Risk Factors Predicting Prognosis and Outcome of Elderly Patients With Isolated Traumatic Brain...
Brain InjuriesAlthough several prognostic models have been developed to predict outcome for patients with severe traumatic brain injury (TBI), currently no study describes the impact of respiratory failure during Emergency Department treatment on mortality in a population of elderly patients. The purpose of the present study was to evaluate factors predicting poor outcome with special emphasis on the impact of respiratory failure on mortality in elderly patients with isolated severe TBI. All elderly patients (age ≥ 65 years) with isolated severe head injury, admitted to this Level I trauma center, during a period of 16 years (from January 1992 to December 2008) were identified from the trauma registry. Stepwise logistic regression analysis was used to identify risk factors for a poor prognosis and outcome. The logistic regression found the following variables influencing the mortality: respiratory failure (p<0.0005; OR: 9.369), pupillary response (p<0.0212, OR: 3.393) and ISS score (p<0.0001, OR:1.179). A significant (p<0.0001) increased risk of death was also found for patients with a midline shift >15 mm. The present study predicts a strong correlation between respiratory failure, pathological pupillary response, a higher ISS and substantial midline shift with poor outcomes in elderly patients sustaining an isolated severe TBI.
Identification of Predictive Neuroinflammatory Biomarkers of Neuro-radiological Evolution in Severe...
Severe Traumatic Brain InjuryTertiary lesions responsible of the neurological decline after severe traumatic brain injury (TBI) are partially due to a persistent neuro-inflammation directly modulated by inflammatory mediators during the acute phase and detectable by using both multimodal MRI imaging and biological biomarkers during the acute phase after traumatic brain injury. The main objective is to identify if the level of IL-1beta in cerebrospinal fluid predict in a reliable and reproducible way, the neuro-radiological evolution evaluated by the comparison of a quantitative MRI performed in post-resuscitation and at one year (quantitative ΔIRM) in traumatic brain injuried patients. The secondary objectives are: To understand the links between the acute and chronic neuro-inflammatory phase in a population of TBI, To explore the contribution of the adaptive immune response in the persistent activation of the immune response, To Examine the links between persistent neuroinflammation, clinical deterioration and neuroimaging, To establish a correlation between the pathology and the physio-pathology of TBI.
Chronic Headache and Chronic Backache Following Unintentional Dural Puncture at Delivery Room.
Parturient Who Underwent Epidural Anesthesia During Which an Unintentional Dural Punctur OccurredParturient Who Develop a Postdural Puncture Headache1 morehe study is a telephone questionnaire. The study will include 400 women, 100 in each group. OBJECTIVE: To investigate the prevalence of chronic and chronic back pain following PDPH accidental dural puncture during epidyral analgesia for delivery. Parturients who gave birth to a normal birth and did not receive epidural anesthesia. Parturients who gave birth to a normal birth with epidural anesthesia without an unintentional dural puncture. Parturients who gave birth to a normal birth with epidural anesthesia and had an unintentional dural puncture, these women were treated conservatively. Parturients who had a normal birth with epidural anesthesia and had an unintentional dural puncture and were treated with a blood patch following PDPH.
Neurobehavioral Moderators of Post-traumatic Disease Trajectories
PTSDTraumaThe research goal is to uncover the neurocognitive moderators of PTSD trajectories, by documenting clinical symptoms, cognitive functioning, and brain structure and function, one-, six- and fourteen months following a traumatic event, in a large population of survivors at initial high risk for PTSD.
Observational Study to Evaluate the Epidemiology of Surgical-induced Acute Kidney Injury
Acute Kidney Injury (AKI)The evaluation of an accurate occurrence rate for AKI is of great importance for health policy, quality initiatives as well as for designing clinical trials. The primary objective is to prospectively evaluate the incidence of AKI within 72 h after extended surgical procedures that require admission to an observation unit.
7T MRI to Evaluate Cartilage Defects in the Knee
Cartilage InjuryKnee Injuries3 moreThe investigators propose to prospectively evaluate the accuracy of a novel 7-Tesla (7T) knee MRI protocol for the detection and grading of cartilage lesions in the knee, which is a significant limitation of current MRI techniques.
Opioid Use After Traumatic Injury in Adolescents
Opioid UseTraumatic Injury2 moreCurrently, 1 in 8 adolescents continue to receive prescription opioids a year or more after injury. By longitudinally surveying patients, we can identify risk factors and pathways to nonmedical opioid use. Furthermore, by assessing whether pain management and mental health treatment after injury moderates sustained opioid use and prescription opioid misuse, we can create targeted interventions to reduce future nonmedical opioid use in adolescents.
Module on Preventing Fire, Burns and Scalds Injury Among Children
Burn InjuryThe main aim of this intervention study is to test the hypothesis if school based educational intervention program will significantly improve the knowledge of primary school student on childhood burn prevention in Kuala Lumpur. The secondary aim the evaluate the association of demographics background, burn injury history with knowledge on burn. The study was conducted in 12 primary school in Kuala Lumpur from 1st January 2015 to 31st December 2017 in three different phases.
Alterations in Subgingival Microbiota and Hypoxia in Occlusal Trauma
Chronic PeriodontitisOcclusal TraumaPresent study suggests that excessive occlusal forces did not cause a significant change in hypoxia and vascular markers, however a slight alteration in subgingival microbiota was observed.
Understanding Concussion/Mild Traumatic Brain Injury
Traumatic Brain InjuryConcussion1 moreUsing the Blink Reflexometer, athletes are scanned if they are potentially thought to have a concussion during a game or practice.