Global neurotrauma research challenges and opportunities

Rubiano, Andrés M.; Carney, Nancy; Chesnut, Randall M.; Puyana, Juan Carlos

doi:10.1038/nature16035

Cited by 425 publications

(295 citation statements)

References 55 publications

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“…It follows that TSCI following fall with heavy load on the head is more common among female population of this region than to their male counterparts. Based on these facts, prevention of falls in this region should consider the fact that the trauma-precipitating activities are motivated by both culture and economy [26]. It is important that the inhabitants of north-east Tanzania are well informed that falling either from trees or with heavy loads on the head adds to their risk of TSCI but also enabled to run safer socioeconomic and cultural activities.…”

Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Moshi

Sundelin

Sahlén

et al. 2017

Global Health Action

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Background: Causes, magnitude and consequences of traumatic spinal cord injury depend largely on geography, infrastructure, socioeconomic and cultural activities of a given region. There is a scarcity of literature on profile of traumatic spinal cord injury to inform prevention and rehabilitation of this health condition in African rural settings, particularly Tanzania. Objective: To describe the incidence, etiology and clinical outcomes of traumatic spinal cord injury and issues related to retrospective study in underdeveloped setting. Methods: Records for patients with traumatic spinal cord injury for five consecutive years (2010–2014) were obtained retrospectively from the admission wards and health records archives of the Kilimanjaro Christian Medical Center. Sociodemographic, cause, complications and patients’ condition on discharge were recorded and analyzed descriptively. Results: The admission books in the wards registered 288 new traumatic spinal cord injury cases from January 2010 to December 2014. Of the 288 cases registered in the books, 224 were males and 64 females with mean age 39.1(39.1 ± 16.3) years and the majority of individuals 196(68.1%) were aged between 16 and 45 years. A search of the hospital archives provided 213 full patient records in which the leading cause of injury was falls 104(48.8%) followed by road traffic accidents 73(34.3%). Cervical 81(39.9%) and lumbar 71(34.74%) spinal levels were the most affected. The annual incidence for the Kilimanjaro region (population 1,640,087) was estimated at more than 26 persons per million population. The most documented complications were pressure ulcers 42(19.7%), respiratory complications 32(15.0%) and multiple complications 28(13.1%). The mean length of hospital stay was 64.2 ± 54.3 days and the mortality rate was 24.4%. Conclusion: Prevention of traumatic spinal cord injury in North-east Tanzania should consider falls (particularly from height) as the leading cause, targeting male teenagers and young adults. Pressure ulcers, respiratory complications, in-hospital mortality and availability of wheelchairs should be addressed.

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Section: Discussionmentioning

confidence: 99%

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Moshi

Sundelin

Sahlén

et al. 2017

Global Health Action

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“…In the United States, every year, more than 500,000 children ranging in age from 0 to 14 years incur a TBI, and more than 235,000 people aged 65 years old and older are involved in TBI-related emergency visits and hospitalizations-14,000 of them resulting in death [Faul et al, 2010]. The worldwide liability is much greater; 10% (6 million people) of the world's annual disease-related deaths is attributed to neurotraumatic injuries [Rubiano et al, 2015]. There is currently no clinical treatment option for TBI [Kochanek and Clark, 2016].…”

Section: Traumatic Brain Injurymentioning

confidence: 99%

Epigenetic Treatment of Neurodegenerative Disorders: Alzheimer and Parkinson Diseases

Irwin

Moos

Faller

et al. 2016

Drug Development Research

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Preclinical Research In this review, we discuss epigenetic-driven methods for treating neurodegenerative disorders associated with mitochondrial dysfunction, focusing on carnitinoid antioxidant-histone deacetylase inhibitors that show an ability to reinvigorate synaptic plasticity and protect against neuromotor decline in vivo. Aging remains a major risk factor in patients who progress to dementia, a clinical syndrome typified by decreased mental capacity, including impairments in memory, language skills, and executive function. Energy metabolism and mitochondrial dysfunction are viewed as determinants in the aging process that may afford therapeutic targets for a host of disease conditions, the brain being primary in such thinking. Mitochondrial dysfunction is a core feature in the pathophysiology of both Alzheimer and Parkinson diseases and rare mitochondrial diseases. The potential of new therapies in this area extends to glaucoma and other ophthalmic disorders, migraine, Creutzfeldt-Jakob disease, post-traumatic stress disorder, systemic exertion intolerance disease, and chemotherapy-induced cognitive impairment. An emerging and hopefully more promising approach to addressing these hard-to-treat diseases leverages their sensitivity to activation of master regulators of antioxidant and cytoprotective genes, antioxidant response elements, and mitophagy. Drug Dev Res 77 : 109-123, 2016. © 2016 Wiley Periodicals, Inc.

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“…Recent epidemiological studies indicate that around 5.3 million people in the United States and nearly 7.7 million people in Europe live with a TBI-related disability [2]. Mild TBI (mTBI) accounts for 70%–90% of all cases [3].…”

Section: Introductionmentioning

confidence: 99%

Fluid Biomarkers of Traumatic Brain Injury and Intended Context of Use

et al. 2016

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Traumatic brain injury (TBI) is one of the leading causes of death and disability around the world. The lack of validated biomarkers for TBI is a major impediment to developing effective therapies and improving clinical practice, as well as stimulating much work in this area. In this review, we focus on different settings of TBI management where blood or cerebrospinal fluid (CSF) biomarkers could be utilized for predicting clinically-relevant consequences and guiding management decisions. Requirements that the biomarker must fulfill differ based on the intended context of use (CoU). Specifically, we focus on fluid biomarkers in order to: (1) identify patients who may require acute neuroimaging (cranial computerized tomography (CT) or magnetic resonance imaging (MRI); (2) select patients at risk for secondary brain injury processes; (3) aid in counseling patients about their symptoms at discharge; (4) identify patients at risk for developing postconcussive syndrome (PCS), posttraumatic epilepsy (PTE) or chronic traumatic encephalopathy (CTE); (5) predict outcomes with respect to poor or good recovery; (6) inform counseling as to return to work (RTW) or to play. Despite significant advances already made from biomarker-based studies of TBI, there is an immediate need for further large-scale studies focused on identifying and innovating sensitive and reliable TBI biomarkers. These studies should be designed with the intended CoU in mind.

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Global neurotrauma research challenges and opportunities

Cited by 425 publications

References 55 publications

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Traumatic spinal cord injury in the north-east Tanzania – describing incidence, etiology and clinical outcomes retrospectively

Epigenetic Treatment of Neurodegenerative Disorders: Alzheimer and Parkinson Diseases

Fluid Biomarkers of Traumatic Brain Injury and Intended Context of Use

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