Ava M. Puccio
A5056459555- Traumatic Brain Injury and Neurovascular Disturbances
- Traumatic Brain Injury Research
- Cardiac Arrest and Resuscitation
- Trauma and Emergency Care Studies
- S100 Proteins and Annexins
- Neurosurgical Procedures and Complications
- Cerebrospinal fluid and hydrocephalus
- Sepsis Diagnosis and Treatment
- Advanced Neuroimaging Techniques and Applications
- Thermal Regulation in Medicine
- Epilepsy research and treatment
- Pharmacological Effects and Toxicity Studies
- Anesthesia and Neurotoxicity Research
- Advanced MRI Techniques and Applications
- Spinal Fractures and Fixation Techniques
- Cardiac, Anesthesia and Surgical Outcomes
- Acute Ischemic Stroke Management
- EEG and Brain-Computer Interfaces
- Drug Transport and Resistance Mechanisms
- Neonatal Respiratory Health Research
- Functional Brain Connectivity Studies
- Medical Imaging Techniques and Applications
- Venous Thromboembolism Diagnosis and Management
- Neonatal and fetal brain pathology
- Intensive Care Unit Cognitive Disorders
Neurological Surgery
2016-2025
University of Pittsburgh Medical Center
2016-2025
University of Pittsburgh
2016-2025
UPMC Health System
2018-2024
Morehouse School of Medicine
2024
University of Milano-Bicocca
2022
University of California, San Diego
2021-2022
University of California, San Francisco
2014-2022
University of Cincinnati
2021
Oxford University Press (United Kingdom)
2018-2020
Mild Traumatic Brain Injury (mTBI), or concussion, is a major public health concern. There controversy in the literature regarding true incidence of postconcussion syndrome (PCS), with constellation physical, cognitive, emotional, and sleep symptoms after mTBI. In current study, we report on evolution PCS patient outcomes mTBI at 3, 6, 12 months large, prospective cohort patients. Participants were identified as part prospective, multi-center Transforming Research Clinical Knowledge Study....
A relationship between reduced brain tissue oxygenation and poor outcome following severe traumatic injury has been reported in observational studies. We designed a Phase II trial to assess whether neurocritical care management protocol could improve levels patients with the feasibility of III efficacy study.
Biomarkers are important for accurate diagnosis of complex disorders such as traumatic brain injury (TBI). For a and multifaceted condition TBI, it is likely that single biomarker will not reflect the full spectrum response tissue to injury. Ubiquitin C-terminal hydrolase L1 (UCH-L1) glial fibrillary acidic protein (GFAP) among most widely studied biomarkers TBI. Because UCH-L1 GFAP measure distinct molecular events, we hypothesized analysis both would be superior each alone prognosis Serum...
Most traumatic brain injuries (TBIs) are classified as mild (mTBI) based on admission Glasgow Coma Scale (GCS) scores of 13 to 15. The prevalence persistent functional limitations for these patients is unclear.To characterize the natural history recovery daily function following mTBI vs peripheral orthopedic injury in first 12 months postinjury using data from Transforming Research and Clinical Knowledge Traumatic Brain Injury (TRACK-TBI) study, and, clinical computed tomographic (CT) scans,...
Traumatic brain injury (TBI) is among the leading causes of death and disability worldwide, with enormous negative social economic impacts. The heterogeneity TBI combined lack precise outcome measures have been central to discouraging results from clinical trials. Current approaches characterization disease severity not changed in more than three decades. This prospective multicenter observational pilot study aimed validate feasibility implementing Common Data Elements (TBI-CDEs). A total...
<h3>Importance</h3> Traumatic brain injury (TBI) has been associated with adverse mental health outcomes, such as posttraumatic stress disorder (PTSD) and major depressive (MDD), but little is known about factors that modify risk for these psychiatric sequelae, particularly in the civilian sector. <h3>Objective</h3> To ascertain prevalence of PTSD MDD among patients evaluated emergency department mild TBI (mTBI). <h3>Design, Setting, Participants</h3> Prospective longitudinal cohort study...
<h3>Importance</h3> Annually in the United States, at least 3.5 million people seek medical attention for traumatic brain injury (TBI). The development of therapies TBI is limited by absence diagnostic and prognostic biomarkers. Microtubule-associated protein tau an axonal phosphoprotein. To date, presence hypophosphorylated (P-tau) plasma from patients with acute chronic has not been investigated. <h3>Objective</h3> examine associations between P-tau total-tau (T-tau) levels presence,...
We evaluated 3T diffusion tensor imaging (DTI) for white matter injury in 76 adult mild traumatic brain (mTBI) patients at the semiacute stage (11.2±3.3 days), employing both whole-brain voxel-wise and region-of-interest (ROI) approaches. The subgroup of 32 with any intracranial lesion on either day-of-injury computed tomography (CT) or magnetic resonance (MRI) demonstrated reduced fractional anisotropy (FA) numerous tracts, compared to 50 control subjects. In contrast, 44 CT/MRI-negative...
<h3>Importance</h3> Moderate to severe traumatic brain injury (msTBI) is a major cause of death and disability in the US worldwide. Few studies have enabled prospective, longitudinal outcome data collection from acute chronic phases recovery after msTBI. <h3>Objective</h3> To prospectively assess outcomes areas life function at 2 weeks 3, 6, 12 months <h3>Design, Setting, Participants</h3> This cohort study, as part Transforming Research Clinical Knowledge TBI (TRACK-TBI) was conducted 18...
In nearly all clinical and research contexts, the initial severity of a traumatic brain injury (TBI) is measured using Glasgow Coma Scale (GCS) total score. The GCS score however, may not accurately reflect level consciousness, critical indicator severity. We investigated relationship between scores consciousness in consecutive sample 2455 adult subjects assessed with 69,487 times as part multi-center Transforming Research Clinical Knowledge TBI (TRACK-TBI) study. assigned each subscale...
The prognostic value of glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1) as day-of-injury predictors functional outcome after traumatic brain injury is not well understood. GFAP a found in cells UCH-L1 neurons, these biomarkers have been cleared to aid decision making regarding whether CT should be performed injury. We aimed quantify their accuracy investigate contribute novel information existing clinical models.
<h3>Importance</h3> Knowledge of differences in mild traumatic brain injury (mTBI) recovery by sex and age may inform individualized treatment these patients. <h3>Objective</h3> To identify sex-related symptom from mTBI; secondarily, to explore within women, who demonstrate poorer outcomes after TBI. <h3>Design, Setting, Participants</h3> The prospective cohort study Transforming Research Clinical Traumatic Brain Injury (TRACK-TBI) recruited 2000 patients with mTBI February 26, 2014, July 3,...
Striking gender differences have been reported in the pathophysiology and outcome of acute neurological injury. Greater neuroprotection females versus males may be due, part, to direct indirect sex hormone-mediated antioxidant mechanisms. Progesterone administration decreases brain levels F2-isoprostane, a marker lipid peroxidation, after experimental traumatic injury (TBI) male rats, estrogen is neuroprotective In this study, we evaluated effect on as assessed by cerebrospinal fluid (CSF)...
Reliable diagnosis of traumatic brain injury (TBI) is a major public health need. Glial fibrillary acidic protein (GFAP) expressed in the central nervous system, and breakdown products (GFAP-BDP) are released following parenchymal injury. Here, we evaluate diagnostic accuracy elevated levels plasma GFAP-BDP TBI. Participants were identified as part prospective Transforming Research And Clinical Knowledge Traumatic Brain Injury (TRACK-TBI) Study. Acute samples (<24 h post-injury) collected...
Cortical spreading depolarizations occur spontaneously after ischaemic, haemorrhagic and traumatic brain injury. Their effects vary spatially temporally as graded phenomena, from infarction to complete recovery, are reflected in the duration of depolarization measured by negative direct current shift electrocorticographic recordings. In focal ischaemic penumbra, peri-infarct have prolonged shifts cause progressive recruitment penumbra into core infarct. injury, unknown, although events not...
Object Current standard of care for patients with severe traumatic brain injury (TBI) is prophylactic treatment phenytoin 7 days to decrease the risk early posttraumatic seizures. Phenytoin alters drug metabolism, induces fever, and requires therapeutic-level monitoring. Alternatively, levetiracetam (Keppra) does not require serum monitoring or have significant pharmacokinetic interactions. In current study, authors compare EEG findings in receiving those monotherapy seizure prophylaxis...
Although the majority of patients with mild traumatic brain injury (mTBI) recover completely, some still suffer from disabling ailments at 3 or 6 months. We validated existing prognostic models for mTBI and explored predictors poor outcome after mTBI. selected TRACK-TBI Pilot, an unselected observational cohort TBI three centers in United States. two Glasgow Outcome Scale Extended (GOS-E) months injury. One model was based on CRASH study data another Nijmegen, The Netherlands. Possible 3-...
<h3>Importance</h3> Mild traumatic brain injury (mTBI) affects millions of Americans each year. Lack consistent clinical practice raises concern that many patients with mTBI may not receive adequate follow-up care. <h3>Objective</h3> To characterize the provision care to during first 3 months after injury. <h3>Design, Setting, and Participants</h3> This cohort study used data on enrolled in Transforming Research Clinical Knowledge Traumatic Brain Injury (TRACK-TBI) between February 26, 2014,...
Brain-derived neurotrophic factor (BDNF) is important for neuronal survival and regeneration. We investigated the diagnostic prognostic values of serum BDNF in traumatic brain injury (TBI). examined two independent cohorts TBI cases presenting to emergency departments (EDs) Johns Hopkins Hospital (JHH; n = 76) San Francisco General (SFGH, 80), a control group JHH ED patients without (n 150). Findings were subsequently validated prospective, multi-center Transforming Research Clinical...
Traumatic brain injury (TBI) is characterized by acute neurological dysfunction and associated with the development of chronic traumatic encephalopathy (CTE) Alzheimer's disease. We previously showed that cis phosphorylated tau (cis P-tau), but not trans form, contributes to pathology functional impairment in an animal model severe TBI. Here we found human samples obtained post TBI due a variety causes, P-tau induced cortical axons cerebrospinal fluid positively correlates axonal clinical...
The idea that multiple traumatic brain injury (TBI) can have a cumulative detrimental effect on functioning is widely accepted. Most research supporting this comes from athlete samples, and it not known whether remote history of previous TBI affects after subsequent in community-based samples. This study investigates with loss consciousness (LOC) associated worse health sample individuals who require emergency department care for current TBI. Twenty-three percent the 586 Transforming...