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  1. Article ; Online: The management of severe traumatic brain injury in the initial postinjury hours - current evidence and controversies.

    Hossain, Iftakher / Rostami, Elham / Marklund, Niklas

    Current opinion in critical care

    2023  Volume 29, Issue 6, Page(s) 650–658

    Abstract: Purpose of review: To provide an overview of recent studies discussing novel strategies, controversies, and challenges in the management of severe traumatic brain injury (sTBI) in the initial postinjury hours.: Recent findings: Prehospital management ...

    Abstract Purpose of review: To provide an overview of recent studies discussing novel strategies, controversies, and challenges in the management of severe traumatic brain injury (sTBI) in the initial postinjury hours.
    Recent findings: Prehospital management of sTBI should adhere to Advanced Trauma Life Support (ATLS) principles. Maintaining oxygen saturation and blood pressure within target ranges on-scene by anesthetist, emergency physician or trained paramedics has resulted in improved outcomes. Emergency department (ED) management prioritizes airway control, stable blood pressure, spinal immobilization, and correction of impaired coagulation. Noninvasive techniques such as optic nerve sheath diameter measurement, pupillometry, and transcranial Doppler may aid in detecting intracranial hypertension. Osmotherapy and hyperventilation are effective as temporary measures to reduce intracranial pressure (ICP). Emergent computed tomography (CT) findings guide surgical interventions such as decompressive craniectomy, or evacuation of mass lesions. There are no neuroprotective drugs with proven clinical benefit, and steroids and hypothermia cannot be recommended due to adverse effects in randomized controlled trials.
    Summary: Advancement of the prehospital and ED care that include stabilization of physiological parameters, rapid correction of impaired coagulation, noninvasive techniques to identify raised ICP, emergent surgical evacuation of mass lesions and/or decompressive craniectomy, and temporary measures to counteract increased ICP play pivotal roles in the initial management of sTBI. Individualized approaches considering the underlying pathology are crucial for accurate outcome prediction.
    MeSH term(s) Humans ; Decompressive Craniectomy/methods ; Brain Injuries, Traumatic/therapy ; Brain Injuries ; Tomography, X-Ray Computed ; Intracranial Hypertension/etiology ; Intracranial Hypertension/therapy ; Intracranial Pressure/physiology
    Language English
    Publishing date 2023-10-11
    Publishing country United States
    Document type Review ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1235629-3
    ISSN 1531-7072 ; 1070-5295
    ISSN (online) 1531-7072
    ISSN 1070-5295
    DOI 10.1097/MCC.0000000000001094
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 4999: Show issues Location:
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  2. Article ; Online: Preparation of pH-sensitive composite polyethersulfone membranes embedded by Ag(I) coordination polymer for the removal of cationic and anionic dyes.

    Daraei, Parisa / Rostami, Elham / Nasirmanesh, Farzad / Nobakht, Valiollah

    Journal of environmental management

    2023  Volume 347, Page(s) 119083

    Abstract: A pH-sensitive polyethersulfone (PES) membrane was prepared with the aid of newly synthesized Ag(I) coordination polymer (Ag(I)-CP) particles. Indicating obvious adsorptive property toward dyes, the Ag(I)-based metalorganic framework (MOF) was selected ... ...

    Abstract A pH-sensitive polyethersulfone (PES) membrane was prepared with the aid of newly synthesized Ag(I) coordination polymer (Ag(I)-CP) particles. Indicating obvious adsorptive property toward dyes, the Ag(I)-based metalorganic framework (MOF) was selected to be used as an additive to improve the dye selectivity of PES membranes for both cationic and anionic dyes. The performance examination and characterization of prepared membranes indicated the influence of Ag(I)-CP in PES membrane improvement. The effect of feed pH approved the membrane response to pH changes in dye removal results. By adjusting feed pH based on pH
    MeSH term(s) Coloring Agents/chemistry ; Polymers ; Sulfones ; Cations ; Hydrogen-Ion Concentration
    Chemical Substances Coloring Agents ; polyether sulfone (25667-42-9) ; Polymers ; Sulfones ; Cations
    Language English
    Publishing date 2023-09-25
    Publishing country England
    Document type Journal Article
    ZDB-ID 184882-3
    ISSN 1095-8630 ; 0301-4797
    ISSN (online) 1095-8630
    ISSN 0301-4797
    DOI 10.1016/j.jenvman.2023.119083
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    In stock of ZB MED Bonn / Germany

    Z 7556: Show issues

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  3. Article ; Online: Interleukin-1 Receptor Antagonist as Therapy for Traumatic Brain Injury.

    Lindblad, Caroline / Rostami, Elham / Helmy, Adel

    Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics

    2023  Volume 20, Issue 6, Page(s) 1508–1528

    Abstract: Traumatic brain injury is a common type of acquired brain injury of varying severity carrying potentially deleterious consequences for the afflicted individuals, families, and society. Following the initial, traumatically induced insult, cellular injury ... ...

    Abstract Traumatic brain injury is a common type of acquired brain injury of varying severity carrying potentially deleterious consequences for the afflicted individuals, families, and society. Following the initial, traumatically induced insult, cellular injury processes ensue. These are believed to be amenable to treatment. Among such injuries, neuroinflammation has gained interest and has become a specific focus for both experimental and clinical researchers. Neuroinflammation is elicited almost immediately following trauma, and extend for a long time, possibly for years, after the primary injury. In the acute phase, the inflammatory response is characterized by innate mechanisms such as the activation of microglia which among else mediates cytokine production. Among the earliest cytokines to emerge are the interleukin- (IL-) 1 family members, comprising, for example, the agonist IL-1β and its competitive antagonist, IL-1 receptor antagonist (IL-1ra). Because of its early emergence following trauma and its increased concentrations also after human TBI, IL-1 has been hypothesized to be a tractable treatment target following TBI. Ample experimental data supports this, and demonstrates restored neurological behavior, diminished lesion zones, and an attenuated inflammatory response following IL-1 modulation either through IL-1 knock-out experiments, IL-1β inhibition, or IL-1ra treatment. Of these, IL-1ra treatment is likely the most physiological. In addition, recombinant human IL-1ra (anakinra) is already approved for utilization across a few rheumatologic disorders. As of today, one randomized clinical controlled trial has utilized IL-1ra inhibition as an intervention and demonstrated its safety. Further clinical trials powered for patient outcome are needed in order to demonstrate efficacy. In this review, we summarize IL-1 biology in relation to acute neuroinflammatory processes following TBI with a particular focus on current evidence for IL-1ra treatment both in the experimental and clinical context.
    MeSH term(s) Humans ; Interleukin 1 Receptor Antagonist Protein/therapeutic use ; Neuroinflammatory Diseases ; Brain Injuries, Traumatic/drug therapy ; Brain Injuries, Traumatic/pathology ; Brain Injuries/drug therapy ; Receptors, Interleukin-1
    Chemical Substances Interleukin 1 Receptor Antagonist Protein ; Receptors, Interleukin-1
    Language English
    Publishing date 2023-08-23
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2316693-9
    ISSN 1878-7479 ; 1933-7213
    ISSN (online) 1878-7479
    ISSN 1933-7213
    DOI 10.1007/s13311-023-01421-0
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6156: Show issues Location:
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  4. Article ; Online: Traumatic Brain Injury Models in Animals.

    Rostami, Elham

    Methods in molecular biology (Clifton, N.J.)

    2016  Volume 1462, Page(s) 47–59

    Abstract: Traumatic brain injury (TBI) is the leading cause of death in young adults in industrialized nations and in the developing world the WHO considers TBI a silent epidemic caused by an increasing number of traffic accidents. Despite the major improvement of ...

    Abstract Traumatic brain injury (TBI) is the leading cause of death in young adults in industrialized nations and in the developing world the WHO considers TBI a silent epidemic caused by an increasing number of traffic accidents. Despite the major improvement of TBI outcome in the acute setting in the past 20 years, the assessment, therapeutic interventions, and prevention of long-term complications remain a challenge. In order to get a deeper insight into the pathology of TBI and advancement of medical understanding and clinical progress experimental animal models are an essential requirement. This chapter provides an overview of most commonly used experimental animal TBI models and the pathobiological findings based on current data. In addition, limitations and advantages of each TBI model are mentioned. This will hopefully give an insight into the possibilities of each model and be of value in choosing one when designing a study.
    Language English
    Publishing date 2016
    Publishing country United States
    Document type Journal Article
    ISSN 1940-6029
    ISSN (online) 1940-6029
    DOI 10.1007/978-1-4939-3816-2_4
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  5. Article ; Online: Prehospital and emergency department airway management of severe penetrating trauma in Sweden during the past decade.

    Renberg, Mattias / Dahlberg, Martin / Gellerfors, Mikael / Rostami, Elham / Günther, Mattias

    Scandinavian journal of trauma, resuscitation and emergency medicine

    2023  Volume 31, Issue 1, Page(s) 85

    Abstract: Background: Prehospital tracheal intubation (TI) is associated with increased mortality in patients with penetrating trauma, and the utility of prehospital advanced airway management is debated. The increased incidence of deadly violence in Sweden ... ...

    Abstract Background: Prehospital tracheal intubation (TI) is associated with increased mortality in patients with penetrating trauma, and the utility of prehospital advanced airway management is debated. The increased incidence of deadly violence in Sweden warrants a comprehensive evaluation of current airway management for patients with penetrating trauma in the Swedish prehospital environment and on arrival in the emergency department (ED).
    Methods: This was an observational, multicenter study of all patients with penetrating trauma and injury severity scores (ISSs) ≥ 15 included in the Swedish national trauma register (SweTrau) between 2011 and 2019. We investigated the frequency and characteristics of prehospital and ED TI, including 30-day mortality and patient characteristics associated with TI.
    Result: Of 816 included patients, 118 (14.5%) were intubated prehospitally, and 248 (30.4%) were intubated in the ED. Patients who were intubated prehospitally had a higher ISS, 33 (interquartile range [IQR] 25, 75), than those intubated in the ED, 25 (IQR 18, 34). Prehospital TI was associated with a higher associated mortality, OR 4.26 (CI 2.57, 7.27, p < 0.001) than TI in the ED, even when adjusted for ISS (OR 2.88 [CI 1.64, 5.14, p < 0.001]). Hemodynamic collapse (≤ 40 mmHg) and low GCS score (≤ 8) were the characteristics most associated with prehospital TI. Traumatic cardiac arrests (TCAs) occurred in 154 (18.9%) patients, of whom 77 (50%) were intubated prehospitally and 56 (36.4%) were intubated in the ED. A subgroup analysis excluding TCA showed that patients with prehospital TI did not have a higher mortality rate than those with ED TI, OR 2.07 (CI 0.93, 4.51, p = 0.068), with OR 1.39 (0.56, 3.26, p = 0.5) when adjusted for ISS.
    Conclusion: Prehospital TI was associated with a higher mortality rate than those with ED TI, which was specifically related to TCA; intubation did not affect mortality in patients without cardiac arrest. Mortality was high when airway management was needed, regardless of cardiac arrest, thereby emphasizing the challenges posed when anesthesia is needed. Several interventions, including whole blood transfusions, the implementation of second-tier EMS units and measures to shorten scene times, have been initiated in Sweden to counteract these challenges.
    MeSH term(s) Humans ; Sweden/epidemiology ; Emergency Medical Services ; Retrospective Studies ; Emergency Service, Hospital ; Airway Management ; Wounds, Penetrating/epidemiology ; Wounds, Penetrating/therapy ; Intubation, Intratracheal ; Heart Arrest
    Language English
    Publishing date 2023-11-24
    Publishing country England
    Document type Observational Study ; Multicenter Study ; Journal Article
    ZDB-ID 2455990-8
    ISSN 1757-7241 ; 1757-7241
    ISSN (online) 1757-7241
    ISSN 1757-7241
    DOI 10.1186/s13049-023-01151-4
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  6. Article ; Online: Mild Traumatic Brain Injury in the Maturing Brain: An Investigation of Symptoms and Cognitive Performance in Soldiers Returning From Afghanistan and Iraq.

    Ivins, Brian / Risling, Mårten / Wisén, Niclas / Schwab, Karen / Rostami, Elham

    The Journal of head trauma rehabilitation

    2023  

    Abstract: Objective: The majority of traumatic brain injuries (TBIs) are classified as mild and occur in young individuals. The course of recovery varies but can result in chronic or troubling outcomes. The impact of age on TBI outcomes in young adults before ... ...

    Abstract Objective: The majority of traumatic brain injuries (TBIs) are classified as mild and occur in young individuals. The course of recovery varies but can result in chronic or troubling outcomes. The impact of age on TBI outcomes in young adults before complete brain maturation is not well studied.
    Methods: In this study, we compared the effects of mild TBI on cognitive performance and self-reported TBI symptoms and posttraumatic stress disorder (PTSD) in 903 soldiers in 3 different age groups: 24 years or younger, 25 to 27 years, and 28 to 40 years. The soldiers had returned from war zones in Iraq and were screened for TBI within a few days of return. Cognitive performance was measured with the Automated Neuropsychological Assessment Metrics of Military TBI Version 4 (ANAM4). Symptoms associated with mild TBI were self-reported on the Neurobehavioral Symptom Inventory, and the PTSD Checklist-Civilian Version (PCL-C).
    Results: Soldiers with TBI in every age group had significantly higher prevalence of most symptoms than those with no TBI. Soldiers with TBI also reported more chronic pain sites, regardless of age. Soldiers aged 28 to 40 years with TBI had the lowest cognitive performance scores (ANAM) across several subtests, both unadjusted and adjusted. The Global Deficit Score was significantly higher for soldiers aged 28 to 40 years and 25 to 27 years with TBI than for soldiers younger than 24 years with no TBI. After adjusting for PTSD symptoms, education, and number of lifetime TBIs, the overall test battery mean for soldiers aged 28 to 40 years with TBI was significantly lower than for soldiers younger than 24 years with no TBI.
    Conclusion: Soldiers with mild TBI in the younger age group show more symptoms associated to frontal lobe function while soldiers in the older group suffer more cognitive impairment. This may warrant further study as it may indicate a propensity to later cognitive decline among soldiers who were older at the time of injury.
    Language English
    Publishing date 2023-12-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639221-0
    ISSN 1550-509X ; 0885-9701
    ISSN (online) 1550-509X
    ISSN 0885-9701
    DOI 10.1097/HTR.0000000000000919
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 2278: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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  7. Article ; Online: Evaluation of Miethke M.scio Device Implantation for Intracranial Pressure Monitoring in Patients with Cerebrospinal Fluid Disorders.

    Jirlow, Unni / Arvidsson, Lisa / Magneli, Sara / Cesarini, Kristina / Rostami, Elham

    World neurosurgery

    2023  Volume 179, Page(s) e63–e74

    Abstract: Background: Patients with complex shunt-related problems and varying diagnoses of cerebrospinal fluid (CSF) disturbance can present with headache and clinical symptoms that may be difficult to relate to underdrainage or overdrainage. Telemetric ... ...

    Abstract Background: Patients with complex shunt-related problems and varying diagnoses of cerebrospinal fluid (CSF) disturbance can present with headache and clinical symptoms that may be difficult to relate to underdrainage or overdrainage. Telemetric intracranial pressure (ICP) monitoring may assist in evaluating individual patients and assessing shunt function and adjustment. We report a case series of patients receiving a Miethke M.scio sensor.
    Methods: Between June 2016 and August 2021, 14 patients older than 18 years with different diagnoses underwent ventriculoperitoneal shunt surgery and received a Miethke M.scio sensor.
    Results: Patients had idiopathic intracranial hypertension (n = 3), obstructive hydrocephalus caused by tumors (n = 4), and malformations (n = 5). Headaches (71%) and visual impairment (50%) were the most common symptoms before surgery and 65% of the symptoms were improved after surgery. In total, 25 measurements were made and 11 of these led to changes in the shunt settings. Postoperative measurements were taken in 8 patients and the most common indication of ICP measurement was headache and/or control of the shunt settings.
    Conclusions: The Miethke M.scio is a safe and valuable device to use in shunt-treated patients, in particular those expected to need assessment of ICP monitoring postoperatively. Repeated ICP measurements can also assist in personalized adjustment of the shunt setting to optimize CSF flow in this diverse patient group. Future studies should include a standardized protocol with ICP measurements correlated to the symptoms and cause of CSF disturbances to provide better understanding of the dynamics of the ICP in each patient.
    MeSH term(s) Humans ; Intracranial Pressure ; Cerebrospinal Fluid Shunts/methods ; Hydrocephalus/diagnosis ; Hydrocephalus/surgery ; Monitoring, Physiologic/methods ; Headache/diagnosis ; Headache/etiology ; Headache/surgery
    Language English
    Publishing date 2023-07-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2023.07.102
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    In stock of ZB MED Cologne/Königswinter

    Zs.A 1159: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article: Effect of video games on preoperative anxiety in 3- to-6-year-old of a sample of Iranian children undergoing elective surgery.

    Rostami, Elham / Khanjari, Sedigheh / Haghani, Hamid / Amirian, Houshang

    Journal of education and health promotion

    2022  Volume 11, Page(s) 135

    Abstract: Background: As pediatric surgeries are rising and current methods to reduce perioperative anxiety are lacking in preschool children. The purpose of this study was to determine the effect of video games on preoperative anxiety in 3- to-6-year old of a ... ...

    Abstract Background: As pediatric surgeries are rising and current methods to reduce perioperative anxiety are lacking in preschool children. The purpose of this study was to determine the effect of video games on preoperative anxiety in 3- to-6-year old of a sample of Iranian children undergoing elective surgery children.
    Materials and methods: In the current quasi-experimental pretest posttest design, after standard translation, the modified Yale preoperative anxiety scale was administered to 102 children undergoing surgery from December 2016 to August 2017 in Kermanshah, Iran. Children are assigned to an intervention or control group. Each child's anxiety was measured at two points at the time of arrival and after waiting for 20 min in the holding area. Data were analyzed by SPSS, version 22. The Chi-square, independent
    Results: There was no significant difference between the mean anxieties in control group (42.58 ± 18.54) and intervention group (46.11 ± 14.09) before the game (
    Conclusion: Findings of the present study suggest that approved video game by experts to decrease mean preoperative anxiety in 3- to-6-year-old children. Therefore, video games recommended to be implemented at the preventive level in hospital.
    Language English
    Publishing date 2022-04-28
    Publishing country India
    Document type Journal Article
    ZDB-ID 2715449-X
    ISSN 2319-6440 ; 2277-9531
    ISSN (online) 2319-6440
    ISSN 2277-9531
    DOI 10.4103/jehp.jehp_455_21
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  9. Article: How Can a Punch Knock You Out?

    Hånell, Anders / Rostami, Elham

    Frontiers in neurology

    2020  Volume 11, Page(s) 570566

    Abstract: Several hypotheses have been put forth over time to explain how consciousness can be so rapidly lost, and then spontaneously regained, following mechanical head trauma. The knockout punch in boxing is a relatively homogenous form of traumatic brain ... ...

    Abstract Several hypotheses have been put forth over time to explain how consciousness can be so rapidly lost, and then spontaneously regained, following mechanical head trauma. The knockout punch in boxing is a relatively homogenous form of traumatic brain injury and can thus be used to test the predictions of these hypotheses. While none of the hypotheses put forth can be considered fully verified, pore formation following stretching of the axonal cell membrane, mechanoporation, is a strong contender. We here argue that the theoretical foundation of mechanoporation can be strengthened by a comparison with the experimental method electroporation.
    Language English
    Publishing date 2020-10-26
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2020.570566
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  10. Article: Glucose and the injured brain-monitored in the neurointensive care unit.

    Rostami, Elham

    Frontiers in neurology

    2014  Volume 5, Page(s) 91

    Abstract: Brain has a continuous demand for energy that is met by oxidative metabolism of oxygen and glucose. This demand is compromised in the injured brain and if the inadequate supply persists it will lead to permanent tissue damage. Zero values of cerebral ... ...

    Abstract Brain has a continuous demand for energy that is met by oxidative metabolism of oxygen and glucose. This demand is compromised in the injured brain and if the inadequate supply persists it will lead to permanent tissue damage. Zero values of cerebral glucose have been associated with infarction and poor neurological outcome. Furthermore, hyperglycemia is common in patients with neurological insults and associated with poor outcome. Intensive insulin therapy (IIT) to control blood glucose has been suggested and used in neurointensive care with conflicting results. This review covers the studies reporting on monitoring of cerebral glucose with microdialysis in patients with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH) and ischemic stroke. Studies investigating IIT are also discussed. Available data suggest that low cerebral glucose in patients with TBI and SAH provides valuable information on development of secondary ischemia and has been correlated with worse outcome. There is also indication that the location of the catheter is important for correlation between plasma and brain glucose. In conclusion considering catheter location, monitoring of brain glucose in the neurointensive care not only provides information on imminent secondary ischemia it also reveals the effect of peripheral treatment on the injured brain.
    Language English
    Publishing date 2014-06-06
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2564214-5
    ISSN 1664-2295
    ISSN 1664-2295
    DOI 10.3389/fneur.2014.00091
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