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  1. AU="Andres M. Rubiano"
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  1. Article ; Online: Role of mHealth applications for emergency medical system activation in reducing mortality in low-income and middle-income countries

    Andres M Rubiano / Dylan Griswold

    BMJ Open, Vol 12, Iss

    a systematic review protocol

    2022  Volume 2

    Keywords Medicine ; R
    Language English
    Publishing date 2022-02-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Neurotrauma clinicians’ perspectives on the contextual challenges associated with long-term follow-up following traumatic brain injury in low-income and middle-income countries

    Tom Bashford / Andres M Rubiano / Anthony Figaji / Brandon George Smith / Charlotte Jane Whiffin / Ignatius N Esene / Claire Karekezi / Muhammad Mukhtar Khan / Davi Jorge Fontoura Solla / Bhagavatula Indira Devi / Peter John Hutchinson

    BMJ Open, Vol 11, Iss

    a qualitative study protocol

    2021  Volume 3

    Abstract: Introduction Traumatic brain injury (TBI) is a global public health concern; however, low/middle-income countries (LMICs) face the greatest burden. The WHO recognises the significant differences between patient outcomes following injuries in high-income ... ...

    Abstract Introduction Traumatic brain injury (TBI) is a global public health concern; however, low/middle-income countries (LMICs) face the greatest burden. The WHO recognises the significant differences between patient outcomes following injuries in high-income countries versus those in LMICs. Outcome data are not reliably recorded in LMICs and despite improved injury surveillance data, data on disability and long-term functional outcomes remain poorly recorded. Therefore, the full picture of outcome post-TBI in LMICs is largely unknown.Methods and analysis This is a cross-sectional pragmatic qualitative study using individual semistructured interviews with clinicians who have experience of neurotrauma in LMICs. The aim of this study is to understand the contextual challenges associated with long-term follow-up of patients following TBI in LMICs. For the purpose of the study, we define ‘long-term’ as any data collected following discharge from hospital. We aim to conduct individual semistructured interviews with 24–48 neurosurgeons, beginning February 2020. Interviews will be recorded and transcribed verbatim. A reflexive thematic analysis will be conducted supported by NVivo software.Ethics and dissemination The University of Cambridge Psychology Research Ethics Committee approved this study in February 2020. Ethical issues within this study include consent, confidentiality and anonymity, and data protection. Participants will provide informed consent and their contributions will be kept confidential. Participants will be free to withdraw at any time without penalty; however, their interview data can only be withdrawn up to 1 week after data collection. Findings generated from the study will be shared with relevant stakeholders such as the World Federation of Neurosurgical Societies and disseminated in conference presentations and journal publications.
    Keywords Medicine ; R
    Subject code 170
    Language English
    Publishing date 2021-03-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Prevention of road traffic collisions and associated neurotrauma in Colombia

    Santhani M Selveindran / Gurusinghe D N Samarutilake / David Santiago Vera / Carol Brayne / Christine Hill / Angelos Kolias / Alexis J Joannides / Peter J A Hutchinson / Andres M Rubiano

    PLoS ONE, Vol 16, Iss 3, p e

    An exploratory qualitative study.

    2021  Volume 0249004

    Abstract: Introduction Neurotrauma is an important but preventable cause of death and disability worldwide, with the majority being associated with road traffic collisions (RTCs). The greatest burden is seen in low -and middle- income countries (LMICs) where ... ...

    Abstract Introduction Neurotrauma is an important but preventable cause of death and disability worldwide, with the majority being associated with road traffic collisions (RTCs). The greatest burden is seen in low -and middle- income countries (LMICs) where variations in the environment, infrastructure, population and habits can challenge the success of conventional preventative approaches. It is therefore necessary to understand local perspectives to allow for the development and implementation of context-specific strategies which are effective and sustainable. Methods This study took place in Colombia where qualitative data collection was carried out with ten key informants between October and November 2019. Semi-structured interviews were conducted and explored perceptions on RTCs and neurotrauma, preventative strategies and interventions, and the role of research in prevention. Interview transcripts were analysed by thematic analysis using a framework approach. Results Participants' confirmed that RTCs are a significant problem in Colombia with neurotrauma as an important outcome. Human and organisational factors were identified as key causes of the high rates of RTCs. Participants described the current local preventative strategies, but were quick to discuss limitations and challenges to their success. Key barriers reported were poor attitudes and knowledge, particularly in the community. Suggestions were provided on ways to improve prevention through better education and awareness, stricter enforcement and new policies on prevention, proper budgeting and resource allocation, as well as through collaboration and changes in attitudes and leadership. Participants identified four key research areas they felt would influence prevention of RTCs and associated neurotrauma: causes of RTCs; consequences and impact of RTCs; public involvement in research; improving prevention. Conclusion RTCs are a major problem in Colombia despite the current preventative strategies and interventions. Findings from this study have a ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2021-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: The Evolution of the Role of External Ventricular Drainage in Traumatic Brain Injury

    Charlene Y. C. Chau / Claudia L. Craven / Andres M. Rubiano / Hadie Adams / Selma Tülü / Marek Czosnyka / Franco Servadei / Ari Ercole / Peter J. Hutchinson / Angelos G. Kolias

    Journal of Clinical Medicine, Vol 8, Iss 9, p

    2019  Volume 1422

    Abstract: External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). ... ...

    Abstract External ventricular drains (EVDs) are commonly used in neurosurgery in different conditions but frequently in the management of traumatic brain injury (TBI) to monitor and/or control intracranial pressure (ICP) by diverting cerebrospinal fluid (CSF). Their clinical effectiveness, when used as a therapeutic ICP-lowering procedure in contemporary practice, remains unclear. No consensus has been reached regarding the drainage strategy and optimal timing of insertion. We review the literature on EVDs in the setting of TBI, discussing its clinical indications, surgical technique, complications, clinical outcomes, and economic considerations.
    Keywords neurosurgery ; ventriculostomy ; neurotrauma ; intracranial pressure ; EVD ; TBI ; ICP ; Medicine ; R
    Language English
    Publishing date 2019-09-01T00:00:00Z
    Publisher MDPI AG
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Mapping global evidence on strategies and interventions in neurotrauma and road traffic collisions prevention

    Santhani M Selveindran / Tamara Tango / Muhammad Mukhtar Khan / Daniel Martin Simadibrata / Peter J. A. Hutchinson / Carol Brayne / Christine Hill / Franco Servadei / Angelos G. Kolias / Andres M. Rubiano / Alexis J. Joannides / Hamisi K. Shabani

    Systematic Reviews, Vol 9, Iss 1, Pp 1-

    a scoping review

    2020  Volume 22

    Abstract: Abstract Background Neurotrauma is an important global health problem. The largest cause of neurotrauma worldwide is road traffic collisions (RTCs), particularly in low- and middle-income countries (LMICs). Neurotrauma and RTCs are preventable, and many ... ...

    Abstract Abstract Background Neurotrauma is an important global health problem. The largest cause of neurotrauma worldwide is road traffic collisions (RTCs), particularly in low- and middle-income countries (LMICs). Neurotrauma and RTCs are preventable, and many preventative interventions have been implemented over the last decades, especially in high-income countries (HICs). However, it is uncertain if these strategies are applicable globally due to variations in environment, resources, population, culture and infrastructure. Given this issue, this scoping review aims to identify, quantify and describe the evidence on approaches in neurotrauma and RTCs prevention, and ascertain contextual factors that influence their implementation in LMICs and HICs. Methods A systematic search was conducted using five electronic databases (MEDLINE, EMBASE, CINAHL, Global Health on EBSCO host, Cochrane Database of Systematic Reviews), grey literature databases, government and non-government websites, as well as bibliographic and citation searching of selected articles. The extracted data were presented using figures, tables, and accompanying narrative summaries. The results of this review were reported using the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Results A total of 411 publications met the inclusion criteria, including 349 primary studies and 62 reviews. More than 80% of the primary studies were from HICs and described all levels of neurotrauma prevention. Only 65 papers came from LMICs, which mostly described primary prevention, focussing on road safety. For the reviews, 41 papers (66.1%) reviewed primary, 18 tertiary (29.1%), and three secondary preventative approaches. Most of the primary papers in the reviews came from HICs (67.7%) with 5 reviews on only LMIC papers. Fifteen reviews (24.1%) included papers from both HICs and LMICs. Intervention settings ranged from nationwide to community-based but were not reported in 44 papers (10.8%), most of which were reviews. Contextual factors were described in 62 papers and ...
    Keywords Neurotrauma prevention ; Road traffic collisions prevention ; Preventative strategies and interventions ; Low- and middle-income countries ; High-income countries ; Contextual factors ; Medicine ; R
    Subject code 306
    Language English
    Publishing date 2020-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Results of early cranial decompression as an initial approach for damage control therapy in severe traumatic brain injury in a hospital with limited resources

    José D Charry / Andrés M Rubiano / Christine V Nikas / Juan C Ortíz / Juan C Puyana / Nancy Carney / P David Adelson

    Journal of Neurosciences in Rural Practice, Vol 7, Iss 1, Pp 7-

    2016  Volume 12

    Abstract: Introduction: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with ... ...

    Abstract Introduction: Severe traumatic brain injury (sTBI) is a disease that generates significant mortality and disability in Latin America, and specifically in Colombia. The purpose of this study was to evaluate the 12-month clinical outcome in patients with sTBI managed with an early cranial decompression (ECD) as the main procedure for damage control (DC) therapy, performed in a University Hospital in Colombia over a 4-year period. Materials and Methods: A database of 106 patients who received the ECD procedure, and were managed according to the strategy for DC in neurotrauma, was analyzed. Variables were evaluated, and the patient outcome was determined according to the Glasgow Outcome Score (GOS) at 12 months postinjury. This was used to generate a dichotomous variable with “favorable” (GOS of 4 or 5) or “unfavorable” (GOS of 1–3) outcomes; analysis of variance was performed with the Chi-square, Wilcoxon–Mann–Whitney and Fisher tests. Results: An overall survival rate of 74.6% was observed for the procedure, At 12 months postsurgery, a favorable clinical outcome (GOS 4–5) was found in 70 patients (66.1%), Unfavorable outcomes in patients were associated with the following factors: Closed trauma, an Injury Severity Score >16 , obliterated basal cisterns, subdural hematoma as the main injury seen on the admission computed tomography, and nonreactive pupils observed in the emergency department. Conclusion: Twelve months outcome of patients with sTBI managed with ECD in a neuromonitoring limited resource University Hospital in Colombia shows an important survival rate with favorable clinical outcome measure with GOS.
    Keywords Cranial decompression ; damage control ; traumatic brain injury ; Neurosciences. Biological psychiatry. Neuropsychiatry ; RC321-571 ; Internal medicine ; RC31-1245 ; Medicine ; R
    Subject code 616
    Language English
    Publishing date 2016-01-01T00:00:00Z
    Publisher Wolters Kluwer Medknow Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Emergent Decompressive Craniectomy in Patients with Fixed Dilated Pupils; A Single Center Experience

    Luis Rafael Moscote-Salazar / Hernando Raphael Alvis-Miranda / Camilo Palencia / Andres M. Rubiano

    Bulletin of Emergency And Trauma, Vol 1, Iss 4, Pp 175-

    2013  Volume 178

    Abstract: This is a case series which report the clinical results of decompressive craniectomy in 4 patients with dilated pupils secondary to traumatic brain injury and postoperative edema. Between 2011 and 2012, four patients,3 males and 1 female, aged between 35 ...

    Abstract This is a case series which report the clinical results of decompressive craniectomy in 4 patients with dilated pupils secondary to traumatic brain injury and postoperative edema. Between 2011 and 2012, four patients,3 males and 1 female, aged between 35 and 64 with mean age of 50.1 ± 8.9 years, underwent decompressive craniectomy due to brain traumatic edema. The follow up period ranged between 1 to 6 months. All patients had Glasgow coma score (GCS) of 3-4 at admission, and the duration of pupils being mydriatic was less than 20 minutes before the operation. All patients had moderate disability with GCS of 4 after the operation. Decompressive craniectomy can be a life-saving procedure which provides a better outcome in patients with dilated pupils secondary to brain trauma injury and postoperative edema with timing of less than 20 minutes. However, the small number of the patients in this study is the main limitation to the accuracy of the results, and more studies with larger number of patients are warranted to evaluate the efficiency of decompressive craniectomy in patients with dilated pupils.
    Keywords Decompressive craniectomy ; Intracranial hypertension ; Brain edema ; Surgery ; RD1-811 ; Medicine ; R ; DOAJ:Surgery ; DOAJ:Medicine (General) ; DOAJ:Health Sciences
    Subject code 616 ; 610
    Language English
    Publishing date 2013-10-01T00:00:00Z
    Publisher Shiraz University of Medical Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Fatal Massive Cerebral Infarction in a Child after Mild Brain Trauma

    Willen Guillermo Calderon-Miranda / Hernando Raphael Alvis-Miranda / Andres M. Rubiano / Luis Rafael Moscote-Salazar

    Bulletin of Emergency And Trauma, Vol 2, Iss 2, Pp 96-

    A Case Report and Literature Review

    2014  Volume 98

    Abstract: Traumatic brain injury is a common entity. However cerebral infarction in infants is a rare entity while the diagnosis of this pathology in the pediatric population is usually difficult. The mild head trauma is rarely accompanied by intracranial injury ... ...

    Abstract Traumatic brain injury is a common entity. However cerebral infarction in infants is a rare entity while the diagnosis of this pathology in the pediatric population is usually difficult. The mild head trauma is rarely accompanied by intracranial injury and even less, with cerebral infarction. We herein report the first case of cerebral infarction after a mild brain trauma in a 2-year-old Latin-American male patient, in which brain computed tomography (CT) scan was performed on the first day of the accident, showed right hemispheric cerebral ischemia compromising the fronto-parieto-occipital region. Conservative management was established. The patient died at day 5. So Brain CT scan may be beneficial to reveal any hemispheric infarction due to a probable mass effect.
    Keywords Stroke ; Mild head trauma ; Brain injury ; Neurotrauma ; Surgery ; RD1-811 ; Medicine ; R
    Language English
    Publishing date 2014-04-01T00:00:00Z
    Publisher Shiraz University of Medical Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  9. Article ; Online: Bilateral Traumatic Basal Ganglia Hemorrhage Associated With Epidural Hematoma

    Willem Guillermo Calderon-Miranda / Hernando Raphael Alvis-Miranda / Gabriel Alcala-Cerra / Andres M. Rubiano / Luis Rafael Moscote-Salazar

    Bulletin of Emergency And Trauma, Vol 2, Iss 3 JUL, Pp 130-

    Case Report and Literature Review

    2014  Volume 132

    Abstract: Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare ... ...

    Abstract Traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. Bilateral basal ganglia hematoma are among the devastating and rare condition. We herein report a 28-year old man, a victim of car-car accident who was brought to our surgical emergency room by immediate loss of consciousness and was diagnosed to have hyperdense lesion in the basal ganglia bilaterally, with the presence of right parietal epidural hematoma. Craniotomy and epidural hematoma drainage were considered, associated to conservative management of gangliobasal traumatic contusions. On day 7 the patient had sudden neurologic deterioration, cardiac arrest unresponsive to resuscitation. Management of these lesions is similar to any other injury in moderate to severe traumatic injury. The use of intracranial pressure monitoring must be guaranteed.
    Keywords Traumatic brain injury ; Cerebral contusion ; Basal ganglia hemorrhage ; Neurotrauma ; Surgery ; RD1-811 ; Medicine ; R
    Language English
    Publishing date 2014-07-01T00:00:00Z
    Publisher Shiraz University of Medical Sciences
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Fluid therapy in neurotrauma

    Hernando Raphael Alvis-Miranda / Andres M. Rubiano Rubiano / Juan C. Puyana / Gabriel Alcala-Cerra / Luis Rafael Moscote-Salazar

    Reviews in Health Care, Vol 5, Iss 1, Pp 7-

    basic and clinical concepts

    2014  Volume 22

    Abstract: The patient with head trauma is a challenge for the emergency physician and for the neurosurgeon. Currently traumatic brain injury constitutes a public health problem. Knowledge of the various therapeutic strategies to provide support in the prehospital ... ...

    Abstract The patient with head trauma is a challenge for the emergency physician and for the neurosurgeon. Currently traumatic brain injury constitutes a public health problem. Knowledge of the various therapeutic strategies to provide support in the prehospital and perioperative are essential for optimal care. Rapid infusion of large volumes of crystalloids to restore blood volume and blood pressure quickly is now the standard treatment for patients with combined TBI and HS The fluid in patients with brain and especially in the carrier of brain injury is a critical topic; we present a review of the literature about the history, physiology of current fluid preparations, and a discussion regard the use of fluid therapy in traumatic brain injury and decompressive craniectomy. http://dx.doi.org/10.7175/rhc.v5i1.636
    Keywords Brain trauma ; Colloid solutions ; Fluid resuscitation ; Public aspects of medicine ; RA1-1270
    Subject code 616
    Language English
    Publishing date 2014-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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