Browsing by Subject "Traumatic brain injury (TBI)"

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    A Feasibility Assessment of a Traumatic Brain Injury Predictive Modelling Tool at Kilimanjaro Christian Medical Center and Duke University Hospital
    (2020) O'Leary, Paige

    Traumatic brain injury (TBI) is the most common cause of death and disability globally. TBI is a leading cause of resource consumption and disproportionately affects LMICs. Innovative solutions are required to address this high burden of TBI. Prognostic models could provide a solution since the models enhance diagnostic ability of physicians, thereby helping to tailor treatments more effectively. This study aims to evaluate the feasibility of a prognostic model developed in Tanzania for TBI patients amongst Kilimanjaro Christian Medical Center (KCMC) healthcare providers and Duke affiliated healthcare providers. Duke health system participants were included primarily to gain insight from a different context with more established practices to inform the TBI tool implementation strategy at KCMC. To evaluate the feasibility of integrating the TBI tool into potential workflows co-design interviews were conducted with emergency physicians and nursing staff. Qualitatively, the tool was assessed using human centered design (HCD) techniques. Our research design methods were created using the Consolidated Framework for Implementation Research which considers overarching characteristics of successful implementation to contribute to theory development and verification of implementation strategies across multiple contexts. Findings of this study will aid in determining under what conditions a TBI prognostic model intervention will work at KCMC and the potential use of HCD in implementation research.

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    Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE.
    (Front Neurosci, 2015) Sundman, Mark; Doraiswamy, P Murali; Morey, Rajendra A
    Traumatic brain injury (TBI) has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE). The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i.e., impulsivity, aggression, depression, suicidality, etc.), and diminished motor control. Notably, mounting evidence suggests that the pathology contributing to CTE may be caused by repetitive exposure to subconcussive hits to the head, even in those with no history of a clinically evident head injury. Given the millions of athletes and military personnel with potential exposure to repetitive subconcussive insults and TBI, CTE represents an important public health issue. However, the incidence rates and pathological mechanisms are still largely unknown, primarily due to the fact that there is no in vivo diagnostic tool. The primary objective of this manuscript is to address this limitation and discuss potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features. Additionally, we will discuss the challenges of TBI research, outline the known pathology of CTE (with an emphasis on Tau), review current neuroimaging modalities to assess the potential routes for in vivo diagnosis, and discuss the future directions of CTE research.