Traumatic Brain Injury
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Trials ◽  
2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Tao Yuan ◽  
Hongyu He ◽  
Yuepeng Liu ◽  
Jianwei Wang ◽  
Xin Kang ◽  
...  

Abstract Background Blood glucose levels that are too high or too low after traumatic brain injury (TBI) negatively affect patient prognosis. This study aimed to demonstrate the relationship between blood glucose levels and the Glasgow Outcome Score (GOS) in TBI patients. Methods This study was based on a randomized, dual-center, open-label clinical trial. A total of 208 patients who participated in the randomized controlled trial were followed up for 5 years. Information on the disease, laboratory examination, insulin therapy, and surgery for patients with TBI was collected as candidate variables according to clinical importance. Additionally, data on 5-year and 6-month GOS were collected as primary and secondary outcomes, respectively. For multivariate analysis, a generalized additive model (GAM) was used to investigate relationships between blood glucose levels and GOS. The results are presented as odds ratios (ORs) with 95% confidence intervals (95% CIs). We further applied a two- piecewise linear regression model to examine the threshold effect of blood glucose level and GOS. Results A total of 182 patients were included in the final analysis. Multivariate GAM analysis revealed that a bell-shaped relationship existed between average blood glucose level and 5-year GOS score or 6-month GOS score. The inflection points of the average blood glucose level were 8.81 (95% CI: 7.43–9.48) mmol/L considering 5-year GOS as the outcome and were 8.88 (95% CI 7.43−9.74) mmol/L considering 6-month GOS score as the outcome. The same analysis revealed that there was also a bell relationship between average blood glucose levels and the favorable outcome group (GOS score ≥ 4) at 5 years or 6 months. Conclusion In a population of patients with traumatic brain injury, blood glucose levels were associated with the GOS. There was also a threshold effect between blood glucose levels and the GOS. A blood glucose level that is either too high or too low conveys a poor prognosis. Trial registration ClinicalTrials.gov NCT02161055. Registered on 11 June 2014.


Author(s):  
Parul Vaid ◽  
Bhavuk Kapoor ◽  
Mayank Kapoor

Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem throughout the world TBI is called the ‘silent epidemic’ because problems resulting from TBI are often not immediately visible and TBI patients are not very vociferous. Epidemiological studies of TBI are essential to the targeted prevention and effective treatment of brain-injured patients. Epidemiology analysis of surgically managed traumatic brain injury patients was done. Mean age was 35.9 years. Males were more commonly (80%) involved than females (20%). In 57.5% of cases, falls were responsible for TBI and in 42.5% of cases, Road traffic accidents were responsible. Edh was the most common type of TBI in (50%). Chronic SDH occurred in 25% of cases. Acute SDH and Contusions were both seen in 13.75% of cases. Depressed fractures occurred in 6.25% of cases and ICH occurred in 1.25% of cases. Craniotomy was the most common (42%) surgical procedure performed, followed by burrhole drainage (22.5%). Decompressive craniectomy was done in 18.75% of cases and elevation of depressed fracture was performed in 6.25% of cases. Traumatic brain injury (TBI) constitutes a major health and socioeconomic problem throughout the world. People of all ages are affected by it. Males are more commonly involved as compared to females. Timely hospitalisation and surgical management whenever indicated improves the survival.


Author(s):  
Swatabdi R. Kamal ◽  
Shreya Potukutchi ◽  
David J. Gelovani ◽  
Robin E. Bonomi ◽  
Srinivasu Kallakuri ◽  
...  

NeuroSci ◽  
2022 ◽  
Vol 3 (1) ◽  
pp. 52-62
Author(s):  
Mira White ◽  
Fauve Duquette-Laplante ◽  
Benoît Jutras ◽  
Caryn Bursch ◽  
Amineh Koravand

Purpose: The main purpose of this retrospective study was to identify auditory dysfunctions related to traumatic brain injury (TBI) in individuals evaluated in an Audiology clinic. Method: Peripheral and central auditory evaluations were performed from March 2014 to June 2018 in 26 patients (14 males) with TBI. The age of the participants ranged from 9 to 59 years old (34.24 ± 15.21). Six participants had blast-related TBI and 20 had blunt force TBI. Sixteen experienced a single TBI event whereas ten experienced several. Correlation analyses were performed to verify the relationship, if any, between the number of auditory tests failed and the number, type, and severity of TBIs. Result: All participants failed at least one auditory test. Nearly 60% had abnormal results on degraded speech tests (compressed and echoed, filtered or in background noise) and 25% had a high frequency hearing loss. There was no statistically significant correlation between the number of auditory tests failed and the number, type, and severity of TBIs. Conclusion: Results indicated negative and heterogenous effects of TBI on peripheral and central auditory function and highlighted the need for a more extensive auditory assessment in individuals with TBI.


2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Daniel A. Godoy ◽  
Alejandro A. Rabinstein

2022 ◽  
Vol 1 ◽  
Author(s):  
Christopher R. Apostol ◽  
Kelsey Bernard ◽  
Parthasaradhireddy Tanguturi ◽  
Gabriella Molnar ◽  
Mitchell J. Bartlett ◽  
...  

There is an unmet clinical need for curative therapies to treat neurodegenerative disorders. Most mainstay treatments currently on the market only alleviate specific symptoms and do not reverse disease progression. The Pituitary adenylate cyclase-activating polypeptide (PACAP), an endogenous neuropeptide hormone, has been extensively studied as a potential regenerative therapeutic. PACAP is widely distributed in the central nervous system (CNS) and exerts its neuroprotective and neurotrophic effects via the related Class B GPCRs PAC1, VPAC1, and VPAC2, at which the hormone shows roughly equal activity. Vasoactive intestinal peptide (VIP) also activates these receptors, and this close analogue of PACAP has also shown to promote neuronal survival in various animal models of acute and progressive neurodegenerative diseases. However, PACAP’s poor pharmacokinetic profile (non-linear PK/PD), and more importantly its limited blood-brain barrier (BBB) permeability has hampered development of this peptide as a therapeutic. We have demonstrated that glycosylation of PACAP and related peptides promotes penetration of the BBB and improves PK properties while retaining efficacy and potency in the low nanomolar range at its target receptors. Furthermore, judicious structure-activity relationship (SAR) studies revealed key motifs that can be modulated to afford compounds with diverse selectivity profiles. Most importantly, we have demonstrated that select PACAP glycopeptide analogues (2LS80Mel and 2LS98Lac) exert potent neuroprotective effects and anti-inflammatory activity in animal models of traumatic brain injury and in a mild-toxin lesion model of Parkinson’s disease, highlighting glycosylation as a viable strategy for converting endogenous peptides into robust and efficacious drug candidates.


2022 ◽  
Author(s):  
Daniel Hendrik Baron ◽  
Olivia A Skrobot ◽  
Jennifer C Palmer ◽  
Kanchan Sharma ◽  
Patrick Kehoe

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