A population study on the epidemiology and outcome of brain injuries in intensive care.

BACKGROUND: Traumatic Brain Injury (TBI) is characterized by a highly heterogenous profile in terms of pathophysiology, clinical presentation and outcome. OBJECTIVE: This is the first population study investigating the epidemiology and outcomes of moderate-to-severe TBI in Cyprus. Patients treated in the Intensive Care Unit (ICU) of Nicosia General Hospital, the only Level 1 Trauma Centre in the country, were recruited between January 2013 and December 2016. METHODS: This was an observational cohort study, using longitudinal methods and six-month follow-up. Patients (N = 203) diagnosed with TBI were classified by the Glasgow Coma Scale at the Emergency Department as moderate or severe. RESULTS: Compared to international multicentre studies, the current cohort demonstrates a different case mix that includes older age, more motor vehicle collisions and lower mortality rates. There was a significantly higher proportion of injured males. Females were significantly older than males. There were no sex differences in the type, severity or place of injury. Sex did not yield differences in mortality or outcomes or on injury indices predicting outcomes. In contrast, older age was a predictor of higher mortality rates and worse outcomes. CONCLUSION: Trends as described in the study emphasize the importance of continuous evaluation of TBI epidemiology and outcome in different countries.

Pictorial superiority during verbal learning tasks in moderate to severe closed head injury: additional evidence.

Evidence for picture superiority in verbal learning following moderate to severe closed head injury (CHI) was found in a study involving 31 participants with CHI and 31 noninjured participants. A multitrial free-recall paradigm was implemented incorporating three modalities: Auditory, visual, and simultaneous auditory plus visual. Participants with moderate to severe CHI learned fewer words and at a slower rate than the noninjured participants. The visual presentation of objects (with or without the simultaneous auditory presentation of names) resulted in better learning than the auditory presentation alone.

Decline in homophone spelling associated with loss of semantic influence on spelling in Alzheimer's disease.

The homophone spellings of 20 subjects with Alzheimer's disease (AD) and mild dementia were compared to those of matched normal controls. Both groups were tested once (Time 1) and then again 9 months to 1 year later (Time 2). At Time 1, AD subjects misspelled more homophones than the control group and the discrepancy between the two groups' performances significantly increased by Time 2. Two types of errors were tabulated: homophone confusions (i.e. an inappropriate yet correctly spelled homophone given the context, such as spelling doe, given the context "bake the bread dough") and other spelling errors (e.g. doue, dogh). The relationship between homophone confusions and confrontation naming increased from Time 1 to Time 2. In contrast, the relationship between the number of spelling errors (that were not homophone confusions) and confrontation naming performance was not significant at Time 2. One subgroup of 3 subjects showed an increase in homophone confusions and confrontational naming errors and not more spelling errors. Another subgroup of 4 subjects showed neither an increase in homophone confusions nor in confrontational naming errors, but did show an increase in spelling errors. Based on these results, we suggest that homophone confusions are primarily due to impairment of semantic access to a functional orthographic output lexicon. Other spelling errors may reflect post-linguistic spelling deficits without a significant change in the use of semantic input for spelling homophones.