***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The Glasgow Coma Scale ( GCS ) is a routine component of a neurological exam for critically ill traumatic brain injury ( TBI ) patients , yet has been criticized for not accurately depicting verbal status among intubated patients or including brain stem reflexes . Preliminary research on the Full Outline of UnResponsiveness ( FOUR ) Scale suggests it overcomes these limitations . Research is needed to determine correlations with patient outcomes . The aims of this study were to : ( 1 ) examine correlations between 24 and 72 h FOUR and GCS scores and functional/cognitive outcomes ; ( 2 ) determine relationship between 24 and 72 h FOUR scores and mortality . Methods Prospect i ve cohort study . Data gathered on adult TBI patients at a Level I trauma center .  FOUR scores assigned at 24 , 72 h. Functional outcome measured by functional independence measure scores at rehabilitation discharge ; cognitive status measured by Weschler Memory Scale scores 3 months post-injury . Results n = 136 . Mean age 53.1 . 72 h FOUR and GCS scores correlated with functional outcome ( rs = 0.34 , p = 0.05 ; rs = 0.39 , p = 0.02 ) , but not cognitive status . Receiver operating characteristic curves were comparable for FOUR and GCS at 24 and 72 h for functional status ( 24 h FOUR , GCS = 0.625 , 0.602 , respectively ; 72 h FOUR , GCS = 0.640 , 0.688 ) , cognitive status ( 24 h FOUR , GCS = 0.703 , 0.731 ; 72 h FOUR , GCS = 0.837 , 0.674 ) , and mortality ( 24 h FOUR , GCS = 0.913 , 0.935 ; 72 h FOUR , GCS = 0.837 , 0.884 ) . Conclusions FOUR is comparable to GCS in terms of predictive ability for functional status , cognitive outcome 3 months post-injury , and in-hospital mortality OBJECTIVE This study investigated effects of oral glibenclamide on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injuries . METHODS A r and omized clinical trial including 66 patients with moderate ( Glasgow Coma Scale score 9 - 12 ) to severe ( Glasgow Coma Scale score 5 - 8 ) traumatic brain injury and brain contusions of < 30 mL volume was conducted from May 2015 to August 2016 in a Level I trauma center in southern Iran . Patients who required surgical intervention were excluded . Patients were r and omly assigned to receive 10 mg oral glibenclamide daily for 10 days ( n = 29 ) or placebo in the same dosage ( n = 23 ) . Brain contusion volumetry was performed on days 0 , 3 , and 7 using spiral thin-cut brain computed tomography scan ( 1-mm thickness ) . Outcome measures including modified Rankin Scale , Glasgow Outcome Scale , and Disability Rating Scale were evaluated 3 months after injury . RESULTS There was no significant difference between the 2 study groups in baseline , day 3 , and day 7 contusion volumes . Patients receiving glibenclamide had a significantly lower expansion ratio from first to second volumetry ( P < 0.001 ) . Similarly , the first to third expansion ratio was significantly lower in the glibenclamide group compared with placebo ( P = 0.003 ) . There was no significant difference between the 2 groups regarding functional outcome measured by Glasgow Outcome Scale , modified Rankin Scale , and Disability Rating Scale . CONCLUSIONS Oral glibenclamide is associated with decreased contusion expansion rate in patients with moderate and severe traumatic brain injuries sustaining cerebral contusions The aim of the current study was to investigate the effects of atorvastatin on brain contusion volume and functional outcome of patients with moderate and severe traumatic brain injury ( TBI ) . The study was conducted as a r and omized clinical trial during a 16-month period from May 2015 and August 2016 in a level I trauma center in Shiraz , Southern Iran . We included 65 patients with moderate ( GCS : 9 - 13 ) to severe ( GCS : 5 - 8 ) TBI who had brain contusions of less than 30cc volume . We excluded those who required surgical intervention . Patients were r and omly assigned to receive daily 20 mg atorvastatin for 10days ( n=21 ) or placebo in the same dosage ( n=23 ) . The brain contusion volumetry was performed on days 0 , 3 and 7 utilizing spiral thin-cut brain CT-Scan ( 1-mm thickness ) . The outcome measured included modified Rankin scale ( MRS ) , Glasgow Outcome Scale ( GOS ) and Disability rating Scale ( DRS ) which were all evaluated 3months post-injury . There was no significant difference between two study group regarding the baseline , 3rd day and 7th day of the contusion volume and the rate of contusion expansion . However , functional outcome scales of GOS , MRS and DRS at 3-months post-injury were significantly better in atorvastatin arm of the study compared to placebo ( p values of 0.043 , 0.039 and 0.030 respectively ) . Even though atorvastatin was not found to be more effective than placebo in reducing contusion expansion rate , it was associated with improved functional outcomes at 3-months following moderate to severe TBI Background Cerebrolysin , a brain-derived neuropeptide , has been shown to improve the neurological outcomes of stroke , but no study has demonstrated its effect on cerebral blood flow . This study aim ed to determine the cerebrolysin impact on the neurological outcomes and cerebral blood flow . Methods In a r and omized , double-blinded , placebo-controlled trial , 46 patients who had acute focal ischemic stroke were r and omly assigned into two groups to receive intravenously either 30 mL of cerebrolysin diluted in normal saline daily for 10 days ( n=23 ) or normal saline alone ( n=23 ) adjunct to 100 mg of aspirin daily . All patients were examined using the National Institutes of Health Stroke Scale and transcranial Doppler to measure the mean flow velocity and pulsatility index ( PI ) of their cerebral arteries at baseline as well as on days 30 , 60 , and 90 . Results The patients ’ mean age was 60±9.7 years , and 51.2 % of patients were male . The National Institutes of Health Stroke Scale was significantly lower in the cerebrolysin group compared with the placebo group on day 60 ( median 10 , interquartile range 9–11 , P=0.008 ) and day 90 ( median 11 , interquartile range 10–13.5 , P=0.001 ) . The median of PI in the right middle cerebral artery was significantly lower in the cerebrolysin group compared with the placebo group on days 30 , 60 , and 90 ( P<0.05 ) . One patient in the cerebrolysin group and two patients in the placebo group died before day 30 ( 4.3 % versus 8.7 % ) . Conclusion Cerebrolysin can be useful to improve the neurological outcomes and the PI of middle cerebral artery in patients with acute focal ischemic stroke Background and Purpose The neuroregenerative drug Cerebrolysin has demonstrated efficacy in improving cognition in adults with stroke and Alzheimer 's disease . The aim of this study was to determine the efficacy and safety of Cerebrolysin in the treatment of communication defects in infants with severe perinatal brain insult . Methods A r and omized placebo-controlled clinical trial was conducted in which 158 infants ( age 6 - 21 months ) with communication defects due to severe perinatal brain insult were enrolled ; 120 infants completed the study . The Cerebrolysin group ( n=60 ) received twice-weekly Cerebrolysin injections of 0.1 mL/kg body weight for 5 weeks ( total of ten injections ) . The placebo group ( n=60 ) received the same amount and number of normal saline injections . Results The baseline Communication and Symbolic-Behavior-Scale-Developmental Profile scores were comparable between the two groups . After 3 months , the placebo group exhibited improvements in the social ( p<0.01 ) and speech composite ( p=0.02 ) scores , with 10 % and 1.5 % increases from baseline , respectively . The scores of the Cerebrolysin group changed from concern to no concern , with increases of 65.44 % , 45.54 % , 358.06 % , and 96.00 % from baseline in the social ( p<0.001 ) , speech ( p<0.001 ) , symbolic ( p<0.001 ) , and total ( p<0.001 ) scores . Conclusions Cerebrolysin dramatically improved infants ' communication especially symbolic behavior which positively affected social interaction . These findings suggest that cerebrolysin may be an effective and feasible way equivalent to stem cell therapy Traumatic brain injury ( TBI ) is one of the leading causes of injury-related death . In the United States alone , an estimated 1.7 million people sustain a TBI each year , and approximately 5.3 million people live with a TBI-related disability . The direct medical costs and indirect costs such as lost productivity of TBIs totaled an estimated $ 76.5 billion in the U.S. in the year 2000 . Improving the limited treatment options for this condition remains challenging . However , recent reports from interdisciplinary working groups ( consisting primarily of neurologists , neurosurgeons , neuropsychologists , and biostatisticians ) have stated that to improve TBI treatment , important method ological lessons from the past must be taken into account in future clinical research . An evaluation of the neuroprotection intervention studies conducted over the last 30 years has indicated that a limited underst and ing of the underlying biological concepts and method ological design flaws are the major reasons for the failure of pharmacological agents to demonstrate efficacy . Cerebrolysin is a parenterally-administered neuro-peptide preparation that acts in a manner similar to endogenous neurotrophic factors . Cerebrolysin has a favorable adverse effect profile , and several meta-analyses have suggested that Cerebrolysin is beneficial as a dementia treatment . CAPTAIN is a r and omized , double-blind ,  placebo-controlled , multi-center , multinational trial of the effects of Cerebrolysin on neuroprotection and neurorecovery after TBI using a multidimensional ensemble of outcome scales . The CAPTAIN trial will be the first TBI trial with a ' true ' multidimensional approach based on full outcome scales , while avoiding prior weaknesses , such as loss of information through " dichotomization , " or unrealistic assumptions such as " normal distribution . Changes in quantitative EEG ( qEEG ) recordings over a 1-year period and the effects of Cerebrolysin ( Cere ) on qEEG slowing and cognitive performance were investigated in postacute moderate – severe traumatic brain injury ( TBI ) patients . Time-related changes in qEEG activity frequency b and s ( increases of alpha and beta , and reductions of theta and delta relative power ) and in qEEG slowing ( reduction of EEG power ratio ) were statistically significant in patients with a disease progress of less than 2 years at baseline , but not in those patients having a longer disease progress time . Slowing of qEEG activity was also found to be significantly reduced in TBI patients after 1 month of treatment with Cere and 3 months later . Therefore , Cere seems to accelerate the time-related reduction of qEEG slowing occurring in untreated patients . The decrease of qEEG slowing induced by Cere correlated with the improvement of attention and working memory . Results of this exploratory study suggest that Cere might improve the functional recovery after brain injury and encourage the conduction of further controlled clinical trials The potential effects of Cerebrolysin ( EBEWE Pharma , Unterach , Austria ) , a peptide preparation with neurotrophic activity , on brain bioelectrical activity , cognitive performance and clinical outcome in postacute traumatic brain injury ( TBI ) patients , were investigated in an exploratory study . A decrease in slow electroencephalogram ( EEG ) activity and an increase in fast frequencies were observed after the administration of Cerebrolysin . This EEG-activating effect was not influenced by TBI time course or severity , nor by the chronic treatment with nootropic compounds . Cognitive performance , evaluated with the Syndrome Kurztest test , improved in TBI patients after Cerebrolysin treatment , independent of disease severity , time course or disability . A significant improvement in the patients ' clinical outcome , only evident during the first year after brain trauma , was also found following Cerebrolysin infusions . No relevant changes in biological parameters nor drug-related adverse events were observed . These promising preliminary results suggest that Cerebrolysin might be a useful treatment to improve the recovery of patients with traumatic brain damage , and encourage the conduction of confirmatory clinical trials Cerebrolysin is used as a neurotrophic agent for the treatment of ischemic stroke and Alzheimer 's Disease . Exploratory studies in patients with post-acute traumatic brain injury have shown that this treatment might help improve recovery . Aim of this study was to investigate whether addition of Cerebrolysin to the initial treatment regimen of moderate and severe head injury patients would improve their outcome . At 6 months , 67 % of the patients ( Cerebrolysin group ) attained good outcome ( GOS 3 - 5 ) . The study group was compared with the historical cohort of patients from the hospital trauma data bank , with age 
    Output:
    
Conclusion The results of the current study revealed that intravenous administration of cerebrolysin is associated with improved functional outcome in patients with TBI measured by the Glasgow Outcome Scale and the modified Rankin Scale scores