How Do Intensity and Duration of Rehabilitation Services Affect Outcomes From Severe Traumatic Brain Injury? A Natural Experiment Comparing Health Care Delivery Systems in 2 Developed Nations.

Objective: To determine the effects of inpatient and outpatient treatment intensity on functional and emotional well-being outcomes at 1 year after severe traumatic brain injury (TBI).

Design: Prospective, quasiexperimental study comparing outcomes in a U.S.

Early endocrine alterations reflect prolonged stress and relate to 1-year functional outcome in patients with severe brain injury.

Objective: Severe brain injury may increase the risk of developing acute and chronic hypopituitarism. Pituitary hormone alterations developed in the early recovery phase after brain injury may have implications for long-term functional recovery. The objective of the present study was to assess the pattern and prevalence of pituitary hormone alterations 3 months after a severe brain injury with relation to functional outcome at a 1-year follow-up.

Functional recovery after severe traumatic brain injury: an individual growth curve approach.

Objective: To examine person, injury, and treatment characteristics associated with recovery trajectories of people with severe traumatic brain injury (TBI) during inpatient rehabilitation.

Design: Observational prospective longitudinal study.

Setting: TBI rehabilitation units.

Patients with severe acquired brain injury show increased arousal in tilt-table training.

Introduction: Patients with severe acquired brain injury (ABI) are often mobilised using a tilt-table. Complications such as orthostatic intolerance have been reported. The primary objective of this study was to investigate if using a tilt-table was feasible for mobilising patients with severe ABI admitted for sub-acute rehabilitation.

Medical complications during inpatient rehabilitation among patients with traumatic disorders of consciousness.

Objective: To assess the incidence of medical complications in patients with recent traumatic disorders of consciousness (DOCs).

Design: Data on adverse events in a placebo controlled trial of amantadine hydrochloride revealed no group difference, which allowed these events to be reanalyzed descriptively as medical complications experienced by the 2 groups collectively.

Setting: Eleven clinical facilities in the United States, Denmark, and Germany with specialty rehabilitation programs for patients with DOCs.

Placebo-controlled trial of amantadine for severe traumatic brain injury.

Background: Amantadine hydrochloride is one of the most commonly prescribed medications for patients with prolonged disorders of consciousness after traumatic brain injury. Preliminary studies have suggested that amantadine may promote functional recovery.

Methods: We enrolled 184 patients who were in a vegetative or minimally conscious state 4 to 16 weeks after traumatic brain injury and who were receiving inpatient rehabilitation.

Gabapentin in the management of dysautonomia following severe traumatic brain injury: a case series.

The pharmacological management of dysautonomia, otherwise known as autonomic storms, following acute neurological insults, is problematic and remains poorly researched. This paper presents six subjects with dysautonomia following extremely severe traumatic brain injury where gabapentin controlled paroxysmal autonomic changes and posturing in the early post-acute phase following limited success with conventional medication regimens. In two subjects, other medications were reduced or ceased without a recurrence of symptoms.

[Subacute intensive rehabilitation after severe traumatic brain injury. Follow-up 6 months after discharge].

Introduction: In September 2000 the Brain Injury Unit at Hvidovre Hospital was established, offering subacute intensive rehabilitation to patients with severe traumatic brain injury. Uptake area: Eastern part of Denmark, the Faroe Islands and Greenland. Outcome 6 months after discharge is presented for patients from the first 2 years, focusing on disability and social factors.

Centralized rehabilitation after severe traumatic brain injury--a population-based study.

Objectives: To present results from the first 3 years of centralized subacute rehabilitation after very severe traumatic brain injury (TBI), and to compare results of centralized versus decentralized rehabilitation.

Material And Methods: Prospectively, the most severely injured group of adults from an uptake area of 2.4 million in Denmark were included at admission to a regional brain injury unit (BIU), on average 19 days after injury.

Conservative bladder management in advanced multiple sclerosis.

Anticholinergics and intermittent catheterization are the cornerstones of bladder management in early multiple sclerosis (MS). In advanced MS however, bladder management is based more on tradition than on evidence. Nurses seem to deal with catheter problems and chronic incontinence.

Sympathetic vasoconstrictor responses in multiple sclerosis with thermo-regulatory dysfunction.

Centrally and locally mediated sympathetic vasoconstrictor responses in skeletal muscle and subcutaneous tissue were studied in six patients with definite multiple sclerosis and severely affected thermoregulatory sweating. The purpose of the study was to evaluate vasomotor function in patients with pronounced thermoregulatory dysfunction and to differentiate between locally and centrally elicited vasomotor reflexes in two different tissues. The method used, the 133-Xenon washout technique, makes such a distinction possible.

Disturbances of ano-rectal function in multiple sclerosis.

Thirty patients with multiple sclerosis (MS) [18 men and 12 women, mean age 40 years (range 22-50), disease duration 12 years (range 0.5-34), Kurtzke's Expanded Disability Status Score 6.0 (range 4.

Plasma exchange combined with azathioprine in multiple sclerosis using serial gadolinium-enhanced MRI to monitor disease activity: a randomized single-masked cross-over pilot study.

We enrolled 11 patients with secondary progressive MS in a randomized single-masked cross-over study of plasma exchange (PE) in combination with azathioprine 2 mg/kg. PE was performed once a week for 4 weeks and thereafter every second week for 20 weeks (14 treatments). Eight patients completed the whole trial, and three patients discontinued the trial, two during the run-in period of azathioprine treatment and one at the introduction of PE.

Ciprofloxacin as prophylaxis for urinary tract infection: prospective, randomized, cross-over, placebo controlled study in patients with spinal cord lesion.

To evaluate the efficacy of low-dose long-term treatment with ciprofloxacin in the prevention of recurrent urinary tract infections in patients with spinal cord lesions and neurogenic bladder dysfunction, a prospective, randomized, cross-over, placebo-controlled study was performed. The study period was 12 months long, including 6 months of treatment with 100 mg. ciprofloxacin at night and 6 months of placebo treatment.

Biofeedback treatment of bladder dysfunction in multiple sclerosis. A randomized trial.

Fifteen women and five men with bladder dysfunction due to multiple sclerosis were randomized to plus/minus biofeedback using bladder pressure and simultaneous EMG registration via surface electrodes. All the patients had behavioural modification, pharmacological adjustment and pelvis floor training. The number of incontinence episodes decreased and maximal cystometric capacity increased, while first sensation and pad test were unchanged.

Treatment of lower urinary tract dysfunction in patients with multiple sclerosis. Committee of the European Study Group of SUDIMS (Sexual and Urological Disorders in Multiple Sclerosis).

Bladder symptoms in patients with multiple sclerosis (MS) are common and usually arise as a result of spinal lesions which interrupt the neural pathways connecting the pontine micturition centre to the sacral spinal cord. Thus these symptoms are particularly likely to occur in those with lower limb neurological deficits. Fortunately bladder dysfunction in MS is rarely associated with serious upper tract disease so that the problem is usually one of symptomatic management.

Plaques causing hemianopsia or quadrantanopsia in multiple sclerosis identified by MRI and VEP.

Four patients with definite multiple sclerosis (MS) gave evidence of demyelinating plaques that produced a form of visual loss atypical of MS, i.e. homonymous quadrantanopsia (women, 22 and 30 years), and homonymous hemianopsia (men, 30 and 42 years).

Assessment of demyelination, edema, and gliosis by in vivo determination of T1 and T2 in the brain of patients with acute attack of multiple sclerosis.

This study intended to investigate the possibility of magnetic resonance (MR) to characterize the acute plaque due to multiple sclerosis (MS). To obtain information, in vivo measurements of relaxation processes were performed in 10 patients with known acute MS plaques, using a whole-body superconductive MR-scanner, operating at 1.5 T.

Cardiovascular autonomic function in multiple sclerosis.

The autonomic nervous function of the cardiovascular system was investigated by non-invasive methods in 30 multiple sclerosis patients between 20 and 50 years of age. The results were compared to those of 30 healthy controls in the same age group. Minor abnormalities of parasympathetic and sympathetic function occurred.