J Trauma
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: Previous studies indicate that age, Glasgow Coma Scale score (GCS), arterial hypotension, computed tomography (CT) findings, and pupillary reactivity are strong predictors of outcome for patients with severe traumatic brain injury (TBI). However, the predictive validity of these variables has never been rigorously tested in patients from the developing world. The objective of this study was to evaluate the prognostic value of these variables in a resource-limited setting and to test their predictive power by using them to create an outcome model. ⋯ : This study provides rigorous, prospective data that (1) validates the generalizability of the five World Health Organization/Organization Mondiale de la Santé TBI prognostic predictors outside of the developed world, and (2) provides outcome benchmarks for mortality and morbidity from severe TBI in developing countries.
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Comparative Study Controlled Clinical Trial
Brain death confirmation: comparison of computed tomographic angiography with nuclear medicine perfusion scan.
: Brain death is a difficult diagnosis to make, relying primarily on clinical examination. Ancillary tests are used when confounders exist. Nuclear medicine perfusion test (NMPT) is currently the preferred test for confirming brain death. Computed tomographic angiography (CTA) may be an alternative test to confirm brain death. It is readily available 24 hours a day at most level I trauma centers and is easy to perform. ⋯ : CTA is a quick and efficient test for brain death confirmation. CTA demonstrated no false negative studies. The resolution of CTA seems to have an increased sensitivity for cerebral blood flow. Further studies with larger sample sizes need to be performed.
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Controlled Clinical Trial
Spleen artery embolization aggravates endotoxin hyporesponse of peripheral blood mononuclear cells in patients with spleen injury.
: Spleen artery embolization (SAE) increases the success of nonoperative management of spleen injury; however, the immune alternation after SAE is unclear. This study searched the endotoxin responses of peripheral blood mononuclear cells (PBMCs) in injured patients who received SAE. ⋯ : SAE dysregulates the NF-kB system and aggravates the cytokine hyporesponse upon ES of PBMCs in patients with spleen injury. These results implicate that SAE alters immune response and may increase susceptibility to infections in injured patients.
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Controlled Clinical Trial
Measuring tissue oxygen saturation via spectrometer in children.
: Near-infrared spectroscopy is a new noninvasive method of monitoring oxygen saturation at a tissue level. The purpose of this study was to evaluate new near-infrared tissue spectrometer InSpectra (Hutchinson Technology Inc.) in children and to determine preferable areas of the body to measure tissue oxygen saturation (StO2). ⋯ : Bicep and deltoid muscles are the most appropriate areas to measure StO2 using the 25-mm transducer in children of different ages. The use of near-infrared spectroscopy on the thenar eminence, which is usually used for measurement in adults, has varied results in children depending on the age, weight, and presence of fever.