in productive age. Secondary effects of brain injury are impaired cognitive function in the form of memory, visuospatial, attention and concentration, language, calculation, and orientation. There are few research on the assessment of memory function in brain injury patients in Indonesia.Purpose To describes the decreasing cognitive function, particularly memory function in patients with moderate brain injury with cerebral edema.Method Descriptive study with cross-sectional design using MMSE and MoCA-INA questionnaires as assessment modalities.Results Of the 30 patients with moderate-grade traumatic head injury, the mean MMSE score was 27.1 ± 2.13 (intervals 20-29). The average MoCA-INA score is 24.4 ± 2.99 (intervals 16-28). Both scores indicate that the MoCA-INA has a lower mean and a wider score range. The most disturbed domain is recall memory function (96%)Conclusion Overall patients with traumatic brain injury with cerebral edema experience impaired memory function, especially the area of explicit memory in the form of recall function. Adequate and sustainable curative and rehabilitative management is needed to accelerate the healing process Keywords Traumatic Head Injury Moderate Level, Memory Function, MMSE, MoCA-INA 


2019 ◽  
Vol 185 (3-4) ◽  
pp. 428-435
Author(s):  
Marcy M Pape ◽  
Paula N Kodosky ◽  
Peter Hoover

Abstract Introduction The objective of this study was to determine the utility of the Community Balance and Mobility scale (CB&M) among service members presenting with mild traumatic brain injury (mTBI), to compare the results against well-established balance assessments, and to find a new military-specific CB&M cut score to help differentiate those with and without mTBI. Materials and Methods The setting was a 4-week, intensive-outpatient, interdisciplinary program for active duty service members with mTBI. This was a nonrandomized, cross-sectional design that compared multiple measures between two groups: active duty service members with (n = 45) and without (n = 45) mTBI. The assessments, including the Activities-Specific Balance Confidence Scale, gait speed (comfortable and fast), the Functional Gait Assessment, and the CB&M, were provided to both sample groups. Results The mTBI group performed significantly worse (P ≤ 0.01) across all measures. A higher cut score for the CB&M of 81.5 is suggested. The CB&M demonstrated the best sensitivity (78%) and specificity (91%) ratio, as well as the largest effect size and area under the curve(0.92). Conclusion All objective measures distinguish participants with mTBI from controls, ranging from fair to excellent. The recommended CB&M cut score of 81.5 allows for good variance, standard deviation, and reduced risk of ceiling or floor effects. Further examination of the recommended CB&M cut score is warranted for use in the mTBI civilian populations.


e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 504
Author(s):  
Akbar S. Putera ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley ◽  
Fima L. F. G. Langi

Abstract: Traumatic brain injury (TBI) could result in disorders of central nervous system (CNS). Serum laminin level and the FOUR score have both been suggested as predictors for the outcomes after TBI. This study was aimed to evaluate the relationship between serum laminin level and the FOUR score in TBI patients. This was an observational and analytical study with a cross-sectional design. Subjects were 32 patients with TBI and FOUR scores of 0-16 admitted at the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital. Venous blood sample for laminin was taken less than 24 hours after trauma. Assessment of the level of consciousness was determined by using the FOUR score at Emergency Surgery Installation admission <24 hours and observation after >24 hours. Proportional regression model was used to assess changes in FOUR score associated with laminin level. The results obtained 32 patients with TBI, mean laminin level was 818.4 pg/mL with range IQR 597.4-1235.4 pg/mL. In final regression model, each increase of one unit of pre-24 hours FOUR score decreased serum laminin level by 54.4 pg/mL (95% CI -76.3; 32.1 pg/mL, p<0.001). Same as the relationship occurred for the FOUR score after 24 hours, but the decrease was slightly smaller, at 37.2 pg/mL (95% CI -50.2; -24.3 pg/mL, p<0.001). FOUR scores with a high risk of mortality were more likely to be found in relatively high serum laminin levels. In conclusion, there is a relationship between serum laminin level and the FOUR score. Increase in serum laminin level is a potential alternative to lower FOUR score and to predictof poorer outcome in patient with TBI.Keywords: laminin; FOUR score; traumatic brain injury (TBI) Abstrak: Pada cedera otak akibat trauma (COT) sering terjadi gangguan saraf pusat. Laminin serum dan skor FOUR disarankan sebagai prediktor luaran setelah COT. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dan skor FOUR pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Penelitian dilaksanakan pada 32 pasien dengan COT dan skor FOUR 0-16 yang masuk ke Instalasi Rawat Darurat Bedah (IRDB) RSUP Prof. Dr.R. D. Kandou, Manado. Sampel darah vena untuk pemeriksaan serum laminin diambil kurang dari 24 jam setelah trauma. Penilaian tingkat kesadaran ditetapkan dengan skor FOUR saat masuk IRDB <24 jam dan observasi setelah >24 jam. Model regresi proporsional digunakan untuk menilai hubungan kadar laminin serum dengan skor FOUR. Hasil penelitian mendapatkan 32 pasien dengan COT. Rerata kadar laminin serum 818,4 pg/mL dengan range IQR 597,4-1.235,4 pg/mL. Pada model regresi akhir, setiap peningkatan satu unit skor FOUR pra 24 jam rata-rata menurunkan kadar laminin serum sebesar 54,4 pg/mL (95% CI -76,3; 32,1 pg/mL, p<0,001). Hubungan sejenis terjadi untuk skor FOUR pasca 24 jam, tetapi nilai penurunannya sedikit lebih kecil, yakni 37,2 pg/mL (95% CI -50,2; -24,3 pg/mL, p<0,001). Skor FOUR dengan risiko mortalitas tinggi lebih cenderung ditemukan pada kadar laminin serum relatif tinggi. Simpulan penelitian ini ialah terdapat hubungan antara kadar laminin serum dengan skor FOUR. Peningkatan kadar laminin serum merupakan alternatif potensial skor FOUR yang lebih rendah untuk memrediksi luaran yang lebih buruk pada pasien COT.Kata kunci: laminin; skor FOUR; cedera otak akibat trauma (COT)


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Zeyu Wang ◽  
Haichen Wang ◽  
Ryan Becker ◽  
Joseph Rufo ◽  
Shujie Yang ◽  
...  

AbstractTraumatic brain injury (TBI) is a global cause of morbidity and mortality. Initial management and risk stratification of patients with TBI is made difficult by the relative insensitivity of screening radiographic studies as well as by the absence of a widely available, noninvasive diagnostic biomarker. In particular, a blood-based biomarker assay could provide a quick and minimally invasive process to stratify risk and guide early management strategies in patients with mild TBI (mTBI). Analysis of circulating exosomes allows the potential for rapid and specific identification of tissue injury. By applying acoustofluidic exosome separation—which uses a combination of microfluidics and acoustics to separate bioparticles based on differences in size and acoustic properties—we successfully isolated exosomes from plasma samples obtained from mice after TBI. Acoustofluidic isolation eliminated interference from other blood components, making it possible to detect exosomal biomarkers for TBI via flow cytometry. Flow cytometry analysis indicated that exosomal biomarkers for TBI increase in the first 24 h following head trauma, indicating the potential of using circulating exosomes for the rapid diagnosis of TBI. Elevated levels of TBI biomarkers were only detected in the samples separated via acoustofluidics; no changes were observed in the analysis of the raw plasma sample. This finding demonstrated the necessity of sample purification prior to exosomal biomarker analysis. Since acoustofluidic exosome separation can easily be integrated with downstream analysis methods, it shows great potential for improving early diagnosis and treatment decisions associated with TBI.


2021 ◽  
Vol 53 (1) ◽  
pp. 31
Author(s):  
Selvaraj Samuelkamaleshkumar ◽  
CatherineJudithHossanna ◽  
Ranjan Aruna ◽  
Suresh Annpatriciacatherine ◽  
Stephen Reethajanetsurekha ◽  
...  

2021 ◽  
Vol 5 (8) ◽  
pp. 811-817
Author(s):  
Nora Fitri ◽  
Syarif Indra ◽  
Hendra Permana

Background: Traumatic brain injury is still a major threat because it can cause global morbidity and mortality. Many factors can affect the outcome of a traumatic brain injury. Some conditions that can exacerbate traumatic brain injury include GCS conditions, blood pressure variability, and pupillary reflexes.Methods: The research was conducted in M. Djamil Padang Hospital from October 2020 to March 2021. The study design was a cross-sectional study in traumatic brain injury patients with ≤ 48 hours of onset and the aged between 18-60 years. The subjects in this study consisted of 66 subjects. At 6 weeks after onset, a GOS assessment was performed to assess patient outcomes. Statistical analysis was performed computerized with SPSS 22.0. P-value <0.05 was considered statistically significant. Results: Most of the patients were male (71.2%) with an average age of 36.41 ± 14,275 years, and the most common injury mechanism was traffic accidents (95.5%). There was a significant relationship between onset of incidence, hypotension, pupillary reflexes, and Rotterdam score with the outcome of traumatic brain injury patients (p<0.05) and there was no significant relationship between age, gender, and mechanism of injury with the outcome patients with traumatic brain injury. Conclution: The onset of events, hypotension, pupillary reflexes, and Rotterdam scores significantly affect the outcome patients of traumatic brain injury.


2010 ◽  
Vol 11 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Angela Colantonio ◽  
Dana Howse ◽  
Jigisha Patel

AbstractThe aim of this research was to identify the number and characteristics of adults under the age of 65 with a diagnosis of traumatic brain injury (TBI) living in long-term care homes (nursing homes, homes for the aged and charitable homes) in Ontario, Canada. Methods: The study used a cross-sectional design. Secondary data analysis of a comprehensive provincial database of long-term care homes was conducted. Results: Of the 399 residents coded as having a TBI, 154 were < 65 years of age. Virtually all residents were limited in personal care and required assistance for eating (94.2%), toileting (92.2%) and dressing (99.4%). A large percentage also required care for challenging behaviours, while care needs due to substance abuse was common among 12.3% of TBI residents. Conclusion: As similar research in Australia has found, young persons in long-term care homes in Ontario, Canada, have high level personal health needs, however the appropriateness of this environment is questionable.


Neurology ◽  
2018 ◽  
Vol 91 (15) ◽  
pp. 702-709 ◽  
Author(s):  
Stephanie M. Williams ◽  
Carrie Peltz ◽  
Kristine Yaffe ◽  
Philip Schulz ◽  
Michael R. Sierks

ObjectiveTo utilize a panel of 11 single chain variable fragments (scFvs) that selectively bind disease-related variants of TAR DNA-binding protein (TDP)-43, β-amyloid, tau, and α-synuclein to assess damage following traumatic brain injury (TBI), and determine if the presence of protein variants could account for the increased risk of various neurodegenerative diseases following TBI.MethodsWe utilized the panel of 11 scFvs in a sensitive ELISA format to analyze sera from 43 older veterans, 25 who had experienced at least 1 TBI incident during their lifetime (∼29.4 years after TBI), and 18 controls who did not incur TBI, in a cross-sectional study.ResultsEach of the 11 scFvs individually could significantly distinguish between TBI and control samples, though they did not detect each TBI sample. Comparing the levels of all 11 variants, all 25 TBI cases displayed higher reactivity compared to the controls and receiver operating characteristic analysis revealed 100% sensitivity and specificity. Higher total protein variants levels correlated with TBI severity and with loss of consciousness. Oligomeric tau levels distinguished between single and multiple TBI incidents. While all TBI cases were readily selected with the panel, the binding pattern varied from patient to patient, suggesting subgroups that are at increased risk for different neurodegenerative diseases.ConclusionThe panel of protein variants-specific scFvs can be used to identify blood-based biomarkers indicative of TBI even 20 years or more after the initial TBI. Being able to identify subgroups of biomarker profiles allows for the possibility of individually targeted treatments.


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