| 1. |
- Sojka, Peter, 1950-, et al.
(författare)
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One-year follow-up of patients with mild traumatic brain injury : occurrence of post-traumatic stress-related symptoms and serum levels of cortisol, S-100B and neuron-specific enolase in acute phase
- 2006
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Ingår i: Brain Injury. - : Taylor & Francis. - 0269-9052 .- 1362-301X. ; 20:6, s. 613-620
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate serum levels of cortisol (a biochemical marker of stress), S-100B and neuron-specific enolase (two biochemical markers of brain tissue injury), in acute phase in mild traumatic brain injury patients and the occurrence of post-traumatic stress-related symptoms 1 year after the trauma.METHODS: Blood samples were taken in patients (n = 88) on admission and approximately 7 hours later for analysis. Occurrence of post-traumatic stress-related symptoms was assessed for 69 patients using items from the Impact of Event Scale questionnaire (IES) at follow-up at 15 +/- 4 months after the injury.RESULTS: Serum levels of cortisol were more increased in the first sample (cortisol/1, 628.9 +/- 308.9 nmol L-1) than in the second blood sample (cortisol/2, 398.2 +/- 219.4 nmol L-1). The difference between these samples was statistically significant (p < 0.001). Altogether 12 patients (17%) showed post-traumatic stress related symptoms at the time of the follow-up. Stepwise forward logistic regression analysis of symptoms and serum concentrations of markers revealed that only S-100B in the second sample was statistically significantly (p < 0.05) associated to symptoms (three symptoms of the avoidance sub-set of IES).CONCLUSION: A major increase in serum concentrations of cortisol indicates that high stress levels were reached by the patients, in particular shortly ( approximately 3 hours) after the trauma. The association between the occurrence of post-traumatic stress related symptoms and serum levels of S-100B (generally considered as a biochemical marker of brain injury) seem to reflect the complexity of interactions between brain tissue injury and the ensemble of stress reactions.
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| 2. |
- Styrke, Johan, 1980-, et al.
(författare)
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Traumatic brain injuries in a well-defined population : epidemiological aspects and severity
- 2007
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Ingår i: Journal of Neurotrauma. - New York, NY, USA : Mary Ann Liebert, Inc.. - 0897-7151 .- 1557-9042. ; 24:9, s. 1425-1436
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to describe epidemiological and medical aspects of 449 cases of traumatic brain injury (TBI) from a well-defined geographical area with a population of 137,000 inhabitants. An episode of disturbed consciousness was a prerequisite for inclusion in the study. The incidence of TBI was 354/100,000 inhabitants. Median age was 23 years, range 0–91 years; 55% were men and 45% were women; 33% children 0–14 years, 50% adults 15–64 years, and 17% elderly persons 65–91 years old. Severity classification was based on Glasgow Coma Scale (GCS) on arrival; mild TBI 97% (GCS 13–15), moderate 1% (GCS 9–12), and severe 2% (GCS 3–8). The most common injury events were falls (55%) and vehicle-related events (30%). The percentage of falls was high among children and elderly persons but among adults vehicle-related injury events were also prominent. At least 17% of all patients were under the influence of alcohol, especially adult male bicyclists. CT was performed on 163 cases (36%) revealing 34 cases with intracranial hemorrhage (ICH) which is 21% of the examined or 8% of all the injured. The rate of ICH increased with increasing age (from 3% among children to 17% among the elderly persons) and also increased with decreasing GCS from 6% in the group of mild TBI to 60% among those with severe TBI. Attention should be directed to acute management of mild TBI in order to detect potentially dangerous ICH as well as to preventive actions against falls and vehicle related accidents.
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| 3. |
- Stålnacke, Britt-Marie, 1955-
(författare)
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Community integration, social support and life satisfaction in relation to symptoms 3 years after mild traumatic brain injury
- 2007
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Ingår i: Brain Injury. - : Taylor & Francis Ltd. - 0269-9052 .- 1362-301X. ; 21:9, s. 933-942
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Tidskriftsartikel (refereegranskat)abstract
- PRIMARY OBJECTIVE: To investigate the relation between psychosocial functioning (community integration, life satisfaction and social support) and symptoms (post-concussion, post-traumatic stress and depression) in persons with mild traumatic brain injury (MTBI) 3 years after the trauma. METHODS: Population-based follow-up study of 163 patients. At follow-up, an assessment of community integration, social support, life satisfaction and symptoms was made. RESULTS: Total score of Community Integration Questionnaire (CIQ) was negatively correlated to total score of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ, r = -0.270, p < 0.001) and to total score of the Beck Depression Inventory (BDI, r = -0.332, p < 0.001). Life satisfaction (LiSat-11) was negatively correlated to the RPQ (r = -0.459, p < 0.001), to total score of the Impact of Event Scale (IES, r = -0.365, p < 0.001) and to the BDI (r = -0.642, p < 0.001). Low levels of life satisfaction were common at follow-up. CONCLUSIONS: A large proportion of the individuals with MTBI experienced both psychosocial difficulties, with low levels of life satisfaction in particular and symptoms (post-concussion, post-traumatic stress and depression) 3 years after trauma. Since the possibility of pre-injury factors contributing to the condition at follow-up cannot be ruled out, the study indicates that all these factors should be taken into consideration in the management of persons with MTBI.
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| 4. |
- Stålnacke, Britt-Marie, 1955-, et al.
(författare)
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Erfarenheter från delad examinationsform vid nätbaserad distanskurs
- 2008
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Ingår i: Utsikter, insikter, avsikter. - Umeå : Universitetspedagogiskt Centrum, Umeå universitet. - 9789172645363 ; , s. 249-257
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Vi redovisar 5 års erfarenheter från delad examinationsform vid internetbaserad distanskurs. Kursen Rehabiliteringsmedicin 10 p är avsedd för sjukgymnaster, sjuksköterskor och arbetsterapeuter från hela landet. Studenterna är i olika åldrar och har olika studieerfarenheter. 80-100% av studenter som påbörjat kursen slutför den. Examinationen är delad beträffande form och tid. Den består av: inlämningsuppgifter under höstterminen samt tentamen och uppsats under vårterminen. Samtliga delar måste vara godkända för att få godkänd kurs. Inlämningsuppgifterna har olika struktur, de besvaras enskilt eller i grupp och föregås av nätdiskussioner. Studenterna konstruerar också egna frågor som de utbyter och besvarar. Tentamen utgörs av ett case med frågor. Uppsatsen skrivs parvis med hjälp av nätdiskussioner. För att studenternas synpunkter ska tillvaratas ingår flera utvärderingar under kursen. Resultat av utvärderingar delges skriftligt. Kursens utvärderingar sammanställs efter kursavslut och ligger till grund för eventuell revidering av nästa kurs (gäller även examination). Vid kursstart informeras studenterna om föregående kurs utvärdering. Vår erfarenhet efter fem år är att delad examination är mycket lämplig för nätbaserad undervisning. Studenterna är delaktiga och kan hålla planerad studietakt. Olika kunskaper kan examineras och det ger en rättvisare bedömning av den enskilde studenten.
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| 5. |
- Stålnacke, Britt-Marie, 1955-, et al.
(författare)
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One-year follow-up of mild traumatic brain injury : cognition, disability and life satisfaction of patients seeking consultation.
- 2007
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation of Rehabilitation Information. - 1650-1977 .- 1651-2081 .- 0001-5555. ; 39:5, s. 405-11
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate cognitive function, symptoms, disabilities and life satisfaction of patients with mild traumatic brain injury who accepted consultation one year post-trauma. Design: Prospective study. Patients: Sixty-nine patients (16 accepted the consultation offered, 53 declined). Methods: At follow-up, the patients answered questionnaires about symptoms, disabilities (RHFUQ) and life satisfaction (LiSat-11). The patients who underwent consultation and their healthy control subjects were administered a neuropsychological evaluation. Results: In the group undergoing consultation, the number of cognitive tests with outcomes below cut-off limits (–1.5 SD) was statistically significantly higher compared with a control group (21 tests in 11 patients vs 8 tests in 7 control subjects; p = 0.025). The number of patients with one or more disability was statistically significantly higher among patients with consultation than without (94% and 34%, respectively; p < 0.001). Total RHFUQ score was statistically significantly higher for the group with consultation than without (5.9 ± 3.7 and 1.1 ± 2.3, respectively, p < 0.001). The group with consultation exhibited a lower level of life satisfaction (41.5 ± 10.4 vs 45.8 ± 13.8 for the non-consulting group; p = 0.057). Conclusion: The high frequency of occurrence of disabilities and lower cognitive functioning, together with the lower level of life satisfaction, appear to characterize patients choosing consultation 1 year post-injury. This highlights the importance of offering consultation for persons suffering mild head injuries.
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| 6. |
- Stålnacke, Britt-Marie, 1955-, et al.
(författare)
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One-year follow-up of patients with mild traumatic brain injury : post-concussion symptoms, disabilities and life satisfaction at follow-up in relation to serum levels of S-100B and neuron-specific enolase in acute phase
- 2005
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Ingår i: Journal of Rehabilitation Medicine. - : Taylor & Francis. - 1650-1977 .- 1651-2081. ; 37:5, s. 300-305
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate, in patients with mild traumatic brain injury, serum concentrations of S-100B and neurone-specific enolase in acute phase and post-concussion symptoms, disabilities and life satisfaction 1 year after the trauma.DESIGN: Prospective study.PATIENTS: Eighty-eight patients (age range 18-87 years).METHODS: Blood samples were taken on admission and about 7 hours later. At follow-up 15 +/- 4 months later, the patients filled in questionnaires about symptoms (Rivermead Post Concussion Symptoms), disability (Rivermead Head Injury Follow-up) and life satisfaction (LiSat-11).RESULTS: Concentrations of S-100B and neurone-specific enolase were regularly increased in the first blood sample. Of the 69 patients participating in the follow-up, 45% reported post-concussion symptom, 48% exhibited disability and 55% were satisfied with "life as a whole". In comparison with the "sick-leave" situation on admission to hospital, 3 patients were on sick-leave at the time of follow-up because of the head trauma. Stepwise forward logistic regression analysis revealed a statistically significant association (p<0.05) between disability and S-100B and dizziness.CONCLUSION: In spite of frequent persistent symptoms, disabilities and low levels of life satisfaction, the sick-leave frequency was low at follow-up. The association between S-100B and disability supports the notion that long-term consequences of a mild brain injury may partly be a result of brain tissue injury.
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| 7. |
- Stålnacke, Britt-Marie
(författare)
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Relationship between symptoms and psychological factors five years after whiplash injury.
- 2009
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Ingår i: Journal of Rehabilitation Medicine. - : Foundation for Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 41:5, s. 353-359
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study were: to describe the frequency of whiplash-related symptoms and psychological factors in persons 5 years after a whiplash injury; to study the relationship between symptoms and psychological factors; to examine gender differences; and to investigate the cause of sick leave. METHODS: Questionnaires addressing neck pain, pain intensity, whiplash-related symptoms, post-traumatic stress, depression, social support and life satisfaction were used. RESULTS: Neck pain was reported by 59% of subjects, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ) by 76%, depression (Beck's Depression Inventory, BDI) by 22%, and post-traumatic stress (Impact of Event Scale, IES), by 38%. The scores of pain intensity and RPQ were correlated to BDI, IES and LiSat-11 scores. Men reported a lower level of quality of social support than women. Men reporting many symptoms also reported reduced availability of social interaction, whereas women with many symptoms reported reduced availability of attachment (i.e. lack of intimate partner, close family and friends). A multivariate logistic regression showed an association between sick leave and depression. CONCLUSION: These findings indicate the importance of assessing possible relationships between symptoms, depression and post-traumatic stress in persons with long-term problems after whiplash injury, and of treating existing symptoms, especially depression. Because social support may play a role in recovery, social relationships should also be examined.
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| 8. |
- Stålnacke, Britt-Marie, et al.
(författare)
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Repeatedly Heading a Soccer Ball Does Not Increase Serum Levels of S-100B, a Biochemical Marker of Brain Tissue Damage : an Experimental Study
- 2008
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Ingår i: Biomarker Insights. - : Sage Publications. - 1177-2719. ; 3, s. 87-91
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of the study was to analyse whether the controlled heading of soccer balls elicits increased serum concentrations of a biochemical marker of brain tissue damage S-100B.METHODS: Nineteen male soccer players were randomly divided into two groups, A and B. Group A headed a soccer ball falling from 18 m five times, while group B served as controls (no heading). Blood samples were taken before and 0.5 h, 2 h and 4 h after the heading for analysis of S-100B.RESULTS: No statistically significant (p > 0.05) increases in serum concentrations of S-100B were encountered in group A at 0.5 h (0.109 +/-0.024 mug/L), 2 h (0.098 +/- 0.026 mug/L), and 4 h (0.113 +/- 0.035 mug/L) when the blood samples obtained before and after the heading were compared (0.157 +/- 0.134 mug/L). No statistically significant difference was found when the serum concentrations of S-100B were compared between groups A and B either before or after heading.CONCLUSIONS: Heading a soccer ball dropped from a height of 18 m five times was not found to cause an increase in serum concentrations of S-100B, indicating that the impact was not sufficient to cause biochemically discernible damage of brain tissue.
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| 9. |
- Stålnacke, Britt-Marie, et al.
(författare)
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[S100B for diagnosis and prognosis of sequelae following minor head injury : contradictory results according to studies]
- 2008
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 105:24-25, s. 1840-1845
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Tidskriftsartikel (refereegranskat)abstract
- S-100B is a protein that leaks from injured brain tissue into the cerebrospinal fluid and blood, where it can be traced and quantified. Accordingly, it may serve as a 'biochemical marker of brain tissue injury'. The aim of this paper is to survey studies that investigate symptoms, impairments, disabilities and life satisfaction exhibited by patients with mild traumatic brain injury long after the trauma (>3 months) in relation to blood concentrations of S-100B in acute stage. A PubMed search and further analysis revealed 15 papers corresponding to these criteria. The results of these papers conflict and no clear-cut conclusion can be drawn with respect to clinical use of S-100B as a predictor for late sequelae of mild traumatic brain injury. New studies that adequately take into account biological characteristics of S-100B as a 'marker of brain tissue injury' are needed.
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| 10. |
- Stålnacke, Britt-Marie, et al.
(författare)
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Serum concentrations of two biochemical markers of brain tissue damage S-100B and neurone specific enolase are increased in elite female soccer players after a competitive game
- 2006
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Ingår i: British Journal of Sports Medicine. - : BMJ. - 0306-3674 .- 1473-0480. ; 40:4, s. 313-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is a matter of debate whether or not ordinary heading of the ball in soccer causes injury to brain tissue.OBJECTIVE: To analyse concentrations of the biochemical markers of brain tissue damage S-100B and neurone specific enolase (NSE) in serum of female elite soccer players in association with a competitive game.METHODS: Venous blood samples were obtained from 44 female soccer players before and after a competitive game for analysis. The number of headers and trauma events (falls, collisions, etc) was assessed from videotape recordings for each player.RESULTS: Concentrations of both brain damage markers were increased after the game (S-100B, 0.18 (0.11) v 0.11 (0.05) microg/l (p = 0.000); NSE, 10.14 (1.74) v 9.05 (1.59) microg/l (p = 0.001)). There was a significant correlation between changes in S-100B concentrations and both the number of headers (r = 0.430, p = 0.004) and the number of other trauma events (r = 0.517, p < 0.001).CONCLUSION: The concentrations of both S-100B and NSE were increased by game associated activities and events. The increases in S-100B concentration were significantly related to the number of headers and other trauma events, which indicates that both these factors may have contributed to these increases.
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