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  • 1
    Language: English
    In: JAMA, 07 August 2013, Vol.310(5), pp.473-4
    Description: Traumatic brain injury (TBI) is a multifaceted condition, not an event. Traumatic brain injury is broadly defined as an alteration in brain function or other evidence of brain pathology caused by an external force that can occur in traffic, at home, at work, during sports activities, and on the battlefield. Traumatic brain injury is an important cause of death and disability for children and an exponentially increasing source of morbidity and mortality in older adults. Each year in the US, at least 1.7 million people seek medical attention for TBI; it is a contributing factor in a third of all injury-related deaths. Many more persons, particularly those with mild TBI, are never seen by a clinician. These injuries are often dismissed by the medical community as mild with few or no consequences. Although no single definition of concussion is widely accepted, it typically affects orientation, memory, and may involve loss of consciousness. Here, Manley and Maas discuss the classification of TBI.
    Keywords: Brain Injuries ; Internationality ; Biomedical Research -- Organization & Administration
    ISSN: 00987484
    E-ISSN: 1538-3598
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  • 2
    Language: English
    In: JAMA, The Journal of the American Medical Association, August 7, 2013, Vol.310(5), p.473(2)
    Description: The general lack of knowledge and focus on traumatic brain injury (TBI), generally seen in the military and sports is discussed. The need for greater attention to be paid to TBI and its causes as well as treatment methodologies and management regime is highlighted.
    Keywords: Brain Injuries -- Care And Treatment ; Health Literacy -- Research
    ISSN: 0098-7484
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  • 3
    In: Brain, 2011, Vol. 134(5), pp.1259-1261
    Keywords: Age of Onset–Etiology ; Animals–Complications ; Disease Models, Animal–Epidemiology ; Disease Progression–Etiology ; Humans–Complications ; Incidence–Epidemiology ; Inflammation–Metabolism ; Risk Factors–Metabolism ; Spinal Cord Diseases–Metabolism ; Spondylosis–Metabolism ; Fas Receptor–Metabolism ; Abridged ; Fas Receptor;
    ISSN: 0006-8950
    E-ISSN: 1460-2156
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  • 4
    Language: English
    In: The Lancet, 22 September 2012, Vol.380(9847), pp.1088-1098
    Description: Severe traumatic brain injury remains a major health-care problem worldwide. Although major progress has been made in understanding of the pathophysiology of this injury, this has not yet led to substantial improvements in outcome. In this report, we address present knowledge and its limitations, research innovations, and clinical implications. Improved outcomes for patients with severe traumatic brain injury could result from progress in pharmacological and other treatments, neural repair and regeneration, optimisation of surgical indications and techniques, and combination and individually targeted treatments. Expanded classification of traumatic brain injury and innovations in research design will underpin these advances. We are optimistic that further gains in outcome for patients with severe traumatic brain injury will be achieved in the next decade.
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 5
    Language: English
    In: Neuroscience Letters, Jan 1, 2015, Vol.584, p.368(5)
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.neulet.2014.10.040 Byline: Xiaoming Yao, Nikita Derugin, Geoffrey T. Manley, A.S. Verkman Abstract: * Transient focal ischemia and reperfusion injury was produced by 1-h MCA occlusion followed by 23-h reperfusion. * Infarct volume and brain edema were greatly reduced in AQP4-deficient mice. * The neuroprotective effect of AQP4 deletion suggests the therapeutic utility of AQP4 inhibition in stroke. Author Affiliation: (a) Department of Neurological Surgery, University of California, San Francisco, CA 94143, USA (b) Brain and Spinal Injury Center, University of California, San Francisco, CA 94143, USA (c) Departments of Medicine and Physiology, University of California, San Francisco, CA 94143, USA Article History: Received 24 July 2014; Revised 26 September 2014; Accepted 22 October 2014
    Keywords: Cerebral Edema -- Health Aspects ; Ischemia -- Health Aspects ; Aquaporins -- Health Aspects
    ISSN: 0304-3940
    Source: Cengage Learning, Inc.
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  • 6
    Language: English
    In: Neuroscience Letters, 01 January 2015, Vol.584, pp.368-372
    Description: Aquaporin-4 (AQP4) is a water channel expressed in astrocyte end-feet lining the blood–brain barrier. AQP4 deletion in mice is associated with improved outcomes in global cerebral ischemia produced by transient carotid artery occlusion, and focal cerebral ischemia produced by permanent middle cerebral artery occlusion (MCAO). Here, we investigated the consequences of 1-h transient MCAO produced by intraluminal suture blockade followed by 23 h of reperfusion. In nine AQP4 and nine AQP4 mice, infarct volume was significantly reduced by an average of 39 ± 4% at 24 h in AQP4 mice, cerebral hemispheric edema was reduced by 23 ± 3%, and Evans Blue extravasation was reduced by 31 ± 2% (mean ± SEM). Diffusion-weighted magnetic resonance imaging showed greatest reduction in apparent diffusion coefficient around the occlusion site after reperfusion, with remarkably lesser reduction in AQP4 mice. The reduced infarct volume in AQP4 mice following transient MCAO supports the potential utility of therapeutic AQP4 inhibition in stroke.
    Keywords: Aqp4 ; Transient Cerebral Ischemia ; Brain Edema ; Blood–Brain Barrier ; Medicine ; Anatomy & Physiology
    ISSN: 0304-3940
    E-ISSN: 1872-7972
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  • 7
    Language: English
    In: Archives of Physical Medicine and Rehabilitation, 2010, Vol.91(11), pp.1692-1696
    Description: Whyte J, Vasterling J, Manley GT. Common data elements for research on traumatic brain injury and psychological health: current status and future development. The National Institute of Neurologic Disorders and Stroke, Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, National Institute on Disability and Rehabilitation Research, and Defense and Veterans Brain Injury Center jointly supported an effort to develop common data elements (CDEs, ie, consensus-based content domains of importance and recommended ways to measure them) for research on traumatic brain injury and psychological health. The authors served as participants in this effort as well as editors of the resulting articles. This article describes the current status of this multiagency endeavor, the obstacles encountered, and possible directions for future development. Challenges that occurred within the working groups that developed the CDE recommendations and similarities and differences among the articles that describe those recommendations were reviewed. Across all of the working groups, there were challenges in striking a balance between specificity in recommendations to researchers and the need to tailor the selection of variables to specific study aims. The domains addressed by the different working groups varied in the research available to guide the selection of important content areas to be measured and the specific tools for measuring them. The working groups also addressed this challenge in somewhat different ways. The CDE effort must enhance consensus among researchers with similar interests while not stifling innovation and scientific rigor. This will require regular updating of the recommendations and may benefit from more standardized criteria for the selection of important content areas and measurement tools across domains.
    Keywords: Brain Injuries ; Rehabilitation ; Research ; Stress Disorders, Post-Traumatic ; Medicine ; Physical Therapy
    ISSN: 0003-9993
    E-ISSN: 1532-821X
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  • 8
    Language: English
    In: Journal of Neurology, Neurosurgery & Psychiatry, 29 December 2012, Vol.83(12), p.1193
    Description: To study the evolution of traumatic axonal injury (TAI) detected by structural MRI in patients with moderate and severe traumatic brain injury (TBI) during the first year and relate findings to outcome.
    Keywords: Coma ; Neuroimaging ; Inversion ; Brain Stem ; Magnetic Resonance Imaging ; Corpus Callosum ; Traumatic Brain Injury ; Neurosurgery ; Evolution ; Neurology & Neuropathology;
    ISSN: 0022-3050
    ISSN: 00223050
    E-ISSN: 1468-330X
    E-ISSN: 1468330X
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  • 9
    Language: English
    In: Brain Injury, 01 April 2014, Vol.28(4), pp.448-455
    Description: Objective: To determine acceptability and preliminary effectiveness of Emergency Department (ED) Social Work Intervention for Mild Traumatic Brain Injury (SWIFT-Acute) on alcohol use, community functioning, depression, anxiety, post-concussive symptoms, post-traumatic stress disorder and service...
    Keywords: Brain Injury ; Implementation ; Intervention Study ; Treatment Outcome ; Medicine
    ISSN: 0269-9052
    E-ISSN: 1362-301X
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  • 10
    In: The New England Journal of Medicine, 2014, Vol.371(26), pp.2457-2466
    Description: Background Traumatic brain injury (TBI) is a major cause of death and disability worldwide. Progesterone has been shown to improve neurologic outcome in multiple experimental models and two early-phase trials involving patients with TBI. Methods We conducted a double-blind, multicenter clinical trial in which patients with severe, moderate-to-severe, or moderate acute TBI (Glasgow Coma Scale score of 4 to 12, on a scale from 3 to 15, with lower scores indicating a lower level of consciousness) were randomly assigned to intravenous progesterone or placebo, with the study treatment initiated within 4 hours after injury and administered for a total of 96 hours. Efficacy was defined as an increase of 10 percentage points in the proportion of patients with a favorable outcome, as determined with the use of the stratified dichotomy of the Extended Glasgow Outcome Scale score at 6 months after injury. Secondary outcomes included mortality and the Disability Rating Scale score. Results A total of 882 of the planned sample of 1140 patients underwent randomization before the trial was stopped for futility with respect to the primary outcome. The study groups were similar with regard to baseline characteristics; the median age of the patients was 35 years, 73.7% were men, 15.2% were black, and the mean Injury Severity Score was 24.4 (on a scale from 0 to 75, with higher scores indicating greater severity). The most frequent mechanism of injury was a motor vehicle accident. There was no significant difference between the progesterone group and the placebo group in the proportion of patients with a favorable outcome (relative benefit of progesterone, 0.95; 95% confidence interval [CI], 0.85 to 1.06; P=0.35). Phlebitis or thrombophlebitis was more frequent in the progesterone group than in the placebo group (relative risk, 3.03; CI, 1.96 to 4.66). There were no significant differences in the other prespecified safety outcomes. Conclusions This clinical trial did not show a benefit of progesterone over placebo in the improvement of outcomes in patients with acute TBI. (Funded by the National Institute of Neurological Disorders and Stroke and others; PROTECT III ClinicalTrials.gov number, NCT00822900 .) In this phase 3 trial, progesterone had no benefit as a neuroprotective agent in patients with blunt traumatic brain injury. Together with a second negative clinical trial of progesterone for acute TBI (SYNAPSE), the findings provide no support for this therapeutic approach. More than 2.4 million emergency department visits, hospitalizations, or deaths are related to traumatic brain injury (TBI) annually, and approximately 5.3 million Americans are living with disability from TBI. The aggregate annual cost of TBI in the United States now approaches $76.5 billion.1 Survivors of severe TBI typically require 5 to 10 years of intensive therapy and are often left with substantial disability.2 Despite decades of research, no pharmacologic agent has been shown to improve outcomes after TBI. Progesterone is a potent neurosteroid synthesized in the central nervous system. Preclinical studies in laboratory animals indicated that the early administration of . . .
    Keywords: Drug Therapy ; Traumatic Brain Injury ; Randomized Clinical Trial ; Followup Study ; Treatment Effectiveness ; Adults ; Males ; Females ; African Americans ; European Americans ; Hispanic Americans ; Americans ; Motor Traffic Accidents ; Accidents ; Injuries ; Survivors ; Mortality ; Negative Therapeutic Reaction ; Neuroendocrinology ; Glasgow Coma Scale (Teasdale and Jennett) ; Disability Rating Scale (Rappaport et Al) ; Injury Severity Score (Baker et Al) ; Abbreviated Injury Scale (Greenspan et Al) ; Rotterdam CT Classification ; Extended Glasgow Outcome Scale;
    ISSN: 0028-4793
    E-ISSN: 1533-4406
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