Abstract:Despite changes in guideline-based management of moderate/severe traumatic brain injury (TBI) over the preceding decades, little impact on mortality and morbidity have been seen. This argues against the “one-treatment fits all” approach to such management strategies. With this, some preliminary advances in the area of personalized medicine in TBI care have displayed promising results. However, to continue transitioning toward individually-tailored care, we require integration of complex “-omics” data sets. The… Show more
“…Further, integrative neuroinformatic approaches will be critical to make sense of such complex data streams, assuredly requiring application of artificial intelligence approaches. 136 Information gleamed from this approach may then be utilized in a "top-down" fashion to inform both cellular/small-animal and large animal pre-clinical platforms for precision pharmaceutical development directed at various pathways of CA dysfunction/failure. Work is currently underway to develop such comprehensive clinical data collection schemes and pipelines, as well as the pre-clinical infrastructure, for such future precision medication approaches in moderate/severe TBI care.…”
published version features the final layout of the paper including the volume, issue and page numbers.
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“…Further, integrative neuroinformatic approaches will be critical to make sense of such complex data streams, assuredly requiring application of artificial intelligence approaches. 136 Information gleamed from this approach may then be utilized in a "top-down" fashion to inform both cellular/small-animal and large animal pre-clinical platforms for precision pharmaceutical development directed at various pathways of CA dysfunction/failure. Work is currently underway to develop such comprehensive clinical data collection schemes and pipelines, as well as the pre-clinical infrastructure, for such future precision medication approaches in moderate/severe TBI care.…”
published version features the final layout of the paper including the volume, issue and page numbers.
Link to publication
General rightsCopyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.If the publication is distributed under the terms of Article 25fa of the Dutch Copyright Act, indicated by the "Taverne" license above, please follow below link for the End User
“…The development of the "personalized medicine, " particularly in oncology, made possible to adapt chemotherapy to the tumor and to the genetic characteristics of the patients, thus avoiding the principle of "one size fits all" to a tailored approach (172). In TBI patients, research in this 10.3389/fmed.2022.995044 area is in development (173). In ICU patients, the challenge remains to find biomarkers of occurrence of nosocomial infections in order to develop adapted immunomodulatory treatments.…”
Section: Biomakers Of Immune Dysfunctionmentioning
Traumatic brain injury (TBI) induces instant activation of innate immunity in brain tissue, followed by a systematization of the inflammatory response. The subsequent response, evolved to limit an overwhelming systemic inflammatory response and to induce healing, involves the autonomic nervous system, hormonal systems, and the regulation of immune cells. This physiological response induces an immunosuppression and tolerance state that promotes to the occurrence of secondary infections. This review describes the immunological consequences of TBI and highlights potential novel therapeutic approaches using immune modulation to restore homeostasis between the nervous system and innate immunity.
“…In cluster #0, the literature largely reported on the management of severe traumatic brain injury (42)(43)(44)(45)(46)(47). The management of traumatic brain injury (TBI) has changed over the past decade; a multimodal approach is now being applied in detecting and treating the pathophysiological derangements.…”
Section: Research Hotspots and Emerging Topicsmentioning
ObjectiveMajor trauma is currently a global public health issue with a massive impact on health at both the individual and population levels. However, there are limited bibliometric analyses on the management of major trauma. Thus, in this study we aimed to identify global research trends, dynamic structures, and scientific frontiers in the management of major trauma between 2012 and 2021.MethodsWe searched the Web of Science Core Collection to access articles and reviews concerning the management of major traumas and conducted a bibliometric analysis using CiteSpace.ResultsOverall, 2,585 studies were screened and published by 403 institutions from 110 countries/regions. The most productive country and institution in this field of research were the USA and Monash University, respectively. Rolf Lefering was the most prolific researcher and Holcomb JB had the most co-citations. Injury published the highest number of articles, and the Journal of Trauma was the most co-cited journal. A dual-map overlay of the literature showed that the articles of most publications were confined to the areas of medicine/medical/clinical and neurology/sports/ophthalmology. Document clustering indicated severe traumatic brain injury, traumatic coagulopathy, and resuscitative endovascular balloon occlusion as the recent hot topics. The most recent burst keywords were “trauma management,” “neurocritical care,” “injury severity,” and “emergency medical services.”ConclusionThe dynamic structures and emerging trends in the management of major trauma were extensively analyzed using CiteSpace, a visualization software. Based on the analysis, the following research hotspots emerged: management of severe traumatic brain injury and massive hemorrhage, neurocritical care, injury severity, and emergency medical service. Our findings provide pertinent information for future research and contribute toward policy making in this field.
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