Anesthetic Preconditioning of Traumatic Brain Injury is Ineffective in a Drosophila Model of Obesity

We tested the hypothesis that obesity influences the pharmacodynamics of volatile general anesthetics (VGAs) by comparing effects of anesthetic exposure on mortality from traumatic brain injury (TBI) in lean and obese Drosophila melanogaster. We induced TBI with a High-Impact Trauma device. Starvation-selection over multiple generations resulted in an obese phenotype (SS flies). Fed flies served as lean controls (FC flies). Adult (1-7 day old) SS and FC flies were exposed to equianesthetic doses of isoflurane or sevoflurane either before or after TBI. The principal outcome was percent mortality 24 hours after injury, expressed as the Mortality Index at 24 hours (MI24). TBI resulted in lower MI24 in FC than in SS flies (21 (2.35) and 57.8 (2.14), respectively n= 12, p=0.0001). Preexposure to isoflurane or sevoflurane preconditioned FC flies to TBI reducing the risk of death to 0.53 [0.25 to 1.13] and 0.82 [0.43 to 1.58], respectively, but had no preconditioning effect in SS flies. Postexposure to isoflurane or sevoflurane increased the risk of death in SS flies. Only postexposure to isoflurane increased the risk in FC flies (1.39 [0.81 to 2.38]). Thus, obesity affects the pharmacodynamics of VGAs, thwarting the preconditioning effect of isoflurane and sevoflurane in TBI.

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The role of salivary vesicles as a potential inflammatory biomarker to detect traumatic brain injury in mixed martial artists

Scientific Reports ◽

10.1038/s41598-021-87180-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Rani Matuk ◽

Mandy Pereira ◽

Janette Baird ◽

Mark Dooner ◽

Yan Cheng ◽

...

Keyword(s):

Gene Expression ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Head Injury ◽

Injury Severity ◽

Expression Profiles ◽

High Impact ◽

Impact Mechanism ◽

Inflammatory Biomarker ◽

Potential Biomarker

AbstractTraumatic brain injury (TBI) is of significant concern in the realm of high impact contact sports, including mixed martial arts (MMA). Extracellular vesicles (EVs) travel between the brain and oral cavity and may be isolated from salivary samples as a noninvasive biomarker of TBI. Salivary EVs may highlight acute neurocognitive or neuropathological changes, which may be particularly useful as a biomarker in high impact sports. Pre and post-fight samples of saliva were isolated from 8 MMA fighters and 7 from controls. Real-time PCR of salivary EVs was done using the TaqMan Human Inflammatory array. Gene expression profiles were compared pre-fight to post-fight as well as pre-fight to controls. Largest signals were noted for fighters sustaining a loss by technical knockout (higher impact mechanism of injury) or a full match culminating in referee decision (longer length of fight), while smaller signals were noted for fighters winning by joint or choke submission (lower impact mechanism as well as less time). A correlation was observed between absolute gene information signals and fight related markers of head injury severity. Gene expression was also significantly different in MMA fighters pre-fight compared to controls. Our findings suggest that salivary EVs as a potential biomarker in the acute period following head injury to identify injury severity and can help elucidate pathophysiological processes involved in TBI.

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Remarks on patients with traumatic brain injury due to traffic accident related to alcohol comsumption treated in Vietduc hospital after implementing the decree 100

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1327 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Nguyen Duc Chinh ◽

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Road Traffic Accident ◽

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Hospital Death ◽

Risk Of Death

Purpose: Traumatic Brain Injury (TBI) is still considered as a leading cause of morbidity and mortality of victims by traffic accident. Despite a fact that many measurements and preventions have been applied, the rate of TBI is remained high. Aim of this study was to investigate treatment process of TBI caused by road traffic accident at Viet Duc Hospital after the Decree 100 which has been issued in Vietnam in early 2020. Materials and method: A retrospective and prospective study has been conducted in Viet Duc Hospital from Dec, 2020 to March, 2021. All the patients with TBI by road traffic accident were enrolled. Severity of TBI was identified by Glasgow Scale (GCS) and BAC (Blood Alcohol Concentration) test taken on arrival. The data was collected from medical record as well as autopsy report and analysed by SPSS.20.0 Results: A total of 150 patients with TBI by road traffic accidents were enrolled, age group from 21 to 60 years old accounted for 64%, male accounted for 86.7%. Associated injuries were maxillofacial lesions 48%, extremities 24.7%, chest accounted for 20%. Severity of TBI with GCS 6 - 8 was the highest rate 52%, from 3 - 5 GCS accounted for 30%. 40% were operated on emergency; BAC was positive 46.7%, of which over from 50 mg/L accounted for 32.6%. The patients with GCS from 6 to 8 were BAC positive accounted for a higher rate than groups with GCS above 9 or below 5. The most common TBI lesions were subarachnoid hemorrhage, subdural hematoma and cerebral edema accounted for 67.3%, 60% and 58% respectively. Overall mortality was 26% including in-hospital death and discharged to die. Conclusions and recommendations: Data from the study has shown that many young men with severe TBI by road traffic accident were BAC positive which can results in the high risk of death and disability. Thus, we highly recommend counterparts should constantly strengthen the propaganda and enforcement measures in order to reduce traffic accidents and TBI patients. Keywords: traffic accidents; injury; brain trauma severity.

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Living in Fear and Prioritizing Safety: Exploring Women’s Lives After Traumatic Brain Injury From Intimate Partner Violence

Qualitative Health Research ◽

10.1177/1049732318786705 ◽

2018 ◽

Vol 28 (11) ◽

pp. 1708-1718 ◽

Cited By ~ 12

Author(s):

Amanda St Ivany ◽

Linda Bullock ◽

Donna Schminkey ◽

Kristen Wells ◽

Phyllis Sharps ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Intimate Partner Violence ◽

Brain Injury ◽

Partner Violence ◽

Secondary Data ◽

Intimate Partner ◽

Theory Approach ◽

Central Process ◽

Daily Lives ◽

Risk Of Death

There is increasing evidence that women are receiving a traumatic brain injury (TBI) during episodes of intimate partner violence (IPV), but little qualitative research exists around how surviving this experience impacts the lives of women. Primary and secondary data ( N = 19) were used with a constructivist grounded theory approach to explore the lives of women aged 18 to 44 years, who were living with a TBI from IPV. Women described multiple aspects of living in fear that shaped their daily lives and ability to seek help and access resources. The central process of prioritizing safety emerged, with salient dimensions of maintaining a present orientation, exhibiting hyperprotection of children, invoking isolation as protection, and calculating risk of death. These findings add to the growing body of knowledge that women living with IPV are at high risk for receiving a TBI and are therefore a subgroup in need of more prevention and treatment resources.

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Traumatic brain injury associated with dementia risk among people with type 1 diabetes

Neurology ◽

10.1212/wnl.0000000000006391 ◽

2018 ◽

Vol 91 (17) ◽

pp. e1611-e1618 ◽

Cited By ~ 3

Author(s):

Paola Gilsanz ◽

Kathleen Albers ◽

Michal Schnaider Beeri ◽

Andrew J. Karter ◽

Charles P. Quesenberry ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Type 1 Diabetes ◽

Brain Injury ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Competing Risk ◽

Middle Aged ◽

Risk Of Death ◽

Dementia Risk

ObjectiveTo examine the association between traumatic brain injury (TBI) and dementia risk among a cohort of middle-aged and elderly individuals with type 1 diabetes (T1D).MethodsWe evaluated 4,049 members of an integrated health care system with T1D ≥50 years old between January 1, 1996, and September 30, 2015. Dementia and TBI diagnoses throughout the study period were abstracted from medical records. Cox proportional hazards models estimated associations between time-dependent TBI and dementia adjusting for demographics, HbA1c, nephropathy, neuropathy, stroke, peripheral artery disease, depression, and dysglycemic events. Fine and Gray regression models evaluated the association between baseline TBI and dementia risk accounting for competing risk of death.ResultsA total of 178 individuals (4.4%) experienced a TBI and 212 (5.2%) developed dementia. In fully adjusted models, TBI was associated with 3.6 times the dementia risk (hazard ratio [HR] 3.64; 95% confidence interval [CI] 2.34, 5.68). When accounting for the competing risk of death, TBI was associated with almost 3 times the risk of dementia (HR 2.91; 95% CI 1.29, 5.68).ConclusionThis study demonstrates a marked increase in risk of dementia associated with TBI among middle-aged and elderly people with T1D. Given the complexity of self-care for individuals with T1D, and the comorbidities that predispose them to trauma and falls, future work is needed on interventions protecting brain health in this vulnerable population, which is now living to old age.

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Analysis of direct costs of decompressive craniectomy in victims of traumatic brain injury

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x20180016 ◽

2018 ◽

Vol 76 (4) ◽

pp. 257-264 ◽

Cited By ~ 3

Author(s):

Guilherme Lellis Badke ◽

João Luiz Vitorino Araujo ◽

Flávio Key Miura ◽

Vinicius Monteiro de Paula Guirado ◽

Nelson Saade ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Developing Country ◽

Decompressive Craniectomy ◽

Direct Costs ◽

High Morbidity ◽

Prevention Measures ◽

Total Cost ◽

Mortality Index ◽

Epidemiological Profile

ABSTRACT Background: Decompressive craniectomy is a procedure required in some cases of traumatic brain injury (TBI). This manuscript evaluates the direct costs and outcomes of decompressive craniectomy for TBI in a developing country and describes the epidemiological profile. Methods: A retrospective study was performed using a five-year neurosurgical database, taking a sample of patients with TBI who underwent decompressive craniectomy. Several variables were considered and a formula was developed for calculating the total cost. Results: Most patients had multiple brain lesions and the majority (69.0%) developed an infectious complication. The general mortality index was 68.8%. The total cost was R$ 2,116,960.22 (US$ 661,550.06) and the mean patient cost was R$ 66,155.00 (US$ 20,673.44). Conclusions: Decompressive craniectomy for TBI is an expensive procedure that is also associated with high morbidity and mortality. This was the first study performed in a developing country that aimed to evaluate the direct costs. Prevention measures should be a priority.

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Comorbidity and outcomes in traumatic brain injury: protocol for a systematic review on functional status and risk of death

BMJ Open ◽

10.1136/bmjopen-2017-018626 ◽

2017 ◽

Vol 7 (10) ◽

pp. e018626 ◽

Cited By ~ 5

Author(s):

Tatyana Mollayeva ◽

Chen Xiong ◽

Sara Hanafy ◽

Vincy Chan ◽

Zheng Jing Hu ◽

...

Keyword(s):

Systematic Review ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Functional Status ◽

Medical Information ◽

Longitudinal Design ◽

Adverse Outcomes ◽

Current Evidence ◽

Risk Of Death ◽

The Impact

IntroductionReports on the association between comorbidity and functional status and risk of death in patients with traumatic brain injury (TBI) have been inconsistent; it is currently unknown which additional clinical entities (comorbidities) have an adverse influence on the evolution of outcomes across the lifespan of men and women with TBI. The current protocol outlines a strategy for a systematic review of the current evidence examining the impact of comorbidity on functional status and early-term and late-term mortality, taking into account known risk factors of these adverse outcomes (ie, demographic (age and sex) and injury-related characteristics).Methods and analysisA comprehensive search strategy for TBI prognosis, functional (cognitive and physical) status and mortality studies has been developed in collaboration with a medical information specialist of the large rehabilitation teaching hospital. All peer-reviewed English language studies with longitudinal design in adults with TBI of any severity, published from May 1997 to April 2017, found through Medline, Central, Embase, Scopus, PsycINFO and bibliographies of identified articles, will be considered eligible. Study quality will be assessed using published guidelines.Ethics and disseminationThe authors will publish findings from this review in a peer-reviewed scientific journal(s) and present the results at national and international conferences. This work aims to understand how comorbidity may contribute to adverse outcomes in TBI, to inform risk stratification of patients and guide the management of brain injury acutely and at the chronic stages postinjury on a population level.PROSPERO registration numberCRD42017070033.

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Gastrointestinal Failure Score in Children with Traumatic Brain Injury

10.21203/rs.3.rs-36656/v2 ◽

2021 ◽

Author(s):

Ying Zhou ◽

Weifeng Lu ◽

Weibing Tang

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Surgical Intensive Care Unit ◽

Gastrointestinal Dysfunction ◽

Roc Curve Analysis ◽

Surgical Intensive Care ◽

Risk Of Death ◽

Abdominal Hypertension ◽

Gastrointestinal Failure ◽

The Mean

Abstract Purposes: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. Methods: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were retrospectively analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. Results: The percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4% and 21.8% of the patients, respectively. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); these scores were also significantly different between patients who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. Conclusion: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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Gastrointestinal Failure Score in Children with Traumatic Brain Injury

10.21203/rs.3.rs-36656/v1 ◽

2020 ◽

Author(s):

Ying Zhou ◽

Weifeng Lu ◽

Weibing Tang

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Surgical Intensive Care Unit ◽

Gastrointestinal Dysfunction ◽

Roc Curve Analysis ◽

Surgical Intensive Care ◽

Risk Of Death ◽

Abdominal Hypertension ◽

Gastrointestinal Failure ◽

The Mean

Abstract PurposesTo review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function.MethodsA total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and 2019 were retrospectively analyzed. Admission parameters were sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb) and hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). In order to predict outcome, Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS) and mean GIF score for the first three days were also combined.ResultsThe percent of patients with gastrointestinal dysfunction on the first day was 78.8%. Food intolerance (FI) developed in 36.4% and intra-abdominal hypertension (IAH) in 21.8% of patients. The GIF score and mean GIF score for the first three days in children with different degrees of TBI were significantly different (P<0.05); they were also significantly different between those who died and those who survived (P<0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio>1, 95% confidence interval=1.457 to 16.016, P<0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children.ConclusionThe incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has its ability to judge gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

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Association between traumatic brain injury (TBI) patterns and mortality: a retrospective case-control study

F1000Research ◽

10.12688/f1000research.54658.1 ◽

2021 ◽

Vol 10 ◽

pp. 795

Author(s):

Gilbert Koome ◽

Faith Thuita ◽

Thaddaeus Egondi ◽

Martin Atela

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Hospital Care ◽

Case Control Study ◽

Road Traffic ◽

Case Control ◽

Trauma Mechanism ◽

Care Level ◽

Risk Of Death ◽

Control Study

Background: Low and medium income countries (LMICs) such as Kenya experience nearly three times more cases of traumatic brain injury (TBI) compared to high income countries (HICs). This is primarily exacerbated by weak health systems especially at the pre-hospital care level. Generating local empirical evidence on TBI patterns and its influence on patient mortality outcomes is fundamental in informing the design of trauma-specific emergency medical service (EMS) interventions at the pre-hospital care level. This study determines the influence of TBI patterns and mortality. Methods: This was a case-control study with a sample of 316 TBI patients. Data was abstracted from medical records for the period of January 2017 to March 2019 in three tertiary trauma care facilities in Kenya. Logistic regression was used to assess influence of trauma patterns on TBI mortality, controlling for patient characteristics and other potential confounders. Results: The majority of patients were aged below 40 years (73%) and were male (85%). Road traffic injuries (RTIs) comprised 58% of all forms of trauma. Blunt trauma comprised 71% of the injuries. Trauma mechanism was the only trauma pattern significantly associated with TBI mortality. The risk of dying for patients sustaining RTIs was 2.83 times more likely compared to non-RTI patients [odds ratio (OR) 2.83, 95% confidence interval (CI) 1.62-4.93, p=0.001]. The type of transfer to hospital was also significantly associated with mortality outcome, with a public hospital having a two times higher risk of death compared to a private hospital [OR 2.18 95%CI 1.21-3.94, p<0.009]. Conclusion: Trauma mechanism (RTI vs non-RTI) and type of tertiary facility patients are transferred to (public vs private) are key factors influencing TBI mortality burden. Strengthening local EMS trauma response systems targeting RTIs augmented by adequately resourced and equipped public facilities to provide quality lifesaving interventions can reduce the burden of TBIs.

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Enhanced risk of traumatic brain injury in patients with chronic obstructive pulmonary disease

Journal of Investigative Medicine ◽

10.1136/jim-2019-001207 ◽

2019 ◽

Vol 68 (4) ◽

pp. 846-855

Author(s):

Tang-Hsiu Huang ◽

Chiung-Zuei Chen ◽

Hung-I Kuo ◽

Hong-Ping Er ◽

Sheng-Hsiang Lin

Keyword(s):

Chronic Obstructive Pulmonary Disease ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Pulmonary Disease ◽

Acute Exacerbation ◽

Chronic Obstructive ◽

Research Database ◽

Obstructive Pulmonary Disease ◽

Risk Of Death ◽

Increased Risk

This study tests our hypothesis that patients with chronic obstructive pulmonary disease (COPD) have an increased risk of traumatic brain injury (TBI).In this nationwide retrospective cohort study, we used a subset of Taiwan’s National Health Insurance Research Database, involving 1 million randomly selected beneficiaries. Patients with newly diagnosed COPD between 2000 and 2008 were identified. They were subgrouped as ‘COPDAE+’ (if they had severe acute exacerbation of COPD during the follow-ups) or ‘COPDAE−’ (if they had no acute exacerbation), and were frequency matched with randomly selected subjects without COPD (the ‘non-COPD’ group). Baseline differences were balanced by the inverse probability of treatment weighting based on the propensity score. For each patient, the risk of TBI during the subsequent 5 years was determined. The competing risk of death was controlled.We identified 3734 patients in ‘COPDAE+’, and frequency matched them with 11,202 patients in ‘COPDAE−’ and 11,202 subjects in ‘non-COPD’. Compared with those in ‘non-COPD’, patients in ‘COPDAE+’ and ‘COPDAE−’ had an increased risk of TBI: the adjusted HR for ‘COPDAE+’ was 1.50, 95% CI 1.31 to 1.73, and that for ‘COPDAE−’ was 1.21, 95% CI 1.09 to 1.34. The highest risk was observed in the ‘COPDAE+’ group that aged <65 (the adjusted HR was 1.92; 95% CI 1.39 to 2.64).COPD has been linked to complications beyond the respiratory system. In this study we showed that COPD is associated with an increased risk of TBI.

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