Articles: adult.
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Eur J Trauma Emerg S · Apr 2007
Pelvic Ring Fractures: Utility of Clinical Examination in Patients with Impaired Consciousness or Tracheal Intubation.
To define the diagnostic accuracy of clinical examination in patients with impaired consciousness or endotracheal intubation to detect pelvic ring fractures and to identify those with severe bleeding. ⋯ Clinical examination for stability of the pelvis in this selected group of patients missed a significant number of pelvic ring fractures including fractures that require surgical stabilization. The finding of a clinically unstable identifies most of the patients with the pelvic ring fracture being a major source of bleeding. A stable pelvis makes pelvic ring fracture as being the source of bleeding quite unlikely.
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Experimentally restricting dietary calories, while maintaining adequate dietary nutrient content, extends lifespan in phylogenetically diverse species; thus suggesting the existence of conserved pathways which can modify lifespan in response to energy intake. However, in some cases the impact on longevity may depend on the quality of the energy source. In Drosophila, restriction of dietary yeast yields considerable lifespan extension whereas isocaloric restriction of dietary sugar yields only modest extension, indicating that other diet-responsive pathways can modify lifespan in this species. ⋯ All these diet-induced changes were highly significant (log-rank p < 0.0001). Notably, all four diets resulted in considerably longer life spans than those typically reported for flies fed conventional yeast and sugar based diets. Such defined diets can be used to identify lifespan-modifying pathways and specific gene-nutrient interactions in Drosophila.
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Present a critical review of traumatic brain injury (TBI) in children and adolescents, focusing on severe TBI, the mortality and the factors related with poor outcome. ⋯ The factors related with better outcomes in children with severe TBI are still obscures, despite the large number of studies, large numbers of studies. Many of these factors can be avoided or correct by aggressive fluid resuscitation, surgery treatment, monitoration and adequate intensive care.
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Pediatr Crit Care Me · Mar 2007
CommentDo pediatric patients with septic shock benefit from steroid therapy? A critical appraisal of "Low-dose hydrocortisone improves shock reversal and reduces cytokine levels in early hyperdynamic septic shock" by Oppert et al. (Crit Care Med 2005; 33:2457-2464).
To review the findings and discuss the implications of studies on the use of low-dose corticosteroids in septic shock. ⋯ There is some, albeit limited, evidence for the benefit of low-dose steroids in adults with sepsis. No supporting data are available for the pediatric population; therefore, a randomized controlled trial in septic children is needed.