scholarly journals Protein and Nitrogen Metabolism Changes Following Closed Head Injury or Cardiothoracic Surgery in Pediatric Patients

2005 ◽  
Vol 10 (3) ◽  
pp. 183-190
Author(s):  
Emily B. Hak ◽  
David A. Rogers ◽  
Michael C. Storm ◽  
Richard A. Helms
Keyword(s):  
Head Injury ◽  
Nitrogen Balance ◽  
Protein Metabolism ◽  
Nutrient Intake ◽  
Pediatric Patients ◽  
Traumatic Event ◽  
Closed Head Injury ◽  
Stability Index ◽  
Cardiothoracic Surgery ◽  
Closed Head

OBJECTIVE We compared markers of protein metabolism between children who had a controlled injury and an acute traumatic event. Significant protein catabolism occurs after acute severe injury. During surgery the injury is controlled and the degree of subsequent catabolism may be blunted. METHODS This was a prospective, unblinded observational study in 10 children 2 to 12 years old with a closed head injury (CHI) and an admission Physiologic Stability Index of ≥ 10 and in 10 children who underwent elective cardiothoracic surgery (CTS). Nutrient intake, nitrogen balance, serum albumin and prealbumin, urinary 3-methylhistidine excretion, and 3-methylhistidine to creatinine ratios were evaluated on days 1, 2, 3, 4, and 10 after injury. RESULTS Nutrient intake was similar in both groups on study days 1–4 and did not meet estimated needs. By day 10, 7 patients in the CTS group and 2 patients in the CHI group had been discharged home. The 3 CTS patients were still in the ICU while the 8 hospitalized CHI patients had been transferred to the floor. Compared to the CTS group, nitrogen balance in the CHI group was lower on day 1. On day 10, nitrogen balance and prealbumin were greater in the CHI group than in the CTS group, consistent with recovery and increased nutrient intake. CONCLUSIONS Markers of protein metabolism follow similar patterns after CTS or CHI in children. However, markers of protein metabolism indicate more severe catabolism soon after injury in CHI.

Early Versus Late Femoral Fracture Stabilization in Multiply Injured Pediatric Patients With Closed Head Injury

2001 ◽  
Vol 21 (5) ◽  
pp. 594-599 ◽  
Author(s):  
Stephen A. Mendelson ◽  
Timothy S. Dominick ◽  
Elizabeth Tyler-Kabara ◽  
Morey S. Moreland ◽  
P. David Adelson
Keyword(s):  
Head Injury ◽  
Femoral Fracture ◽  
Pediatric Patients ◽  
Closed Head Injury ◽  
Fracture Stabilization ◽  
Closed Head

scholarly journals Comorbidity of posttraumatic stress disorder and mild closed head injury in war veterans: Endocrinological and psychological profiles

2005 ◽  
Vol 62 (1) ◽  
pp. 17-25
Author(s):  
Zeljko Spiric ◽  
Radomir Samardzic
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Head Injury ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Traumatic Event ◽  
Closed Head Injury ◽  
War Veterans ◽  
Closed Head ◽  
Blast Trauma ◽  
Stimulating Hormone

Aim. To determine the degree of psychological and endocrinological changes in war veterans with the diagnosis of Chronic Posttraumatic Stress Disorder (PTSD) regarding presence/absence of comorbid mild closed head injury (mCHI) caused by explosive devices. Methods. Two groups of PTSD inpatients, with (n = 37), and without (n = 86) sustained blast trauma followed by mCHI were formed during the psychiatric treatment. Participants were interviewed by experienced clinicians who used the PTSD Interview (PTSD-I). In addition, patients completed the Symptom Checklist-90-Revised (SCL-90-R). Serum levels of ten hormones were assessed: triiodothyronine, thyroxine, thyrotropin-stimulating hormone, prolactin, luteinizing hormone, follicle-stimulating hormone, and insulin, by radioimmunoassays and hydrocortisone, growth hormone and testosterone by fluoroimmunoassays. Results. Veterans with comorbid mCHI and PTSD showed significantly higher level of amnesia for traumatic event as well as of somatization on the SCL-90-R. Significant differences of hormone levels were not found. Conclusion. The results didn't support the hypothesis on specific PTSD subgroup characterized by history of mCHI and consecutive postconcussion syndrome. The absence of differences in levels of hormones indicated the dominant role of psychogenic trauma in the etiology of hormone disbalance in chronic PTSD. Amnesia for traumatic event in war veterans with comorbid PTSD and mCHI was easily explained by neurogenic peritraumatic amnesia due to the blast trauma, but it did not affect either quality of intensity or posttraumatic symptoms as well as endocrinological parameters.

The Management of Minor Closed Head Injury in Children

PEDIATRICS ◽  
2000 ◽  
Vol 106 (6) ◽  
pp. 1524-1525 ◽  
Author(s):  
C. M. A. LeBlanc; ◽  
J. B. Coombs ◽  
R. Davis
Keyword(s):  
Head Injury ◽  
Closed Head Injury ◽  
Closed Head

Management of Minor Closed Head Injury in Children

PEDIATRICS ◽  
2001 ◽  
Vol 107 (5) ◽  
pp. 1231-1231 ◽  
Author(s):  
A. J. Smally; ◽  
J. B. Coombs ◽  
R. Davis
Keyword(s):  
Head Injury ◽  
Closed Head Injury ◽  
Closed Head

scholarly journals Differential Leukocyte and Platelet Profiles in Distinct Models of Traumatic Brain Injury

Cells ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 500
Author(s):  
William Brad Hubbard ◽  
Meenakshi Banerjee ◽  
Hemendra Vekaria ◽  
Kanakanagavalli Shravani Prakhya ◽  
Smita Joshi ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Head Injury ◽  
Closed Head Injury ◽  
Diffuse Brain Injury ◽  
Blood Brain ◽  
Closed Head ◽  
Leukocyte Counts ◽  
Neutrophil Aggregation ◽  
Blood Leukocyte

Traumatic brain injury (TBI) affects over 3 million individuals every year in the U.S. There is growing appreciation that TBI can produce systemic modifications, which are in part propagated through blood–brain barrier (BBB) dysfunction and blood–brain cell interactions. As such, platelets and leukocytes contribute to mechanisms of thromboinflammation after TBI. While these mechanisms have been investigated in experimental models of contusion brain injury, less is known regarding acute alterations following mild closed head injury. To investigate the role of platelet dynamics and bioenergetics after TBI, we employed two distinct, well-established models of TBI in mice: the controlled cortical impact (CCI) model of contusion brain injury and the closed head injury (CHI) model of mild diffuse brain injury. Hematology parameters, platelet-neutrophil aggregation, and platelet respirometry were assessed acutely after injury. CCI resulted in an early drop in blood leukocyte counts, while CHI increased blood leukocyte counts early after injury. Platelet-neutrophil aggregation was altered acutely after CCI compared to sham. Furthermore, platelet bioenergetic coupling efficiency was transiently reduced at 6 h and increased at 24 h post-CCI. After CHI, oxidative phosphorylation in intact platelets was reduced at 6 h and increased at 24 h compared to sham. Taken together, these data demonstrate that brain trauma initiates alterations in platelet-leukocyte dynamics and platelet metabolism, which may be time- and injury-dependent, providing evidence that platelets carry a peripheral signature of brain injury. The unique trend of platelet bioenergetics after two distinct types of TBI suggests the potential for utilization in prognosis.

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