Articles: traumatic-brain-injuries.
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Randomized Controlled Trial
Neurological and respiratory effects of lung protective ventilation in acute brain injury patients without lung injury: brain vent, a single centre randomized interventional study.
Lung protective ventilation (LPV) comprising low tidal volume (VT) and high positive end-expiratory pressure (PEEP) may compromise cerebral perfusion in acute brain injury (ABI). In patients with ABI, we investigated whether LPV is associated with increased intracranial pressure (ICP) and/or deranged cerebral autoregulation (CA), brain compensatory reserve and oxygenation. ⋯ The present study found that most patients did not experience any adverse effects of LPV, neither on ICP nor CA. However, in almost a quarter of patients, the ICP rose above the safety limit for interrupting the interventions. Baseline ICP, brain compensatory reserve, and mechanical power can predict a potentially deleterious effect of LPV and can be used to personalize ventilator settings. Trial registration NCT03278769 . Registered September 12, 2017.
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The aim of this study was to determine the unique and combined associations of various military stress exposures with positive and negative mental health symptoms in active duty service members. ⋯ Military stressors may adversely influence self-reported symptoms of negative mental health, but deployment experience and combat exposure may confer stress inoculation.
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The Advanced Combat Helmet (ACH) military specification (mil-spec) provides blunt impact acceleration criteria that must be met before use by the U.S. warfighter. The specification, which requires a helmeted magnesium Department of Transportation (DOT) headform to be dropped onto a steel hemispherical target, results in a translational headform impact response. Relative to translations, rotations of the head generate higher brain tissue strains. Excessive strain has been implicated as a mechanical stimulus leading to traumatic brain injury (TBI). We hypothesized that the linear constrained drop test method of the ACH specification underreports the potential for TBI. ⋯ We provide a scientific basis to motivate revision of the ACH mil-spec to include a rotational component, which would enhance the test's relevance to TBI arising from severe head impacts.
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Traumatic brain injury (TBI) entails chronic neurological symptoms and deficits, such as smell and taste impairment. In the general population, a prevalence of 13.5% for smell impairment, 17% for taste impairment, and 2.2% for both have been reported. Studies establishing prevalence of sensorial dysfunction in the U.S. general population showed that prevalence increased with age and was higher in ethnic minorities and men. To understand the mechanisms that lead to these deficits, the prevalence of sensory dysfunction was studied in the Veteran TBI population of the VA Caribbean Healthcare System (VACHS). The aims were to find the prevalence of sensorial dysfunction in smell and/or taste in TBI patients at the VACHS Polytrauma Clinic and its association with demographic characteristics and medical comorbidities. The hypothesis was that the prevalence of sensory dysfunction in smell and/or taste of VACHS Veterans (mostly Hispanics minority) with TBI will be higher than the one historically reported in the literature for the U.S. general population. ⋯ The investigators found that the prevalence of sensory dysfunction in smell and/or taste in VACHS Veterans with TBI was 38.3% (n = 31). A significant association was found between smell and/or taste dysfunction and being a combat veteran (P = .018). A marginally significant association to obesity was also observed (P = .053). To the scientific community, the results will serve as a base for sensorial dysfunction and TBI research given that this prevalence, and the correlation to demographics and comorbidities, has not been fully established in the Veteran population.
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Randomized Controlled Trial
Target temperature management and therapeutic hypothermia in sever neuroprotection for traumatic brain injury: Clinic value and effect on oxidative stress.
This study is to explore the application of target temperature management and therapeutic hypothermia in the treatment of neuroprotection patients with severe traumatic brain injury and its effect on oxidative stress. From February 2019 to April 2021, 120 patients with severe traumatic brain injury cured were selected in our hospital. The patients were randomly divided into control and experimental groups. ⋯ The incidences of pendant pneumonia, atelectasis, venous thrombosis of extremities and ventricular arrhythmias in the experimental group were remarkably lower (P < .05). Targeted temperature management and mild hypothermia treatment can improve neurological function, maintain brain cell function, and reduce stress-reactions risk. The incidence of complications during hospitalization was reduced.