Clinical Deterioration and Neurocritical Care Utilization in Pediatric Patients With Glasgow Coma Scale Score of 9–13 After Traumatic Brain Injury: Associations With Patient and Injury Characteristics

OBJECTIVES: To define the clinical characteristics of hospitalized children with moderate traumatic brain injury and identify factors associated with deterioration to severe traumatic brain injury. DESIGN: Retrospective cohort study. SETTING: Tertiary Children’s Hospital with Level 1 Trauma Center designation. PATIENTS: Inpatient children less than 18 years old with an International Classification of Diseases code for traumatic brain injury and an admission Glasgow Coma Scale score of 9–13. MEASUREMENTS AND RESULTS: We queried the National Trauma Data Bank for our institutional data and identified 177 patients with moderate traumatic brain injury from 2010 to 2017. These patients were then linked to the electronic health record to obtain baseline and injury characteristics, laboratory data, serial Glasgow Coma Scale scores, CT findings, and neurocritical care interventions. Clinical deterioration was defined as greater than or equal to 2 recorded values of Glasgow Coma Scale scores less than or equal to 8 during the first 48 hours of hospitalization. Thirty-seven patients experienced deterioration. Children who deteriorated were more likely to require intubation (73% vs 26%), have generalized edema, subdural hematoma, or contusion on CT scan (30% vs 8%, 57% vs 37%, 35% vs 16%, respectively), receive hypertonic saline (38% vs 7%), undergo intracranial pressure monitoring (24% vs 0%), were more likely to be transferred to inpatient re...
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Clinical Investigations Source Type: research

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Conclusion: In according to FEA results it could be deducted that the post stresses are increased, by increasing of post elastic modulus, as well as the post material has a small contribution to the stress of the cervical area.
Source: Journal of Dental Materials and Techniques - Category: Dentistry Source Type: research
J Egypt Natl Canc Inst. 2021 Dec 6;33(1):37. doi: 10.1186/s43046-021-00097-x.ABSTRACTBACKGROUND: Abnormal expression patterns of microRNAs (miRs) play an important role in the development and progression of malignancy. Identification of the clinical significance and prognostic value of these small molecules in chronic lymphocytic leukemia (CLL); a disease of heterogeneous biological landscape and clinical course, has always been of tremendous translational value.AIM: To evaluate the prognostic value of microRNA17-92 cluster members in Egyptian CLL patients.METHODS: The expression levels of miR17-92 cluster members were eva...
Source: J Egypt Natl Canc In... - Category: Cancer & Oncology Authors: Source Type: research
Ann Med Surg (Lond). 2021 Nov 19;72:103087. doi: 10.1016/j.amsu.2021.103087. eCollection 2021 Dec.ABSTRACTAngiosarcoma of the Posterior Mediastinum is a rare entity. We herein report a case of a giant posterior mediastinal Angiosarcoma. A 54-year female presented with a one-year history of epigastric pain. Her upper gastrointestinal tract endoscopy revealed no abnormality. Chest x-Ray showed a shadow in the hilar area. A computed tomographic scan of the Thorax (CT) and MRI Scan showed a mass in the Posterior Mediastinum. CT-guided biopsy revealed the tumor of vascular origin. The tumor was completely resected. Post-operati...
Source: Annals of Medicine - Category: Internal Medicine Authors: Source Type: research
Monaldi Arch Chest Dis. 2021 Dec 3. doi: 10.4081/monaldi.2021.1962. Online ahead of print.ABSTRACTA 59-year-old female ex-smoker with 40 pack year smoking history and a 5-year current e-cigarette (EC) use history, presented with progressive dyspnea on exertion and daily cough for 2 months. A CT scan showed a consolidation area with air bronchogram in the middle lobe and non-calcific bilateral nodules, which could be attributed to community-acquired pneumonia. The patient was treated with empiric antibiotics and systemic steroids for 10 days. Infectious, neoplastic and autoimmune pathologies were excluded, whereas a broncho...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Authors: Source Type: research
Acta Cardiol. 2021 Dec 6:1-8. doi: 10.1080/00015385.2021.2010009. Online ahead of print.ABSTRACTOBJECTIVE: To investigate the association between epicardial and pericoronary adipose tissue thicknesses measured with computed tomography (CT) and severity of COVID-19 infection.METHODS: We recruited 504 patients admitted with RT-PCR-proven diagnosis of COVID-19 infection and underwent simultaneous Chest CT scanning. Epicardial adipose tissue thickness (EAT) and pericardial adipose tissue thickness (PCAT) were measured by CT. Comparisons were performed between ICU admitting and non-ICU admitting patients were performed.RESULTS:...
Source: Acta Cardiologica - Category: Cardiology Authors: Source Type: research
 Written by Pendell MeyersA man in his 50s presented to the ED with chest pain described as pressure, without radiation, acute onset about three hours prior to arrival. He had had stuttering less severe versions of this pain all week that usually went away after a few minutes. He also had diaphoresis and dyspnea. He had extensive family history of CAD with CABG's in the mid 50s for multiple relatives, but he had no personal known history of CAD. It is unclear whether he had pain at the time of triage, but notes describe that his pain had subsided by the time of EM physician evaluation:Triage at approximately 2130...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
The actual dose received during a computed tomography (CT) examination depends on both the patient size and the radiation output of the scanner. To represent the actual patient morphometry, a new radiation dose metric named size-specific dose estimates (SSDEs) was developed by the American Association of Physicists in Medicine in 2011. The purpose of this article is to review the SSDE concept and the factors influencing it. Moreover, the appropriate methodology of SSDE determination and the application of SSDE as a diagnostic reference-level quantity is critically analyzed based on the data available in the literatur...
Source: Journal of Radiological Protection - Category: Physics Authors: Source Type: research
ConclusionReference phantom selection is highly consistent, with a small but significant number of abdomen and chest scans (~5%) using 16-cm phantoms in younger children, which produces DLP values approximately twice as high as exams referenced to 32-cm phantoms
Source: Pediatric Radiology - Category: Radiology Source Type: research
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Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
ConclusionOur novel 3D printing-aided moulding workflow for elective cranioplasty with patient-specific PMMA implants proved to be an easily implementable alternative to solely manual implant moulding. The “springform” principle, focusing on reconstruction of the precraniectomy skull shape and perfect closure of the craniectomy defect, was feasible and showed excellent cosmetic results. The proposed method combines the precision and cosmetic advantages of computer-aided design (CAD) implants with the cost-effectiveness of manually moulded PMMA implants.
Source: Acta Neurochirurgica - Category: Neurosurgery Source Type: research
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