No abstract

A B S T R A C TObjective: To evaluate whether the shock index (SI), given by the formula SI = heart rate/systolic blood pressure (HR/SBP), is useful for predicting mortality at 24 h in trauma patients admitted to the emergency department of a university hospital in Colombia. Methods: A database of trauma patients admitted between January 2013 and December 2013 was constructed; the result according to the shock index was determined, generating a dichotomous variable with two groups: Group A (SI < 0.9) and Group B (SI > 0.9). Univariate analysis was performed. Results: A total of 666 patients were analyzed, 83.3% (555) had SI < 0.9, and 16.7% (111) SI > 0.9. The mean age for Groups A and B was 32.4 and 35.4 respectively. The average injury severity score for both groups was 9.6 and 17.6 respectively. Mortality at 24 h after injury for both groups was 3.1% (P = 0.032) and 59.5% (P = 0.027) respectively. Conclusions: An initial shock index greater than 0.9 implies a worse prognosis 24 h after injury. The shock index predicts mortality in multiple trauma patients in the emergency department, and is also a quick and applicable in all hospital.

El trauma craneoencefálico (TCE) es una patología médico-quirúrgica caracterizada por una alteración cerebral secundaria a una lesión traumática en la cabeza generando un daño estructural del contenido de ésta, incluyendo el tejido cerebral y sus vasos sanguíneos. La incidencia es de 200 personas por cada 100.000 habitantes, la etiología más frecuente son los accidentes de tránsito (70%), seguidos de hechos violentos y/o caídas desde su propia altura dependiendo del área geográfica en el que se encuentre. En esta revisión, se explicarán las lesiones primarias, secundarias, terciarias, el deterioro retardado, los tipos de hipertensión endocraneana y las lesiones específicas como fisiopatología del TCE, así como la evaluación clínica e imagenológica de las lesiones y su adecuado tratamiento.

Mated CD-1 mice were exposed to 20-kHz sawtooth magnetic fields similar to those associated with video display terminals (VDT). Four groups of animals were continuously exposed from day 1 to day 18 of pregnancy to field strengths of 0, 3.6, 17, or 200 microT. There were no less than 185 mated dams in each exposure group. On day 18, the dams were sacrificed and assessed for weight gain and pregnancy. The litters were evaluated for numbers of implantations, fetal deaths and resorptions, gross external, visceral and skeletal malformations, and fetal weights. There were no less than 140 pregnant females in each group, and there were no significant differences between any of the exposure groups and the sham group (0 microT) for any of the end points. The results of this study do not support the hypothesis that the 20-kHz VLF magnetic fields associated with video display terminals are teratogenic in mammals.

DC for neurotrauma with ECD is an option to improve survival and favourable neurological outcomes 12 months after injury in patients with penetrating traumatic brain injury treated in a university hospital with few resources for ICU neuro-monitoring.