Management and outcomes following emergency surgery for traumatic brain injury - A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study).

Introduction:Traumatic brain injury (TBI) accounts for a significant amount of death and disability worldwide and the majority of this burden affects individuals in low-and-middle income countries. Despite this, considerable geographical differences have been reported in the care of TBI patients. On this background, we aim to provide a comprehensive international picture of the epidemiological characteristics, management and outcomes of patients undergoing emergency surgery for traumatic brain injury (TBI) worldwide. Methods and analysis:The Global Neurotrauma Outcomes Study (GNOS) is a multi-centre, international, prospective observational cohort study. Any unit performing emergency surgery for TBI worldwide will be eligible to participate. All TBI patients who receive emergency surgery in any given consecutive 30-day period beginning between 1st of November 2018 and 31st of December 2019 in a given participating unit will be included. Data will be collected via a secure online platform in anonymised form. The primary outcome measures for the study will be 14-day mortality (or survival to hospital discharge, whichever comes first). Final day of data collection for the primary outcome measure is February 13th. Secondary outcome measures include return to theatre and surgical site infection. Ethics and dissemination:This project will not affect clinical practice and has been classified as clinical audit following research ethics review. Access to source data will be made available to collaborators through national or international anonymised datasets on request and after review of the scientific validity of the proposed analysis by the central study team

Deep Vein Thrombosis Prophylaxis Use in Traumatic Brain Injury Patients in Tropical Climate

Deep Vein Trombosis (DVT) is one of the extracranial complications after TBI. Prophylaxis DVT using on TBI reduce incidence and mortality. Climate variants of an area affect the risk of DVT. UV ray increasing synthesis of vitamin D and lowering risk of thrombus fomation. A systematic review and meta-analysis we performed according PRISMA guidelines. A through literature search was conducted on PubMed, Scopus, and Cochrane database. Total 3 publications match study criteria with 178 samples, without 144 samples and 34 samples with prophylaxis. The overall incidence is 5% (0-6.8%), without 6.25% (5.3-6.8%) and with prophylaxis 0%. No reported complications and 100% survival rate. The incidence of DVT in TBI in tropical climate is low on average 5% (0-6.8%). There was no difference in the outcome of DVT in TBI in tropical climate which given and without DVT prophylaxis. Asian races ethnic protective factor and UV ray exposure may contributed to the low of incidence rate. Prevention of DVT is still recommended for the use of prophylaxis, mechanical compression and early mobilization in cases of TBI to prevent the occurrence of DVT

Studi Pengaruh Penambahan Chitosan terhadap Sifat Fisik dan Mekanik pada Silicone Rubber/Chitosan sebagai Injectable Biomaterial

Penyakit tulang belakang atau biasa disebut nyeri punggung bawah dapat terjadi pada orang dewasa yang lebih tua yang dapat mengubah anatomi nukleus pulposus (NP) dan menyebabkan degenerasi diskus intervertebralis. Baru-baru ini solusi alternatif telah dikembangkan injectable biomaterial pada operasi pasca-mikrodisektomi sebagai material pengganti NP. Penelitian ini membahas terkait studi pengaruh penambahan chitosan pada silicone rubber terhadap sifat fisik dan mekanik sebagai kandidat injectable material untuk pengganti NP. Penambahan chitosan yang digunakan sebesar sebesar 10,20,30,40, dan 50% volum dari total silicone rubber/chitosan. Sampel kemudian dilakukan pengujian FTIR, XRD, curing time, injectable performance, water content dan kekuatan tarik. Penambahan 10%chitosan memiliki nilai curing time paling cepat selama 63.30 ± 1.50 menit Sedangkan untuk water content, kandungan air terbanyak pada penambahan 50%chitosan dengan 16.71±1.41%. Seluruh sampel menunjukkan kemampuan yang baik dalam mengisi rongga-rongga cetakan saat diinjeksikan serta mampu mempertahankan bentuknya ketika berada didalam lingkungan ph7. Dalam hal pengaruhnya terhadap sifat mekanik, penambahan chitosan relatif menurunkan nilai kuat tarik

Current Update on Stroke Ischemic Management: Stem Cell as Emerging Therapy

Stroke is one of the most important causes of morbidity and mortality worldwide, with survivors subjected to long-term disability. Stroke is classified as ischemic and hemorrhagic. 87 % of strokes are classified as ischemic. Except for thrombolytic therapy, there is no established treatment to reduce the neurological deficits caused by an ischemic stroke. Therefore, it is necessary to develop new therapeutic strategies designed to improve neurological functions after ischemic stroke. Stem cell-based therapies aim to promote neurogenesis and replacement of lost neurons or protect surviving neurons to improve neurological recovery. Further understanding of the mechanisms by which the stem cells exert their beneficial effect could potentially revolutionize the field. The next decade of stem cell research in stroke needs to focus on. Although still in need of exploration, stem cell treatments for stroke may offer ways to protect and replace neurons to improve outcomes for stroke patients

Management and outcomes following emergency surgery for traumatic brain injury – A multi-centre, international, prospective cohort study (the Global Neurotrauma Outcomes Study)

Introduction: Traumatic brain injury (TBI) accounts for a significant amount of death and disability worldwide and the majority of this burden affects individuals in low-and-middle income countries. Despite this, considerable geographical differences have been reported in the care of TBI patients. On this background, we aim to provide a comprehensive international picture of the epidemiological characteristics, management and outcomes of patients undergoing emergency surgery for traumatic brain injury (TBI) worldwide. Methods and analysis: The Global Neurotrauma Outcomes Study (GNOS) is a multi-centre, international, prospective observational cohort study. Any unit performing emergency surgery for TBI worldwide will be eligible to participate. All TBI patients who receive emergency surgery in any given consecutive 30-day period beginning between 1st of November 2018 and 31st of December 2019 in a given participating unit will be included. Data will be collected via a secure online platform in anonymised form. The primary outcome measures for the study will be 14-day mortality (or survival to hospital discharge, whichever comes first). Final day of data collection for the primary outcome measure is February 13th. Secondary outcome measures include return to theatre and surgical site infection. Ethics and dissemination: This project will not affect clinical practice and has been classified as clinical audit following research ethics review. Access to source data will be made available to collaborators through national or international anonymised datasets on request and after review of the scientific validity of the proposed analysis by the central study team