Mild traumatic brain injury as a cause of adult growth hormone deficiency: Diagnosis and treatment.

In recent years, mild traumatic brain injury (mTBI) has been recognized as a cause of acquired growth hormone deficiency (AGHD) and is likely much more prevalent than previous estimates. There is great overlap between persistent symptoms following mTBI and those of AGHD and it is possible that these persistent symptoms of mTBI are, at least in part, due to or aggravated by AGHD. This article reviews the current literature of AGHD following mTBI, and proposes practice recommendations for the screening, diagnosis, and management of patients with AGHD following mTBI.

Metabolic and quality of life effects of growth hormone replacement in patients with TBI and AGHD: A pilot study.

Objective: Traumatic brain injury (TBI), a common cause of adult growth hormone deficiency (AGHD), affects 20% of Veterans returning from Iraq and Afghanistan (OEF/OIF/OND). Growth hormone replacement therapy (GHRT) improves quality of life (QoL) in AGHD but remains unexplored in this population. This pilot, observational study investigates the feasibility and efficacy of GHRT in AGHD following TBI.

Pilot clinical trial of macimorelin to assess safety and efficacy in patients with cancer cachexia.

Background: Cancer cachexia is associated with reduced body weight, appetite and quality of life (QOL) with no approved treatments. Growth hormone secretagogues like macimorelin have potential to mitigate these effects.

Methods: This pilot study assessed the safety and efficacy of macimorelin for 1 week.

A case analysis of service-member trauma processing related to art therapy within a military-intensive outpatient program.

Objectives: Art therapy has been widely used in clinical settings and has shown preliminary success in military trauma. This case study describes a mask-making art therapy directive facilitated by a board-certified art therapist as an adjunct to group posttraumatic stress disorder (PTSD) treatment in a military-intensive outpatient program.

Methods: Described are clinical outcome measures, linguistic analysis of a personal journal, evaluation of this service-member's artwork, and experiences in the program.

Effect of Tranexamic Acid on Blood Loss, D-Dimer, and Fibrinogen Kinetics in Adult Spinal Deformity Surgery.

Background: Antifibrinolytics such as tranexamic acid reduce operative blood loss and blood product transfusion requirements in patients undergoing surgical correction of scoliosis. The factors involved in the unrelenting coagulopathy seen in scoliosis surgery are not well understood. One potential contributor is activation of the fibrinolytic system during a surgical procedure, likely related to clot dissolution and consumption of fibrinogen.