Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH-3): a randomised, placebo-controlled trial

Publication date: Available online 14 October 2019Source: The LancetAuthor(s): The CRASH-3 trial collaboratorsSummaryBackgroundTranexamic acid reduces surgical bleeding and decreases mortality in patients with traumatic extracranial bleeding. Intracranial bleeding is common after traumatic brain injury (TBI) and can cause brain herniation and death. We aimed to assess the effects of tranexamic acid in patients with TBI.MethodsThis randomised, placebo-controlled trial was done in 175 hospitals in 29 countries. Adults with TBI who were within 3 h of injury, had a Glasgow Coma Scale (GCS) score of 12 or lower or any intracranial bleeding on CT scan, and no major extracranial bleeding were eligible. The time window for eligibility was originally 8 h but in 2016 the protocol was changed to limit recruitment to patients within 3 h of injury. This change was made blind to the trial data, in response to external evidence suggesting that delayed treatment is unlikely to be effective. We randomly assigned (1:1) patients to receive tranexamic acid (loading dose 1 g over 10 min then infusion of 1 g over 8 h) or matching placebo. Patients were assigned by selecting a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was head injury-related death in hospital within 28 days of injury in patients treated within 3 h of injury. We prespecifie...
Source: The Lancet - Category: General Medicine Source Type: research

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CONCLUSIONS: The concept of soldier-centered care often emerges in discussions about optimal physical performance and medical readiness for soldiers. Although soldier-centered care and patient-centered care have similar conceptual underpinning, it is important to clarify the unique physical and medical requirements for soldiers that differentiate soldier-centered care from patient-centered care. Implementing the defining attributes of soldier-centered care in the U.S. Army primary care setting may improve the quality of care and health outcomes for soldiers. When defining performance metrics for primary care models of care...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
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Source: Applied Developmental Science - Category: Child Development Authors: Source Type: research
This study aimed to reveal the correlation between the radiolucency area around the crown of impacted maxillary canines and dentigerous cysts using cone-beam computed tomography (CBCT). CBCT data were obtained from patients with impacted maxillary canines. Three points of five areas (tooth cusp area and buccal, lingual, mesial and distal areas of the crown) were randomly selected, and the distance between the point and the surrounding hard tissue was measured respectively. The mean values were recorded as the radiolucency area. These results were compared with the occurrence of dentigerous cysts during surgery. 58 patients...
Source: Dentomaxillofacial Radiology - Category: Radiology Tags: Dentomaxillofac Radiol Source Type: research
Publication date: 15 April 2020Source: Journal of Molecular Structure, Volume 1206Author(s): Seyed Reza Nokhbeh, Mostafa Gholizadeh, Alireza Salimi, Hazel A. SparkesAbstractThis paper presents synthesis and structural characterization of new members of phosphorus-based organic bromides. 1,3-Propanediylbis(triphenylphosphonium) dibromide I and 1,3-propanediylbis(triphenylphosphonium) monotribromide II, as a new brominating agent for double bonds and phenolic rings, were synthesized. 1H NMR, 13C NMR, 31P NMR, FT-IR, single crystal X-ray diffraction crystallography, differential scanning calorimetry, thermogravimetric analysi...
Source: Journal of Molecular Structure - Category: Molecular Biology Source Type: research
This study aimed to delineate changes in the patterns of prolonged grief severity in widowed adults following group bereavement interventions and to identify the predictive factors impacting these patterns. We performed a secondary analysis of data from a randomized trial of 125 Chinese widowed older adults who participated in either Loss-oriented or Dual Process group bereavement interventions. Self-ratings of prolonged grief symptoms via Inventory of Complicated Grief were subjected to latent class growth analysis to identify subgroups according to symptomatic changes among baseline, post-treatment and 8-week follow-up. ...
Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
CONCLUSION: According to the high percentage of patients diagnosed with vision-threatening DR in this study, an early diagnosis of this complication of diabetes seems to be important. Teleophthalmology enhances patient accessibility to the healthcare system, making early diagnosis of DR easier, with a high degree of satisfaction among patients and healthcare professionals. PMID: 31941342 [PubMed - in process]
Source: Rural and Remote Health - Category: Rural Health Tags: Rural Remote Health Source Type: research
Discussion: Japan's new HTA program is a first step toward development of a universal healthcare system that can be sustainable for many years into the future. Currently, Japan's HTA program requires provision of incremental cost-effectiveness ratios (ICERs) as evidence, with quality-adjusted life years as the preferred measure. Prices can be adjusted both upward and downward according to the degree of the ICER estimate. Japan is the first country to have adopted an algorithmic method for 'ICER-based' pricing; however, HTA measures that extend beyond a single ICER estimate are needed to take full advantage of HTA in the fu...
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Publication date: Available online 16 January 2020Source: Journal of Hazardous MaterialsAuthor(s): Yasin Orooji, Mojgan Ghanbari, Masoud Salavati-NiasariAbstractSilver iodide/graphitic carbon nitride nanocomposites have been successfully fabricated through sonication-assisted deposition-precipitation route at room temperature and hydrothermal method. Varied mass ratios and preparation processes can modify the structure, purity, shape, and scale of specimens. The purity of the product was confirmed by Energy Dispersive X-Ray Spectroscopy (EDS) and X-ray crystallography. The morphology and size of specimens could be observed...
Source: Journal of Hazardous Materials - Category: Environmental Health Source Type: research
Publication date: Available online 16 January 2020Source: The Journal of the Economics of AgeingAuthor(s): Binjian Yan, Xi Chen, Thomas M. GillAbstractThis paper examines the extent to which childhood circumstances contribute to health inequality in old age and how the contributions may vary across key dimensions of health. We link the China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015 with its Life History Survey in 2014 to quantify health inequality due to childhood circumstances for which they have little control. We evaluate comprehensive dimensions of health ranging from cognitive health, mental ...
Source: The Journal of the Economics of Ageing - Category: Health Management Source Type: research
Introduction Most road traffic crash injuries are minor to moderate in severity, but can still lead to persistent disability. One aspect of this disability is being unable to return to paid employment. Being unable to work has follow-on effects for person...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Economics of Injury and Safety, PTSD, Injury Outcomes Source Type: news
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