The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Review Case Reports
Herbs and the brain: friend or foe? The effects of ginkgo and garlic on warfarin use.
In the quest for longevity and as an alternative to Western medicine, there has been a resurgence in traditional remedies. However, several concerns have been raised about the increased use of herbal remedies, including potential interactions with "Western" medicines, the lack of quality control, the assessment of herbal clinical trials, and the adulteration of herbal remedies by traditional prescribers. ⋯ In the cerebrovascular and cardiac settings, it is particularly important to gain such a history and to educate patients and family members about the potential interactions of herbal remedies with anticoagulants. Two herbal supplements in particular, ginkgo biloba and garlic, have demonstrated effects on warfarin.
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Traumatic brain injuries (TBIs) are the most common disabling injuries in the United States, accounting for 44% of all deaths due to trauma. Once inflicted, primary cerebral injury is immutable and irreversible. ⋯ Relationships exist between therapeutic positioning, multisystemic stability, and prevention of secondary cerebral injury in severe TBI. A critical review and synthesis of current research literature on multisystem responses to positioning led to development of clinical recommendations based on currently available evidence and generated best practices for positioning patients with severe TBI.
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The purpose of this study was to determine the validity and reliability of the SjO2 catheter in neurologically impaired patients. Cerebral hypoxia and ischemia are two of the most important causes of secondary injury after brain trauma. Early detection and treatment of cerebral ischemia may prevent additional damage to the injured brain. ⋯ The initial milestones by Myerson et al. and Gibbs et al. have served as the basis for more refined research on cerebral tissue oxygenation and metabolism. The unreliability of the SjO2 catheter demonstrates how little we still know about cerebral physiology. In spite of the many advancements in healthcare technology, limiting secondary brain injury and improving neurologic outcome have remained elusive.