Articles: traumatic-brain-injuries.
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Neuroinflammation after traumatic brain injury (TBI) is related to chronic neurodegenerative diseases and is one of the causes of acute secondary injury after TBI. Therefore, it is particularly important to clarify the role of cellular mechanisms in the neuroinflammatory response after TBI. The objective of this article is to understand the involvement of cells during the TBI inflammatory response (for instance, astrocytes, microglia, and oligodendrocytes) and shed light on the recent progress in the stimulation and interaction of granulocytes and lymphocytes, to provide a novel approach for clinical research. ⋯ However, not all of the mechanisms of cell-to-cell interactions have been well studied. After TBI, clinical treatment cannot simply suppress the inflammatory response, and the inflammatory phenotype of patients' needs to be defined according to their specific conditions after injury. Clinical trials of personalized inflammation regulation therapy for specific patients should be carried out in order to improve the prognosis of patients.
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Opioid use disorder is a worldwide economic and health concern. Opioid use seems to be increased in those who sustained traumatic brain injury (TBI). The aim of the current systematic review is to examine the prevalence of opioid use disorders among individuals with TBI. ⋯ Opioid use disorder is an imminent danger worldwide. Firm regulation for an opioid prescription for patients with TBI during hospitalization or in rehabilitation centers tackles co-existing behavioral problems, frequent follow-up, and the use of nonopioid medications as possible to control chronic pain in this vulnerable subgroup. Future prospective studies to measure the effect of different intervention methods to mitigate the increased risk of opioid use post-TBI are needed.
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The fluid percussion injury (FPI) model is a surgical method for mimicking traumatic brain injury (TBI) models as it automatically and accurately measures peak impact pressure. Nevertheless, its elevated costs have led numerous researchers to develop more inexpensive alternative methods. Therefore, we used a copy of the classic FPI device to develop a novel method to evaluate the pressure pulse and determine injury severity with even more precision during the surgical procedure to induce an injury. ⋯ The method developed to evaluate pressure pulse in an FPI model proved capable of precisely determining different degrees of injury.
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Randomized Controlled Trial
Modifications of lung microbiota structure in traumatic brain injury ventilated patients according to time and enteral feeding formulas: a prospective randomized study.
Specialized diets enriched with immune nutrients could be an important supplement in patients (pts) with acute traumatic brain injury (TBI). Omega-3 and arginine may interact with immune response and microbiota. No data are available about the role of the specialized diets in modulating the lung microbiota, and little is known about the influence of lung microbiota structure in development of ventilator-associated pneumonia (VAP) in TBI pts. The aims of this study are to evaluate the impact of specific nutrients on the lung microbiota and the variation of lung microbiota in TBI pts developing VAP. ⋯ Our data suggest that TBI patients who developed VAP during ICU stay have different structures of BAL microbiota either at admission and at 7 days post-ICU admission, while no correlation has been observed between different enteral formulas and microbiota composition in terms of richness and evenness. These findings suggest that targeting the lung microbiota may be a promising approach for preventing infections in critically ill patients.
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Randomized Controlled Trial
Effect of propranolol and clonidine after severe traumatic brain injury: a pilot randomized clinical trial.
To evaluate the safety, feasibility, and efficacy of combined adrenergic blockade with propranolol and clonidine in patients with severe traumatic brain injury (TBI). ⋯ Despite the safety and feasibility of adrenergic blockade with propranolol and clonidine after severe TBI, the intervention did not alter the VFD outcome. Given the widespread use of these agents in TBI care, a multi-center investigation is warranted to determine whether adrenergic blockade is of therapeutic benefit in patients with severe TBI. Trial Registration Number NCT01322048.