scholarly journals Longitudinal Growth Curve Trajectories of Family Dynamics after Pediatric Traumatic Brain Injury in Mexico

2020 ◽  
Vol 17 (22) ◽  
pp. 8508
Author(s):  
Grace B. McKee ◽  
Laiene Olabarrieta-Landa ◽  
Paula K. Pérez-Delgadillo ◽  
Ricardo Valdivia-Tangarife ◽  
Teresita Villaseñor-Cabrera ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Growth Curve ◽  
Family Members ◽  
Family Satisfaction ◽  
Health Concern ◽  
Pediatric Traumatic Brain Injury ◽  
Large Hospital ◽  
Pediatric Tbi

Pediatric traumatic brain injury (TBI) represents a serious public health concern. Family members are often caregivers for children with TBI, which can result in a significant strain on familial relationships. Research is needed to examine aspects of family functioning in the context of recovery post-TBI, especially in Latin America, where cultural norms may reinforce caregiving by family members, but where resources for these caregivers may be scarce. This study examined caregiver-reported family satisfaction, communication, cohesion, and flexibility at three time points in the year post-injury for 46 families of a child with TBI in comparison to healthy control families. Families experiencing pediatric TBI were recruited from a large hospital in Guadalajara, Mexico, while healthy controls were recruited from a local educational center. Results from multilevel growth curve models demonstrated that caregivers of children with a TBI reported significantly worse family functioning than controls at each assessment. Families experiencing pediatric TBI were unable to attain the level of functioning of controls during the time span studied, suggesting that these families are likely to experience long-term disruptions in family functioning. The current study highlights the need for family-level intervention programs to target functioning for families affected by pediatric TBI who are at risk for difficulties within a rehabilitation context.

scholarly journals Epidemiology of Pediatric Traumatic Brain Injury in Brazil

2021 ◽  
Author(s):  
Leandro Cândido de Souza ◽  
Ricardo Santos de Oliveira ◽  
Francisco de Assis Carvalho do Vale ◽  
Matheus Fernando Manzolli Ballestero
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Hospital Admissions ◽  
Pediatric Population ◽  
Case Fatality ◽  
Public Health Problem ◽  
Emerging Countries ◽  
Pediatric Traumatic Brain Injury ◽  
Important Public Health Problem ◽  
Pediatric Tbi

Background: Pediatric traumatic brain injury (TBI) is a serious social and economic problem. Emerging countries have 89% of the cases worldwide and lack relevant epidemiological studies on the subject. Objectives: Characterize the demographic, social and economic profiles of the pediatric population suffering TBI in Brazil. Methods: Data on the cases of pediatric TBI in Brazil between 2008 and 2020 were collected through the computer department of the Unified Health System (DATASUS) maintained by the Brazilian Ministry of Health. Results: There are about 28,836 hospital admissions due to pediatric TBI per year and an incidence of 45.11 admissions /100,000/year. The in-hospital mortality rate was 1.47/100,000/year, and the case fatality rate was 3.26%. The average annual cost of hospital expenses was US$ 12.311.759, with the average admission cost having a value of US $417. The 15–19 age group was the most frequently admitted to hospital for pediatric TBI and had the highest number of in- hospital deaths; in addition, more males were affected by this trauma compared to females at a rate of 2.31:1. Ethnic populations that are social minorities are more susceptible to a poor prognosis of TBI. Conclusion: Pediatric TBI should be recognized as an important public health problem in Brazil, as it is responsible for considerable social and economic costs. Public policies that reduce the causes of this type of trauma in the pediatric population are urgently needed in Brazil and other emerging countries.

Validation of prognostic models in intensive care unit–treated pediatric traumatic brain injury patients

2019 ◽  
Vol 24 (3) ◽  
pp. 330-337 ◽  
Author(s):  
Era D. Mikkonen ◽  
Markus B. Skrifvars ◽  
Matti Reinikainen ◽  
Stepani Bendel ◽  
Ruut Laitio ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Intensive Care ◽  
Brain Injury ◽  
Scoring Systems ◽  
Predictive Performance ◽  
Classification Systems ◽  
Prognostic Models ◽  
Pediatric Traumatic Brain Injury ◽  
Pediatric Tbi ◽  
The Impact

OBJECTIVEThere are few specific prognostic models specifically developed for the pediatric traumatic brain injury (TBI) population. In the present study, the authors tested the predictive performance of existing prognostic tools, originally developed for the adult TBI population, in pediatric TBI patients requiring stays in the ICU.METHODSThe authors used the Finnish Intensive Care Consortium database to identify pediatric patients (< 18 years of age) treated in 4 academic ICUs in Finland between 2003 and 2013. They tested the predictive performance of 4 classification systems—the International Mission for Prognosis and Analysis of Clinical Trials (IMPACT) TBI model, the Helsinki CT score, the Rotterdam CT score, and the Marshall CT classification—by assessing the area under the receiver operating characteristic curve (AUC) and the explanatory variation (pseudo-R2 statistic). The primary outcome was 6-month functional outcome (favorable outcome defined as a Glasgow Outcome Scale score of 4–5).RESULTSOverall, 341 patients (median age 14 years) were included; of these, 291 patients had primary head CT scans available. The IMPACT core-based model showed an AUC of 0.85 (95% CI 0.78–0.91) and a pseudo-R2 value of 0.40. Of the CT scoring systems, the Helsinki CT score displayed the highest performance (AUC 0.84, 95% CI 0.78–0.90; pseudo-R2 0.39) followed by the Rotterdam CT score (AUC 0.80, 95% CI 0.73–0.86; pseudo-R2 0.34).CONCLUSIONSPrognostic tools originally developed for the adult TBI population seemed to perform well in pediatric TBI. Of the tested CT scoring systems, the Helsinki CT score yielded the highest predictive value.

scholarly journals Mental Health and Family Functioning in Patients and Their Family Members after Traumatic Brain Injury: A Cross-Sectional Study

2020 ◽  
Vol 10 (10) ◽  
pp. 670
Author(s):  
Mari S. Rasmussen ◽  
Juan Carlos Arango-Lasprilla ◽  
Nada Andelic ◽  
Tonje H. Nordenmark ◽  
Helene L. Soberg
Keyword(s):  
Mental Health ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Family Functioning ◽  
Self Efficacy ◽  
General Health ◽  
Family Members ◽  
Related Factors ◽  
Targeted Interventions ◽  
The Family

Traumatic brain injury (TBI) affects the family as a whole. This study aimed to describe and compare mental health and family functioning in TBI patients and their family members, and to identify individual and family-related factors that were associated with mental health. It was conducted at an urban, specialized, TBI outpatient clinic and included 61 patients with mild to severe TBI and 63 family members. Baseline demographics and injury-related data were collected, and the participants answered standardized, self-reported questionnaires 6–18 months post-injury that assessed mental health; general health; family functioning, communication, and satisfaction; depression and anxiety; self-efficacy; resilience; and condition-specific quality of life. The patients reported significantly worse mental health, depression, resilience, self-efficacy, and general health compared with the family members. Patients and family members had similar perceptions, showing balanced family functioning, high family communication levels, and moderate family satisfaction. Factors significantly associated with mental health in patients and family members were depression, anxiety, and resilience, explaining 56% of the variance (p < 0.001). Family-related factors were not associated with mental health. The disease burden was mainly on the patients; however, the family members also reported emotional distress. Family-targeted interventions across the TBI continuum should be considered.

scholarly journals Clinical guidelines for traumatic brain injuries in children and boys

2020 ◽  
Vol 30 (1) ◽  
pp. 159-170
Author(s):  
Hojjat Derakhshanfar ◽  
Elham Pourbakhtyaran ◽  
Samane Rahimi ◽  
Samira Sayyah ◽  
Zahra Soltantooyeh ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Clinical Practice ◽  
Brain Injury ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Clinical Guidelines ◽  
Pediatric Traumatic Brain Injury ◽  
Normal Ranges ◽  
Pediatric Tbi

The main aim of management of pediatric traumatic brain injury (TBI)  is to hold normal ranges for optimizing the most proper outcomes. However, for providing physiologic requirements of an injured brain it is very important to enhance the quality of recovery and minimize secondary injury. Within this study it is tried to regulate the most proper guidelines for management of pediatric TBI. A comprehensive research was conducted on some biomedical and pharmacological bibliographic database of life sciences such as PubMed, EMBASE, MEDLINE, LILACS database, global independent network of Cochrane, Science Direct and global health library of Global Index Medicus (GIM). By referencing these databases, a universal literature review was carried out through combining various recent studies in terms of pediatric traumatic brain injury, epidemiology, management and related clinical guidelines in accordance with various related articles published from 2000 to 2019 which could cover this area of recommendations.Based on the main objective of this study for providing a comprehensive review around available clinical practice guidelines for more precise management of TBI. These guidelines can be administered especially for pediatric population which possibly could improve the quality of clinical practice guidelines for TBI. The guidelines of TBI could be applied worldwide in various traditional demographic and geographic boundaries which could affect pediatric populations in various ranges of ages. Accordingly, advances in civil foundation and reforms of explicit health policy could decrease the pediatric TBI socioeconomic burdens.

scholarly journals Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Rahul Singh ◽  
Ryan C. Turner ◽  
Linda Nguyen ◽  
Kartik Motwani ◽  
Michelle Swatek ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Drug Targets ◽  
Pediatric Patients ◽  
Treatment Options ◽  
Autism Spectrum ◽  
Pediatric Traumatic Brain Injury ◽  
Gastrointestinal Problems ◽  
Brain Circuitry ◽  
Pediatric Tbi

Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition. We discuss potential therapeutic and pharmacologic options as well as potential novel drug targets. Furthermore, we highlight advances in understanding of brain circuitry that is being propelled by improved imaging modalities. Going forward, advanced imaging will help in diagnosis and treatment planning strategies for pediatric patients. Lessons from each field can be applied to design better and more rigorous trials that can be used to improve guidelines for pediatric patients suffering from TBI or ASD.

Animal Models of Pediatric Traumatic Brain Injury: Lessons Learned

Neurotrauma ◽  
2018 ◽  
pp. 303-314
Author(s):  
Jimmy W. Huh ◽  
Lauren A. Hanlon ◽  
Ramesh Raghupathi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Animal Models ◽  
Age Groups ◽  
Developmental Time ◽  
Lessons Learned ◽  
White Matter Injury ◽  
Pediatric Traumatic Brain Injury ◽  
Injury Severities ◽  
Pediatric Tbi

A predominant focus of both clinical and preclinical pediatric traumatic brain injury (TBI) research is to combat secondary injury processes in the acute posttraumatic period that may contribute to pathologies that lead to long-term functional impairments. Identified therapeutic targets must undergo rigorous preclinical testing in relevant animal models of pediatric TBI. Animal models for pediatric TBI use injury mechanisms such as fluid-percussion, rotational-acceleration, weight-drop, and controlled cortical impact. These models span species (mice, rats, rabbits and pigs) and several age groups to encompass the developmental time points and utilize various injury severities to reproduce the pathologies such as atrophy, ventriculomegaly, white matter injury, and behavioral impairment. This review focuses on the validation of these preclinical models using clinical observations of structural and functional impairment in the acute and chronic period following TBI. In addition, the limitations of the current animal models are discussed within the context of strategies for further development of clinically relevant outcomes and therapeutic strategies.

A Conceptual Framework of Social Communication: Clinical Applications to Pediatric Traumatic Brain Injury

2020 ◽  
Vol 41 (02) ◽  
pp. 143-160
Author(s):  
Catherine Wiseman-Hakes ◽  
Lisa Kakonge ◽  
Meghan Doherty ◽  
Miriam Beauchamp
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Conceptual Framework ◽  
Social Communication ◽  
Clinical Applications ◽  
Future Research ◽  
Sex And Gender ◽  
Pediatric Traumatic Brain Injury ◽  
Communication Impairments ◽  
Pediatric Tbi

AbstractSocial communication impairments are common following pediatric traumatic brain injury (TBI) and can lead to social isolation, and poor social outcomes. Social communication has been documented as a persistent area of need in terms of proper assessment and intervention; however, this is not consistently addressed in clinical practice. While there is a body of evidence regarding social communication impairments and pediatric TBI, this area is not yet fully understood and remains underrecognized. To meet this gap, we provide a conceptual framework of social communication from a neurodevelopmental perspective, which can be applied to better understand the social communication impairments associated with pediatric TBI. We propose a general model of social communication with component constructs and consideration of internal factors such as sex and gender. These can inform considerations, clinical applications, and future research in assessment and evidence-based interventions within the domain of social communication.

scholarly journals Virtual Reality for Pediatric Traumatic Brain Injury Rehabilitation: A Systematic Review

2018 ◽  
Vol 14 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Jiabin Shen ◽  
Sarah Johnson ◽  
Cheng Chen ◽  
Henry Xiang
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Virtual Reality ◽  
Brain Injury ◽  
Research Quality ◽  
Future Research ◽  
Pediatric Traumatic Brain Injury ◽  
Injury Rehabilitation ◽  
Positive Effects ◽  
Pediatric Tbi

Objective. Pediatric traumatic brain injury (TBI) is associated with physical and psychobehavioral impairment in children. Effective rehabilitation programs postinjury are critical for children with TBI. Virtual reality (VR) has been increasingly adopted for brain injury rehabilitation. However, scientific synthesis is lacking in evaluating its effectiveness in pediatric TBI rehabilitation. This article aimed to conduct a systematic review on the effectiveness of VR-based pediatric TBI rehabilitation. Methods. A systematic literature search was conducted in PubMed, PsycInfo, SCOPUS, CENTRAL, BioMed Central, CiNAHL, and Web of Science through November 2015. Personal libraries and relevant references supplemented the search. Two authors independently reviewed the abstracts and/or full text of 5824 articles. Data extraction and qualitative synthesis was conducted along with quantitative assessment of research quality by 2 authors. Results. A positive impact was found for VR-based interventions on children’s physical rehabilitation post-TBI. The quality of research evidence was moderate, which largely suffered from small samples, lack of immersive VR experience, and lack of focus on socioemotional outcomes post-TBI. Conclusions. The present review identified positive effects of VR interventions for pediatric TBI rehabilitation especially in physical outcomes. Future research should include larger samples and broader post-TBI outcomes in children using VR-based interventions.

scholarly journals Clinical trials for pediatric traumatic brain injury: definition of insanity?

2019 ◽  
Vol 23 (6) ◽  
pp. 661-669 ◽  
Author(s):  
Brian Appavu ◽  
Stephen T. Foldes ◽  
P. David Adelson
Keyword(s):  
Traumatic Brain Injury ◽  
Clinical Trials ◽  
Brain Injury ◽  
The United States ◽  
Pediatric Traumatic Brain Injury ◽  
Definition Of ◽  
High Level ◽  
Pediatric Tbi ◽  
Current Guidelines ◽  
Injury Definition

Traumatic brain injury (TBI) is a leading cause of morbidity and mortality in children both in the United States and throughout the world. Despite valiant efforts and multiple clinical trials completed over the last few decades, there are no high-level recommendations for pediatric TBI available in current guidelines. In this review, the authors explore key findings from the major pediatric clinical trials in children with TBI that have shaped present-day recommendations and the insights gained from them. The authors also offer a perspective on potential efforts to improve the efficacy of future clinical trials in children following TBI.

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