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  • McCullough Henry posted an update 6 days, 8 hours ago

    25 hours and no serious adverse events. Fasting duration had a weak to moderate ability to predict “risk” category (area under the curve = 0.73), with no patient (n = 17) who underwent multiple evaluations awaiting PSA progressing from “high” to “low risk.”

    The majority of PED patients undergoing PSA at our institution had “high risk” gastric content with no clinically significant change occurring during serial evaluations. This calls into question the utility of delaying PSA based upon fasting status and lends support to a more comprehensive risk-benefit approach when planning pediatric PSA.

    The majority of PED patients undergoing PSA at our institution had “high risk” gastric content with no clinically significant change occurring during serial evaluations. This calls into question the utility of delaying PSA based upon fasting status and lends support to a more comprehensive risk-benefit approach when planning pediatric PSA.

    Because of the growing concern about the potential effects of traumatic brain injuries (TBIs) on a child’s developing brain and the potential impact of lifetime depression and risk behaviors associated with TBI, further exploration is warranted.

    Data (N = 4917) from the 2017 North Carolina Behavioral Risk Factors Surveillance System (BRFSS).

    Cross-sectional.

    Examine whether a lifetime history of TBI with loss of consciousness (LOC) or having a history of TBI with LOC prior to 18 years of age was associated with a greater likelihood of lifetime depression, current binge drinking, and current cigarette and e-cigarette smoking.

    Respondents with a history of TBI with LOC had 2.1 (95% CI, 1.6-2.8) times higher odds of lifetime depression and 1.7 to 1.8 (95% CI, 1.02-2.97) times higher odds of all risk behaviors than those without a lifetime history of TBI with LOC. There were no statistical differences between age of first TBI with LOC and lifetime depression, binge drinking, cigarette smoking, and e-cigarette use after controlling for key demographics.

    These findings underscore the importance of increasing awareness among healthcare providers of the prevalence of lifetime depression and risk behaviors among individuals with a history of TBI and the need for improved screening and referrals to evidence-based services.

    These findings underscore the importance of increasing awareness among healthcare providers of the prevalence of lifetime depression and risk behaviors among individuals with a history of TBI and the need for improved screening and referrals to evidence-based services.

    To identify risk factors for suicidal ideation (SI) following mild traumatic brain injury (mTBI).

    Eleven US level 1 trauma centers.

    A total of 1158 emergency department patients with mTBI (Glasgow Coma Scale score = 13-15) enrolled in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study.

    Prospective observational study; weights-adjusted multivariable logistic regression models (n’s = 727-883) estimated associations of baseline factors and post-TBI symptoms with SI at 2 weeks and 3, 6, and 12 months postinjury.

    Patient Health Questionnaire, Rivermead Post-Concussion Symptoms Questionnaire.

    Preinjury psychiatric history predicted SI at all follow-ups (adjusted odds ratios [AORs] = 2.26-6.33, P values <.05) and history of prior TBI predicted SI at 2 weeks (AOR = 2.36, 95% confidence interval [CI] = 1.16-4.81, P = .018), 3 months (AOR = 2.62, 95% CI = 1.33-5.16, P = .005), and 6 months postinjury (AOR = 2.54, 95% CI = 1.19-5.42, P = .016). Adjusting for these baseline factors, post-TBI symptoms were strongly associated with SI at concurrent (AORs = 1.91-2.88 per standard deviation unit increase in Rivermead Post-Concussion Symptoms Questionnaire score; P values <.0005) and subsequent follow-up visits (AORs = 1.68-2.53; P values <.005). Most of the associations between post-TBI symptoms and SI were statistically explained by co-occurring depression.

    Screening for psychiatric and prior TBI history may help identify patients at risk for SI following mTBI. Awareness of the strong associations of post-TBI symptoms with SI may facilitate interventions to prevent suicide-related outcomes in patients with mTBI.

    Screening for psychiatric and prior TBI history may help identify patients at risk for SI following mTBI. Awareness of the strong associations of post-TBI symptoms with SI may facilitate interventions to prevent suicide-related outcomes in patients with mTBI.

    To investigate the association between reported traumatic brain injury plus loss of consciousness (TBI + LOC) and a range of demographic, military, and physical and mental health factors among a sample of UK veterans seeking support for mental health difficulties.

    The present study was a cross-sectional study.

    Clinical records were used to identify a sample of treatment-seeking UK veterans (N = 3335), of which a total of 403 took part.

    Information on demographic characteristics, military experiences, and a range of physical and mental health difficulties was collected.

    Almost half of the sample (48%) reported a TBI + LOC, which was most strongly associated with drug use and childhood adversity. More modest associations also emerged with earlier service termination, likelihood of unemployment, as well as chronic pain and poor mobility.

    The findings suggested that TBI + LOC may not specifically be associated with symptoms of posttraumatic stress in a sample of treatment-seeking veterans. The demonstrated links between TBI + LOC and adverse childhood, drug use, physical health, and employment may be useful in improving the assessment and rehabilitation of veterans with TBI + LOC.

    The findings suggested that TBI + LOC may not specifically be associated with symptoms of posttraumatic stress in a sample of treatment-seeking veterans. The demonstrated links between TBI + LOC and adverse childhood, drug use, physical health, and employment may be useful in improving the assessment and rehabilitation of veterans with TBI + LOC.

    To evaluate the feasibility and potential benefits of a manualized, brief cognitive-behavioral therapy-based intervention program for children and adolescents with persistent postconcussive symptoms.

    Two outpatient pediatric concussion programs in the United States.

    Patients aged 8 to 17 years who sustained concussions between 2 and 12 months prior to enrollment.

    Pre-/postretrospective study.

    SCAT-3; HBI; PedsQL 4.0 Generic Core Scales; and RCADS.

    Thirty children and adolescents completed the treatment program. Self- and parent-reported postconcussive symptoms, quality of life, and internalizing symptoms significantly improved with treatment. Vorapaxar manufacturer Mixed-effects models revealed a significant decline in self-reported postconcussive symptoms across treatment sessions, a = -2.07, SE = 0.25, P < .001. The largest change occurred between sessions 2 and 3, following the session focusing on concussion psychoeducation and sleep hygiene (estimated mean change between sessions 2 and 3 = -4.72, P < .0001).

    Our findings indicate that a 6-session manualized cognitive behavioral intervention is feasible to initiate in an outpatient clinic 1 to 12 months following a pediatric mild traumatic brain injury.

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