Joshua S. Speed

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The majority of patients with mild traumatic brain injury (TBI) recover fairly quickly and are usually restored to their previous level of functioning. However, a significant minority have prolonged, complicated, or incomplete recoveries and have outcomes disproportionately worse than would have been predicted by the objective facts of the injury. This(More)
PRIMARY OBJECTIVES To study the variables that relate to outcome after mild traumatic brain injury (TBI). METHODS AND PROCEDURES Sixty-seven adults with disappointing recoveries after mild TBI most occurring in a compensation or litigation context were studied with regard to pre-injury, neuro-trauma, physical, emotional and cognitive variables on outcome.(More)
Over one million mild traumatic brain injuries (TBI) occur annually in the United States. Most of these patients recover full function within about 3 months, but a significant minority do not. Failure to recover as expected following a diagnosed or suspected mild TBI is most commonly related to a concurrent diagnosis or alternative diagnosis or condition.(More)
BACKGROUND The renal medullary endothelin (ET-1) system plays an important role in the control of sodium excretion and arterial pressure (AP) through the activation of renal medullary ET-B receptors. We have previously shown that blockade of endothelin type B receptors (ET-B) leads to salt-sensitive hypertension through mechanisms that are not fully(More)
Classic methods for delivery of agents to specific organs are technically challenging and causes superfluous stress. The current study describes a method using programmable, implantable peristaltic pumps to chronically deliver drugs in vivo, while allowing animals to remain undisturbed for accurate physiological measurements. In this study, two protocols(More)
Acute stress in both rodents and humans causes a transient rise in blood pressure associated with an increase in plasma endothelin-1 (ET-1). High salt (HS) intake also increases ET-1 production, and interestingly, blunts the pressor response to acute air jet stress in rats. We previously reported that female rats lacking functional ETB receptors everywhere(More)
It has been established that specific liver poisons (chloroform, phosphorus) which cause histological changes in the liver cells, decrease the liver excretion of phenoltetrachlorphthalein. Also vascular disturbances (Eck fistula, passive congestion) with or without histological evidence may cause a fall in the output of phthalein through the liver.(More)
Movement disorders following midbrain haemorrhage are infrequently encountered in rehabilitation, and are uncommonly corrected by pharmacologic means. This report describes a 20 year-old male with a prior history of cocaine abuse who presented with a 4 day history of dysarthria and blurred vision following methamphetamine abuse. Physical examination(More)
More aggressive neurosurgical management of intractably elevated intracranial pressure has resulted in increased survival of severely brain injured patients, many of whom are transferred for inpatient rehabilitation status post-craniectomy. Positional headache due to intracranial hypotension has been described in the literature, but is rarely reported as a(More)
Conversion disorder, initially described by Freud over a century ago, has been treated in many ways over the years. A behavioral model of the onset of conversion disorders was first described 50 years ago, and led to efforts to treat it in a behavioral fashion, initially in psychiatric settings. A quarter century ago, the first systematic operant behavioral(More)