Author Interviews, Brain Injury, JAMA / 16.09.2020
Traumatic Brain Injury: Out-of-Hospital Tranexamic Acid vs Placebo
MedicalResearch.com Interview with:
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Dr. Rowell[/caption]
Susan Rowell MD, MBA, MCR
Associate Professor, Department of Surgery
Division of Trauma, Acute & Critical Care Surgery
Duke University School of Medicine
Durham, NC 27710
MedicalResearch.com: What is the background for this study?
Response: Tranexamic acid (TXA) has been increasingly used in trauma patients since publication of the CRASH-2 trial in 2010 demonstrated a survival benefit for patients at risk for traumatic hemorrhage. Subsequently, it was shown that the earlier TXA was administered, the better the outcome. There had been several small studies suggesting that TXA may also be beneficial in patients with traumatic brain injury (TBI), however, an adequate prospective randomized trial was needed.
In this trial we randomized over 1000 patients with moderate and severe TBI as early as possible after injury (by paramedics in the prehospital setting an average of 42 minutes after injury) to either a 1-gram TXA bolus followed by a 1-gram 8-hour TXA infusion (the dose typically used for trauma patients), a 2-gram TXA bolus only (a logistically easier route of administration requiring no maintenance infusion), or placebo only.
Dr. Rowell[/caption]
Susan Rowell MD, MBA, MCR
Associate Professor, Department of Surgery
Division of Trauma, Acute & Critical Care Surgery
Duke University School of Medicine
Durham, NC 27710
MedicalResearch.com: What is the background for this study?
Response: Tranexamic acid (TXA) has been increasingly used in trauma patients since publication of the CRASH-2 trial in 2010 demonstrated a survival benefit for patients at risk for traumatic hemorrhage. Subsequently, it was shown that the earlier TXA was administered, the better the outcome. There had been several small studies suggesting that TXA may also be beneficial in patients with traumatic brain injury (TBI), however, an adequate prospective randomized trial was needed.
In this trial we randomized over 1000 patients with moderate and severe TBI as early as possible after injury (by paramedics in the prehospital setting an average of 42 minutes after injury) to either a 1-gram TXA bolus followed by a 1-gram 8-hour TXA infusion (the dose typically used for trauma patients), a 2-gram TXA bolus only (a logistically easier route of administration requiring no maintenance infusion), or placebo only.
Dr. Ellingson[/caption]
Jarrod Ellingson PhD
Assistant Professor
Department of Psychiatry
Anschutz Medical Campus
University of Colorado Denver
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We know that cannabis use is associated with many negative outcomes, but there could be many of reasons for that. For example, socioeconomic factors and peer influences both affect adolescent cannabis use and poorer cognitive functioning. To account for some of those risk factors, we studied nearly 600 sibling pairs with moderate to heavy cannabis use. We found that, as a person uses more cannabis than their sibling, they tend to have worse memory recall than their sibling.
Dr. Shoaff[/caption]
Jessica Shoaff, MPH, PhD
Postdoctoral Research Fellow and
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Dr. Korrick[/caption]
Susan A. Korrick, MD
Pulmonary and Critical Care
Assistant Professor in the Department of Environmental Health
Harvard Medical School · Harvard T. H. Chan School of Public Health
Brigham and Women's Hospital
Channing Laboratory Boston, MA 02115
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Our study posed the question: Do teenagers’ exposures to chemicals that are often found in consumer products increase behaviors that are common among individuals diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD)? Our results suggest that teenagers exposed to chemicals often found in consumer products (particularly phthalates) may have increased behaviors that are common among individuals diagnosed with ADHD. However, we did not study the diagnosis of ADHD (most of our study teens did not have ADHD). This means our results cannot answer the question of whether these chemical exposures increase the likelihood of being diagnosed with ADHD. Also, in our study design, chemical exposures and ADHD-related behaviors were measured at the same time, so it is not possible to know with certainty whether the chemical exposures altered behavior or behavior altered chemical exposures. 
Dr. Hervé Perron[/caption]
Hervé Perron PhD
Chief Scientific Officer at GeNeuro
MedicalResearch.com: What is the background for this study?
Response: Human endogenous retroviruses (HERVs), remnants of ancestral viral genomic insertions, are known to represent 8% of the human genome and are associated with several pathologies. Certain proteins produced by HERVs have previously been found to be involved in pathogenic mechanisms linked to, e.g., multiple sclerosis (MS) or amyotrophic lateral sclerosis. However, despite previous results having shown an abnormal expression of HERV-W in patients with schizophrenia or bipolar disorder, the mechanisms involved in these psychiatric disorders are poorly understood.
Dr. Jensen[/caption]
Majken K. Jensen, Ph.D.
Adjunct Professor of Nutrition
Harvard T.H. Chan School of Public Health &
Professor in the Department of Public Health
University of Copenhagen, Copenhagen, Denmark
MedicalResearch.com: What is the background for this study?
Response: Alzheimer’s disease and other dementias are highly prevalent conditions. According to the Alzheimer’s Association, 50 million people are currently living with Alzheimer’s disease or other dementias worldwide. Lower apolipoprotein E in plasma is a risk factor for dementia, but the underlying biological mechanisms are not fully understood. Thus, we investigated the role of apolipoprotein E overall and in lipoproteins with distinct metabolic functions in relation to cognitive function and dementia risk..
Dr. Robbins[/caption]
Dr. Rebecca Robbins, PhD MS
Fellow at Brigham & Women's Hospital
and Harvard Medical School
MedicalResearch.com: What is the background for this study?
Response: Sleep difficulties are common among older adults and are associated with cognitive decline. We used data collected over 10 years from a large, nationally representative longitudinal survey of adults over the age of 50 in the U.S. We examined the relationship between specific sleep difficulties and cognitive function over time.
MedicalResearch.com: What are the main findings?
Response: Our results show that early difficulty falling asleep and early morning awakenings, when experienced "most nights" of the week, were each associated with worse cognitive function. Conversely, reports of waking feeling rested was associated with better cognitive function, over time. 
