2 articles
Traumatic brain injury remains a leading global health concern with significant social and economic impact. The main causes include traffic accidents, falls, and violence, especially affecting young adults. In the Republic of Moldova, TBI incidence is rising, particularly during the prehospital phase. TBI involves both primary and secondary brain injuries, the latter often resulting from hypoxia, hypotension, or hyperglycemia. These secondary insults critically influence outcomes and are associated with high mortality. Effective prehospital management – focused on stabilizing oxygenation and hemodynamics – is essential in reducing neurological deterioration. Emergency teams play a key role in preventing secondary injury and improving survival.
This study, conducted from 2020 to 2024, analyzed 486 patients with acute traumatic brain injury (TBI) assessed in both prehospital and emergency department settings. It aimed to evaluate injury severity and prognosis using clinical tools and structured observation forms, developed specifically for this research.
Significant correlations were found between increased age, low systolic blood pressure, prehospital hypoxia, and both TBI severity and mortality (p < 0.0001). While hyperglycemia was not significantly associated with injury severity, it showed a moderate negative correlation with mortality (p < 0.01). Findings emphasize the importance of early monitoring and stabilization of vital signs in the prehospital phase to improve TBI outcomes.
This study emphasizes the importance of systematic prehospital monitoring and management of physiological parameters to mitigate secondary brain injury and improve patient prognosis. Early intervention targeting hypoxia and hypotension remains vital in the acute management of TBI.
Alcohol intoxication is often the cause of traumatic brain injury. The purpose of the work was to study the features of lipid metabolism in erythrocytes and mitochondria of the cerebral cortex cell membranes of rats in traumatic brain injury on the background of chronic alcohol intoxication.
The studies were carried out on 140 male rats of the Wistar line weighing 170-250 g. Chronic alcohol intoxication was caused by using 15% ethanol as the only source of fluid for 20 days. Reproduction of traumatic brain injury was carried out by a shock model. Statistical analysis of data was conducted by using „Primer Biostatistics 6.0”. The criteria of parametric statistics were used. The level of p <0.05 was statistically significant.
Chronic alcohol intoxication in rats and inducing of traumatic brain injury separately causes a significant change of total phospholipids and cholesterol content, and their molar ratio in the membranes of erythrocytes and mitochondria of the cerebral cortex. Particularly pronounced were the changes in studied objects with combined pathology, meaning, traumatic brain injury on the background of chronic alcohol intoxication.
Discoordination of lipid metabolism was unidirectional, manifested in a significant reduction in the content of total phospholipids, and increased total cholesterol, which led to a violation of the molar ratio of total cholesterol/phospholipids in the direction of increasing the coefficient, which is normally about 1.0.
In subsequent monitoring periods, there was a gradual restoration of individual fractions of phospholipids, but on the 30th day of the study, it did not reach the control values. That means that discoordination of the metabolism of individual phospholipid fractions was so pronounced, that even on 30th day of arbitrary reproduction did not reach the initial values, which again emphasizes the severity of the morphofunctional state of red blood cells membranes’ disturbance.
The revealed features of lipid metabolism in the membranes of erythrocytes and mitochondria of the cerebral cortex in traumatic brain injury on the background of chronic alcohol intoxication are an important component for understanding the ongoing pathophysiological processes and searching for new effective drugs with targeted action.