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  1. Article ; Online: Traumatic Brain Injury in Select Low- and Middle-Income Countries: A Narrative Review of the Literature.

    Allen, Beddome C / Cummer, Elaina / Sarma, Anand K

    Journal of neurotrauma

    2023  Volume 40, Issue 7-8, Page(s) 602–619

    Abstract: Low- and middle-income countries (LMICs) experience the majority of traumatic brain injuries (TBIs), yet few studies have examined the epidemiology and management strategies of TBI in LMICs. The objective of this narrative review is to discuss the ... ...

    Abstract Low- and middle-income countries (LMICs) experience the majority of traumatic brain injuries (TBIs), yet few studies have examined the epidemiology and management strategies of TBI in LMICs. The objective of this narrative review is to discuss the epidemiology of TBI within LMICs, describe the adherence to Brain Trauma Foundation (BTF) guidelines for the management of severe TBI in LMICs, and document TBI management strategies currently used in LMICs. Articles from January 1, 2009 to September 30, 2021 that included patients with TBI greater than 18 years of age in low-, low middle-, and high middle-income countries were queried in PubMed. Search results demonstrated that TBI in LMICs mostly impacts young males involved in road traffic accidents. Within LMICs there are a myriad of approaches to managing TBI with few randomized controlled trials performed within LMICs to evaluate those interventions. More studies are needed in LMICs to establish the effectiveness and appropriateness of BTF guidelines for managing TBI and to help identify methods for managing TBI that are appropriate in low-resource settings. The problem of limited pre- and post-hospital care is a bigger challenge that needs to be considered while addressing management of TBI in LMICs.
    MeSH term(s) Male ; Humans ; Developing Countries ; Brain Injuries, Traumatic/epidemiology ; Brain Injuries, Traumatic/therapy
    Language English
    Publishing date 2023-03-09
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 645092-1
    ISSN 1557-9042 ; 0897-7151
    ISSN (online) 1557-9042
    ISSN 0897-7151
    DOI 10.1089/neu.2022.0068
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Transcranial ultrasonography to detect intracranial pathology: A systematic review and meta-analysis.

    Allen, Beddome C / Kapoor, Sahil / Anzalone, Anthony / Mayer, Kirby P / Wolfe, Stacey Q / Duncan, Pam / Asimos, Andrew W / D'Agostino, Ralph / Winslow, James Tripp / Sarwal, Aarti

    Journal of neuroimaging : official journal of the American Society of Neuroimaging

    2023  Volume 33, Issue 3, Page(s) 333–358

    Abstract: Background and purpose: Transcranial ultrasonography (TCU) can be a useful diagnostic tool in evaluating intracranial pathology in patients with limited or delayed access to routine neuroimaging in critical care or austere settings. We reviewed ... ...

    Abstract Background and purpose: Transcranial ultrasonography (TCU) can be a useful diagnostic tool in evaluating intracranial pathology in patients with limited or delayed access to routine neuroimaging in critical care or austere settings. We reviewed available literature investigating the diagnostic utility of TCU for detecting pediatric and adult patient's intracranial pathology in patients with intact skulls and reported diagnostic accuracy measures.
    Methods: We performed a systematic review of PubMed
    Results: A total of 44 studies out of the 3432 articles screened met the eligibility criteria, totaling 2426 patients (Mean age: 60.1 ± 14.52 years). We found tumors, intracranial hemorrhage (ICH), and neurodegenerative diseases in the eligible studies. Sensitivity, specificity, and accuracy of TCU and their 95% confidence intervals were 0.80 (0.72, 0.89), 0.71 (0.59, 0.82), and 0.76 (0.71, 0.82) for neurodegenerative diseases; 0.88 (0.74, 1.02), 0.81 (0.50, 1.12), and 0.94 (0.92, 0.96) for ICH; and 0.97 (0.92, 1.03), 0.99 (0.96, 1.01), and 0.99 (0.97, 1.01) for intracranial masses. No studies reported ultrasound presets.
    Conclusions: TCU has a reasonable sensitivity and specificity for detecting intracranial pathology involving ICH and tumors with clinical applications in remote locations or where standard imaging is unavailable. Future studies should investigate ultrasound parameters to enhance diagnostic accuracy in diagnosing intracranial pathology.
    MeSH term(s) Adult ; Humans ; Child ; Middle Aged ; Aged ; Ultrasonography ; Sensitivity and Specificity
    Language English
    Publishing date 2023-01-29
    Publishing country United States
    Document type Meta-Analysis ; Systematic Review ; Journal Article ; Review ; Research Support, N.I.H., Extramural
    ZDB-ID 1071724-9
    ISSN 1552-6569 ; 1051-2284
    ISSN (online) 1552-6569
    ISSN 1051-2284
    DOI 10.1111/jon.13087
    Database MEDical Literature Analysis and Retrieval System OnLINE

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