RESUMEN
PURPOSE OF REVIEW: Traumatic brain injury is the leading cause of death in young patients and stroke is the leading cause of major disability in elderly patients. Both injuries are often followed by cerebral plasticity changes and increased intracerebral pressure (ICP). Aim of the review is to present current knowledge about amphetamines and other therapeutics concerning the recovery of brain injury based on contemporary findings. RECENT FINDINGS: On the one hand beneficial effects for cognitive and physical outcome after brain injury by coupling amphetamine with physical therapy could be demonstrated; on the other hand its efficacy was shown in only two out of 10 clinical trials. SUMMARY: Impairment after brain injury is reduced if adequate early treatment is established. On the basis of current findings amphetamine after brain injury cannot be recommended. In patients with an increased ICP the maintenance of an adequate cerebral perfusion pressure is required. In patients with increased ICP under controlled ventilation, the combination of ketamine with, for example, a short-acting benzodiazepine and opioid or methohexital is equally well tolerated. Ketamine decreases ICP without lowering blood pressure and cerebral perfusion pressure. Its neuroprotective property might reduce the exacerbation of brain injury following N-methyl-D-aspartate-receptor activation, neuronal apoptosis and systemic inflammatory responses.
Asunto(s)
Anfetaminas/uso terapéutico , Lesiones Encefálicas/tratamiento farmacológico , Estimulantes del Sistema Nervioso Central/uso terapéutico , Accidente Cerebrovascular/tratamiento farmacológico , Anfetaminas/farmacología , Lesiones Encefálicas/psicología , Lesiones Encefálicas/rehabilitación , Estimulantes del Sistema Nervioso Central/farmacología , Traumatismos Craneocerebrales/terapia , Servicios Médicos de Urgencia , Humanos , Hipertensión Intracraneal/tratamiento farmacológico , Hipertensión Intracraneal/etiología , Transferencia de Pacientes , Ensayos Clínicos Controlados Aleatorios como Asunto , Recuperación de la Función , Accidente Cerebrovascular/psicología , Rehabilitación de Accidente CerebrovascularRESUMEN
BACKGROUND: Hospitalization may represent a stressor that can lead to Posttraumatic stress disorder (PTSD). METHODS: Translation of the UK-PTSS-14, conducted in accordance with ISPOR principles and validation with the PDS (86 patients). RESULTS: The ROC analysis showed that the German version of PTSS-14 is a valid instrument with high sensitivity (82%) and specificity (92%) with the optimum cut-off point at 40 points. The translation process was authorized by the author of the UK-PTSS-14. CONCLUSION: The validated German version of PTSS-14 is now ready for use as an efficient and reliable screening-tool for PTSD in a clinical setting.
