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J Nagy

Publications and source records attributed to J Nagy.

At least 55 records · Page 3Linked to original sources

Alcohol dependence at the cellular level: effects of ethanol on calcium homeostasis of IM-9 human lymphoblast cells.

OBJECTIVE: Increased intracellular calcium level ([Ca2+]i) was previously observed in peripheral blood mononuclear cells of alcoholic patients under withdrawal. To determine whether this change in [Ca2+]i is due to direct effect of ethanol on blood cells and shows adaptation of these cells to alcohol, we examined the effect of alcohol on IM-9 human lymphoblast cultures. METHOD: [Ca2+]i of IM-9 lymphoblasts. after acute and chronic alcohol treatment as well as alcohol withdrawal, was measured fluorometrically using Quin2 as a Ca2+-indicator. RESULTS: Acute ethanol treatment induced a rapid, transient increase in intracellular calcium concentration in a dose-dependent manner. During chronic ethanol (50mM) administration, after the first 24 hours, basal [Ca2+]i was significantly lower (44 +/- 8% of control, p < .025), whereas from the fifth day [Ca2+]i was significantly higher (415 +/- 59% of control on the sixth day, p < .01) compared with untreated cells. After a 3-day ethanol (50OmM or 100mM) treatment, elimination of alcohol from the medium caused elevation in [Ca2+]i. After 24-hour ethanol withdrawal, the addition of alcohol decreased the elevated [Ca2+]i of alcohol-adapted cells to the resting level of control cells. Similar results were observed when verapamil, diazepam or haloperidol were applied. Moreover, when ethanol or these agents were administered at the beginning of alcohol withdrawal, they could prevent the increase in [Ca2+]i. CONCLUSIONS: These results suggest that alcohol dependence can develop at the cellular level, and that changes in calcium homeostasis, likely due to direct effects of ethanol on ion channels, may play a central role in processes leading to adaptation of cells to alcohol.

Alcohol Withdrawal Delirium↗

[Comparative study of the reno-protective effect of short- and long-acting antihypertensive agents in IgA nephropathy].

The progression of IgA-NP is influenced unfavourably by development and existence of hypertension. The treatment of hypertension (HTN) has an important role in these patients. Both short- and long-acting formulations of angiotensin convertase enzim inhibitors (ACEi) and calcium channel blockers (CCB) lower blood-pressure, however long-acting preparations may provide better control and may have more renoprotective effect. Verifying this hypothesis, 22 IgA-NP patients were followed for 7.25 +/- 2.36 years. The patients were on short-acting ACEi (captopril, n = 9) or dihydropyridine type CCB (nifedipin, n = 2) or both (captopril + nifedipine n = 11), after at least 3 years the medication was changed to long-acting ACEI (enalapril, n = 4; cilazapril, n = 1), or non dihydropyridine type CCB (diltiazem hydrochlorid, n = 1) or both (n = 16). Just before changing the medication these patients underwent 24 hour ambulatory blood pressure monitoring and at the same time the level of proteinuria and the creatine clearance were measured. Values of serum-creatinine were measured in every 3-4 months within a 3 years period before and after the exchange of antihypertensive drugs. The regression of 1/creatinine was a = -5.28.10(-5) +/- 1.16.10(-4) before and a = 1.03.10(-4) +/- 2.05.10(-4) after the change of medication. Using paired t-test there was a significant difference between the regressions of 1/creatine (p < 0.005). Systolic blood pressure (SBP) (128 +/- 81 Hgmm vs. 126.09 +/- 11.67 Hgmm) was not different, however, diastolic blood pressure (DBP) (84.15 +/- 7.94 Hgmm vs. 79.78 +/- 7.17 Hgmm), diastolic percent time elevation index (HTI) (43.58 +/- 23.57% vs. 25.61 +/- 20.1%) and 24-hour diastolic hyperbaric impact (114.71 +/- 81.9 vs. 51.51 +/- 51.4, p < 0.05) was lower with long-acting antihypertensive agents, as was the proteinuria (1.18 +/- 0.94 g/die vs. 0.69 +/- 1.08 g/die, p < 0.05). Diurnal variation and systolic percent time elevation index were not different. We conclude that long-acting ACEi and non dihydropyridine type CCB formulations result in better outcomes in IgA nephropathy patients compared to short-acting drugs, probably because of better and smoother blood pressure control, lowering of proteinuria and better compliance of the patients.

Adult↗

[Detection of glycation end products in the urine of diabetic patients].

Advanced glycation end products play an important role in the development of tissue damage in diabetes mellitus. The aim of the present study was the investigation of the excretion of different glycation end products in the urine. Methylglyoxal, an intermediate product of the glycation, formed with L-arginine in an in vitro model two fluorescent peaks. These peaks can be characteristic for imidazolone-like product(s) which are produced also in the reaction of methylglyoxal with proteins described in the literature, suggesting modification of proteins with methylglyoxal at the guanidino group of the L-arginine amino acid. Using the fluorescent characteristics of these (excitation/emission: 320/400 nm and 340/425 nm) and the generally accepted wavelength of the so called non-specific advanced glycation end product (370/440 nm) could be identified these glycation end products in the urine of 98 patients with diabetes mellitus (21 type I., 77 type II., 51 female and 47 male, mean age: 56.6 years). These three particular glycation end products showed significant intercorrelations in the urine (p < 0.001). Concentrations of these glycation end products in the urine correlated negatively with the serum creatinine in the range between 120-240 mumol/l (p < 0.001). Data presented here verify that non-specific glycation end product and imidazolone-like glycation end products can be detected in the urine of diabetic patients. Elimination of these products by the urine is markedly decreased in the stage of early renal insufficiency. These decrease in the secretion can cause an elevation of the advanced glycation end products in the circulation leading progression of diabetic complication.

Diabetes Mellitus, Type 1↗

[Detection of carbonyl stress markers in the urine of diabetic patients].

Carbonyl stress-induced tissue damage is caused by reactive aldehydes produced by non-enzymatic glycation, oxidative stress and metabolic processes. The aim of this study was the detection of the major markers of carbonyl stress in the urine of diabetic patients (21 type 1, 77 type 2, 51 female, 47 male, 56.6 +/- 13.7 year of age; mean +/- SD). Oxidative stress was detected by using the reaction of malondialdehyde, the end product of free radical damage of the tissues, with L-arginine. This reaction produced a fluorescent compound, pyrimidinyl-L-ornithine. Thus, pyrimidinyl-L-ornithine, as well as pentosidine, an advanced glycation end product, and the non-specific advanced glycation end product, which is thought to be partially as a result of lipid peroxidation, could be detected simultaneously by using the fluorescent method. Correlation coefficients among the concentrations of these products in the urine of 98 diabetic patients were as follows: pyrimidinyl-L-ornithine vs. non-specific advanced glycation end product: r = 0.72, p < 0.001; pentosidine vs. non-specific advanced glycation end product: r = 0.68, p < 0.001; pentosidine vs. pyrimidinyl-L-ornithine: r = 0.60, p < 0.001. Strong negative correlations were found between the serum creatinine levels of these patients, between 120-240 mumol/l, and the urinary concentration of these products: r = -0.88 for non-specific advanced glycation end products, r = -0.86 for pentosidine and r = -0.89 for pyrimidinyl-L-ornithine (p < 0.001 for all three). These data support a closer relation of the so-called non-specific glycation end product to oxidative stress than to non-enzymatic glycation. Results presented here suggest an early retention of the products of carbonyl stress in the patients with moderate renal insufficiency, which can play a role in the development of diabetic complications.

Adult↗

[Paraneoplastic nephropathy associated with adult renal carcinoma (immunologic and clinicopathologic study)].

Rare "paraneoplastic nephropathies" are associated with a wide variety of human tumors. Little is known about the pathogenetical background. To our knowledge no systematic study about the association of potentially "immunogenic" renal cell cancer (RCC) and "paraneoplastic nephropathy" has been published so far. An immunohistochemical analysis of native kidneys and a nephrological follow up of 60 patients with renal cell cancer (RCC) treated at the Department of Urology, medical University, Pécs (Hungary) between 1993-1998 has been performed. Cellular and humoral immunity was analysed by immunohistochemistry. Clinical/laboratory parameters of the patients with tumor associated nephropathy were pre- and postoperatively registered. Eleven IgA-nephropathy (IgA-NP) and 5 focal segmental glomerulosclerosis (FSGS), manifested in preoperative clinical signs in 11 out of 16 cases were found. Clinical symptoms disappeared in 6 out of 8 IgA-NP patients by tumor nephrectomy in a follow up of 38.7 (18-51) months. Eleven out of 16 tumors were stained with the identical anti human immunoglobulin (IgA or IgM) present in the glomerular immune complexes. The RCC-associated VHL (von Hippel-Lindau) protein was detectable in 3 out of 8 IgA-NP patients as an antigen component of their nephritogenic immune complexes. Tumor infiltrating lymphocytes (TIL) considered as a local sign of cellular tumor immunity were more frequently present in tumors associated with nephropathy than without it (69% vs 25%). Pathogenetic correlation between the tumor immunity in renal cell carcinoma and "paraneoplastic IgA-nephropathy" has been demonstrated in some of the cases. Tumor nephrectomy excluding the need of post-operative single kidney biopsies should be a safe tool in the differential diagnosis of tumor-associated nephrological conditions.

Adenocarcinoma, Clear Cell↗

Ambulatory blood pressure monitoring and progression in patients with IgA nephropathy.

BACKGROUND: Hypertension is a recognized marker of poor prognosis in IgA nephropathy. METHODS: The present study investigated the prevalence of white-coat hypertension, the diurnal rhythm of blood pressure (BP), the effectiveness of antihypertensive drug therapy, and the effect of the above on the progression of the kidney disease in IgA nephropathy. One hundred twenty-six IgA nephropathy patients were selected consecutively for 24-h ambulatory blood pressure monitoring (ABPM). Fifty-five patients were normotensive and 71 were treated hypertensives. Their antihypertensive drugs were angiotensin-converting enzyme inhibitors (ACEI) alone or in combination with calcium-channel blockers (CCB). RESULTS: The mean night-time BP of normotensives (108+/-9/67+/-6 mmHg) was significantly lower than their day-time BP (125+/-8/82+/-7 mmHg, P<0.05). There was no significant difference between the mean day-time and night-time BP in hypertensive patients (125+/-9/82+/-7 mmHg vs 128+/-10/85+/-9 mmHg). The circadian variation of BP was preserved ('dippers') in 82% of the normotensive and 7% of the hypertensive patients (P<0.001). There were 10 'white-coat hypertensives' among the patients classified as normotensives with ABPM (mean office blood pressure 149+/-7/96+/-8 mmHg, 24-h blood pressure 127+/-6/83+/-5 mmHg, P<0.05) and 14 among treated hypertensives (mean office BP 152+/-8/98+/-6 mmHg, 24-h BP 130+/-4/85+/-8 mmHg, P<0.05). There was no difference in mean day-time BP among normotensive and treated hypertensive patients (125+/-8/81+/-5 mmHg vs 128+/-10/85+/-9 mmHg). Hypertensives had significantly higher night-time BP (125+/-9/85+/-9 mmHg) than normotensives (108+/-9/67+/-6 mmHg, P<0.001). There was no difference in serum creatinine levels among the different groups at the time of the ABPM. However, thirty-six+/-4.1 months after the ABPM, hypertensive patients (n=52) had higher serum creatinine levels (124+/-32 micromol/l) than at the time of the ABPM (101+/-28 micromol/l). The serum creatinine of normotensive patients (n=43) did not change during the follow-up period. 'Non-dipper' normotensives (n=10) had significantly higher serum creatinine levels at the end of the follow-up period than at its beginning (106+/-17 micromol/l vs 89+/-18 micromol/l, P<0.05). There was no increase in serum creatinine of 'dipper' normotensives. The mean serum creatinine of 'white-coat hypertensives' was significantly higher at the end of the study period than at its beginning. CONCLUSIONS: There is no diurnal blood pressure variation in most of the hypertensive IgA nephropathy patients. ACEI and CCB treatment have better effect on day-time than night-time hypertension. The lack of the circadian rhythm and 'white-coat hypertension' seems to accelerate the progression of IgA nephropathy.

Adult↗

Sensitivity of three recent questionnaires to mild traumatic brain injury-related effects.

OBJECTIVE: To evaluate the sensitivity of three recently developed questionnaires to mild traumatic brain injury (MTBI)-related effects. DESIGN: Comparison of an MTBI group, within 3 weeks of injury, to a normal control group. SETTING: Outpatient rehabilitation clinic. SUBJECTS: 120 MTBI patients and 120 age, education, sex, and preinjury socioeconomic status-matched normal control subjects. MAIN OUTCOME MEASURES: The Problem Checklist (PCL) from the New York Head Injury Family Interview to assess MTBI symptoms, the Short Form-36 Health Survey (SF-36) to assess functional burden associated with health problems, and the Community Integration Questionnaire (CIQ) to assess home, social, and productive activities. RESULTS: Patients' self-ratings on the PCL and SF-36, but not the CIQ, were generally worse than those of the normal controls. The largest differences were obtained on SF-36 measures that appear to assess musculoskeletal injury effects. CONCLUSIONS: The PCL and SF-36 show promise as sensitive measures of MTBI-related effects. The SF-36 may be particularly useful in evaluating associated musculoskeletal injuries, which might otherwise be overlooked by MTBI health care providers.

Adaptation, Psychological↗

A note on the early history of renal transplantation: Emerich (Imre) Ullmann.

In January 1902 at the Vienna Medical Society Meeting, the surgeon Emerich Ullmann reported the first case of renal autotransplantation performed in the neck of a dog. In the same year, he presented the first xenotransplantation of the kidney (a goat with a dog's kidney). These publications immediately had a great impact on the medical word. After his failed attempt to transplant a pig's kidney into a young uraemic woman he stopped his research in this field in order to devote himself to other lines of surgical research. However, his idea survived him, because, nowadays, nearly 100 years later, pigs appear to be the most suitable donors for human renal xenotransplantation. Ullmann was born in Pécs, Hungary, on February 23, 1861. After a distinguished undergraduate career in 1878 his father (being also a medical doctor) sent him to study medicine at the world-famous Vienna Medical School. He graduated in 1884 and was immediately invited to the Surgical Department where Billroth worked. Next year, because of his interest in bacteriology he visited Pasteur in Paris and successfully volunteered to serve as a healthy subject to prove the effectiveness of Pasteur's antisera against rabies. Although Ullmann did not succeed in doing a human transplantation he gave birth to the era of the organ transplantation, stimulated vascular surgery and the development of transplantation immunology.

Animals↗

Circadian blood pressure changes and cardiac abnormalities in IgA nephropathy.

The absence of diurnal blood pressure rhythm is characteristic of patients with chronic glomerulonephritis already before they develop hypertension. The prognostic importance and possible target organ-damaging effect of the absence are unknown. Simultaneously, 24-hour ambulatory blood pressure monitoring and echocardiographic investigations were done in 12 normotensive and 38 hypertensive IgA nephropathy patients. The hypertensive patients were treated with either angiotensin-converting enzyme inhibitor (ACEI) alone or in combination with a non-dihydropyridine calcium channel blocker. The absence of a night-time blood pressure reduction was frequent in both groups (5/12 vs. 20/38). In the hypertensive patients, blood pressure and left ventricular mass index were higher (124.6 +/- 23. 3/81.2 +/- 15.3 vs. 106.6 +/- 33.4/67.4 +/- 21.8 mm Hg, p < 0.001, and 124.1 +/- 46.2 vs. 89.2 +/- 45.6 g/m(2), p < 0.01). Diastolic left ventricular function was better in normotensive patients, in whom E wave/A wave ratio (E/A) and decelaration time values correlated closely with the diastolic diurnal index (E/A, r = 0.86, p < 0.01; DT, r = -0.70, p < 0.01). In the hypertensive patients, both the left ventricular wall thickness and diastolic function were significantly related to nighttime blood pressure and diurnal index values, but there was no relationship with daytime blood pressure. In conclusion, in IgA nephropathy patients there are mild cardiac abnormalities before they develop hypertension, the abnormalities bearing the closest correlation with the decrease in diurnal blood pressure rhythm. These data suggest the inefficacy of ACEI and calcium channel blockers in treating nighttime hypertension and in reestablishing diurnal rhythm. These phenomena are of great importance in the development of left ventricular hypertrophy and diastolic malfunction.

Adolescent↗

Renal cell carcinoma and paraneoplastic IgA nephropathy.

Paraneoplastic nephropathy is rarely associated with human tumors. Little is known about the pathogenetic background of this relationship. To our knowledge, no conclusive study of the association of potentially 'immunogenic' renal cell carcinoma (RCC) and paraneoplastic nephropathy has been published. For this reason, we performed an immunohistochemical analysis of native resected kidneys of 60 patients with RCC, paying special attention to their pre- and postoperative records. Sixteen (27%) of the 60 tumor patients had immune complex nephropathy (11 IgA nephropathy [IgA NP] and 5 focal segmental glomerulosclerosis [FSGS]). Preoperative proteinuria and/or hematuria observed in 11 of 16 cases disappeared in 6 IgA NP patients within a 2- to 3-month follow-up after nephrectomy. Eleven of 16 tumors stained with the anti human immunoglobulin (IgA or IgM) of the same isotype as that present in glomerular immune complexes. In 3 IgA NP patients RCC-associated von Hippel-Lindau (VHL) protein and IgA staining were found simultaneously in the tumor and glomeruli, with the clinical and laboratory findings disappearing after nephrectomy. Immune injury of the glomeruli due to a tumor-induced antigen-antibody response was demonstrated in these 3 IgA NP patients.

Adult↗

[Analgesic nephropathy].

Analgesic nephropathy is a slowly progressive disease caused by the chronic abuse of analgesic mixtures containing two analgesic components combined with potentially addictive substances (coffeine and/or codeine). Pathologically, the nephropathy is characterized by renal papillary necrosis with calcification and chronic interstitial nephritis sometimes in association with transitional-cell carcinoma of the uroepithelium. In the early stage, the clinical characteristics are polyuria, sterile pyuria, sometimes renal colic and haematuria. With further progression of the disease, there are the nonspecific symptoms of advanced renal failure. The incidence of classic analgesic nephropathy among Hungarian patients on chronic renal replacement therapy has proven. There is an urgent need for the estimation of analgesic nephropathy among patients with chronic renal disease and among patients with chronic pain presumably regularly taking analgesics in Hungary. As long as analgesic mixtures containing phenacetin or paracetamol and/or nonsteroidal antiinflammatory drugs and addictive substances are available "over-the-counter", analgesic nephropathy will continue to be a problem also in our country.

Analgesics↗

[Paracetamol-induced tubulointerstitial nephritis in a chronic alcoholic patient].

Hepatic and renal toxicity of paracetamol overdosage is well known like the fact that ethanol enhances the toxicity of the drug. Scanty data report on reversible hepatic and renal failure appearing after therapeutic dose of paracetamol in alcohol-abusers. Renal damage might also occur without gross hepatocellular damage in alcoholics. We report the case of a young alcoholic male whose first renal biopsy disclosed mesangiocapillary glomerulonephritis. One month later he took 1.5 g paracetamol to control the fever caused by upper respiratory tract infection. Soon he got hospitalised due to fever, toxicoderma, elevated liver and renal function test. While liver enzymes returned to normal, macroscopic haematuria, nephrotic range proteinuria oliguria, uraemia developed. A repeated renal biopsy revealed severe interstitial inflammation, tubular atrophy, progression of the vascular changes seen in the first biopsy. Haemodialysis was started and he got steroids (1 mg/kg body-weight) besides aggressive antihypertensive medication. He showed considerable recovery of renal function in some weeks. The case points to the possibility that paracetamol--even in therapeutic dosage--might result in hepatic and renal damage in alcoholics. The sudden deterioration in renal function was due to the acute tubulointerstitial nephritis superimposed on mesangiocapillary glomerulonephritis, provoked by paracetamol. Early diagnosis, immediate withdrawal of the toxic drug, steroid treatment might have kidney and life saving effect.

Acetaminophen↗

[Surgical trauma induced by laparoscopic cholecystectomy].

The objective demonstration of improved postoperative recovery suggests that surgical injury induced by the laparoscopic approach is less intense than that after open surgery. Forty-two patients diagnosed as having noncomplicated gallstones were studied prospectively. They were operated on by laparoscopy (LC, n = 21) or open surgery (OC, n = 21). Both surgical procedures induced significant changes of investigated parameters (acute-phase response, free radical mediated reactions, neutrophil functions). Comparison of the results of the two cholecystectomy techniques showed that laparoscopic cholecystectomy induced a significantly less intense acute-phase response, a more attenuated oxidative stress characterising by free radical mediated reactions and that is less disruptive to neutrophil function. The results and the data from the literature suggest that surgical injury causing by the laparoscopic cholecystectomy is less intense than that after open cholecystectomy, which can explain partially the better clinical outcome following laparoscopic versus open procedure.

Cholecystectomy↗

[Recurrent significant bacteriuria and progression of IgA nephropathy].

Tubulointerstitial changes seems to be of decisive importance among factors influencing the prognosis of IgA nephropathy. In consequence of decreased protection ability of mucous membranes, in some cases masked urinary tract infections may stand in the background of the tubulointerstitial changes. In this study the connection between urinary tract infections, significant bacteriurias and the progression of IgA nephropathy was retrospectively investigated. The data and the progress of the disease of 19 IgA nephropathy patients with significant bacteriuria (microbiologically identified) were compared to 19 IgA nephropathy patients of similar age, sex and the time of follow-up without bacteriuria. During the follow-up (on the average 8.5 years), the renal function (values of serum creatinine) decreased significantly (p < 0.05) in both groups, but there was no significant difference between the two groups. Neither at start, nor at the end of the follow-up no significant difference was found in the two groups in the prevalence of proteinuria, haematuria, hypertension and between the values of serum parameters. On the basis of these data we assume, that with the help of frequent medical check up and adequate antibiotic treatment the unfavourable effects of urinary tract infections (chronic tubulointerstitial changes) can probably be fended off.

Adult↗

Synthesis of peptide and pseudopeptide amides inhibiting the proliferation of small cell and epithelial types of lung carcinoma cells.

Small cell lung cancer (SCLC) cell lines produce and secrete various peptide hormones, e.g. bombesin (BN)/gastrin releasing peptide (GRP) like peptides that are proposed to function as their autocrine growth factors. To inhibit the proliferative effect of these hormones we have synthesized short chain BN[7-14]-analogues replacing the C-terminal peptide bond by a methylene-amino (-CH2NH-) unit and introducing D-Phe or D-Ser into position 12. As several substance P (SP) analogues were found to inhibit the growth of SCLC cells, some short chain SP-analogues have been synthesized. (Pseudo)octapeptides were synthesized in solution, by fragment condensation using the DCC/HOPfp method. Fragments and SP-analogues were synthesized stepwise using pentafluorophenyl esters. The resistance to hydrolysis of the reduced peptide bond made permitted exact quantification of the Leupsi(CH2NH)Leu pseudopeptide in hydrolysates. The binding ability of both types of peptides to BN-receptors on Swiss 3T3 mouse fibroblast cells and their antiproliferative effect on NCI-H69 human SCLC cell line have been tested and compared with a short chain SP-antagonist pHOPA-D-Trp-Phe-D-Trp-Leu-Leu-NH2 (R) previously described as a potent inhibitor of SCLC proliferation. While BN-analogues showed weak activity in inhibition of proliferation of SCLC cells, SP-analogues 6: D-MePhe-D-Trp-Phe-D-Trp-Leu(psi)(CH2NH)-Leu-NH2 and 7: D-MePhe-DTrp-Phe-D-Trp-Leu-MPA, in spite of greatly diminished affinity towards the BN-receptor, inhibited SCLC proliferation more effectively than R (6: IC50 = 2 microM, 7: IC50 = 5 microM and R: IC50 = 10 microM). Moreover, 6 inhibited the respiratory activity of SK-MES 1 epithelial type of lung carcinoma cells in proliferating but not in the quiescent state, suggesting that the antiproliferative effect of these compounds is not due to simple cytotoxicity. These short chain analogues of SP might be promising candidates as therapeutic agents in the treatment of SCLC.

3T3 Cells↗

A preliminary normative profile of mild traumatic brain injury diagnostic criteria.

This study investigated how mild traumatic brain injury (MTBI) diagnostic and related variables present in a large, nonreferred MTBI sample. Participants were 119 adults with MTBI, drawn from consecutive admissions to two hospital emergency wards. Within 3 weeks of injury, they were asked how the 1993 American Congress of Rehabilitation Medicine MTBI diagnostic criteria and related phenomena presented in their particular cases. Results showed that retrograde amnesia was not reported or was generally very brief; retrograde amnesia was not reported unless posttraumatic amnesia was also reported; and the median ratio of posttraumatic amnesia to retrograde amnesia duration, when both were reported, was 300:1. These and other data provide a preliminary normative profile of such MTBI phenomena, and can help with differential diagnosis of MTBI in individual cases.

Adult↗

A randomized trial of two treatments for mild traumatic brain injury.

The purpose of this study was to compare an education-oriented single session treatment (SS) for mild traumatic brain injury (MTBI) to a more extensive assessment, education, and treatment-as-needed intervention (TAN). Participants were 111 adults with MTBI who were recruited from consecutive admissions to two hospital emergency wards. They were randomly assigned to either the SS or TAN modality. The groups did not differ on any demographic, injury-related, or questionnaire variable when first seen within 3 weeks of injury. The groups generally improved a similar amount and did not differ from each other on any symptom-related, functional, or vocational variables 3-4 months after their baseline session. Patient satisfaction ratings with services provided were also similar for the two groups. Brief educational intervention given soon after MTBI appears to be adequate for most MTBI survivors.

Adult↗