Background: Thorough record taking of traumatic dental injuries is vital. This study aimed to assess the efficacy of a structured paper history for this purpose. Furthermore, the aetiology and epidemiology of these injuries were investigated, with the aim of formulating appropriate preventive guidelines. Methods: A six-month audit of traumatic dental injuries presenting after hours was undertaken at The Children's Hospital at Westmead. A structured paper history form was subsequently created, and the data collected over the following 12 months. Results: Structured paper histories assisted in thorough record taking. Over 12 months, 190 paediatric patients (male: female ratio 1.5:1) were treated after hours with traumatic dental injuries. There were 396 injured teeth among 182 patients (eight patients had soft tissue injuries only). The mean number of injured teeth per patient with dental injuries was 2.18, the vast majority being maxillary central incisors (62% of primary teeth and 66% of permanent teeth). The most common cause was 'accident during play', followed by a fall. The severe injuries, avulsions and luxations, comprised 63% of injuries to primary teeth and 26% to permanent teeth. Conclusions: Structured paper histories are useful for recording traumatic dental injuries. The vast majority of these injuries are due to unavoidable accidents, rendering their prevention challenging from a public health perspective.
Background and Purpose The current study aimed to identify predictors of acute mortality after intracerebral hemorrhage (ICH), including voxel-wise analysis of hematoma location. Methods In 282 consecutive patients with acute ICH, clinical and radiological predictors of acute mortality were identified. Voxel-based lesion-symptom mapping examined spatial correlates of acute mortality, contrasting results in basal ganglia ICH and lobar ICH. Results Acute mortality was 47.9%. In bivariate analyses, one clinical (serum glucose) and two radiological (hematoma volume and intraventricular extension) measures significantly predicted mortality. The relationship was strongest for hematoma volume. Multivariable modeling identified four significant predictors of mortality (ICH volume, intraventricular extension, serum glucose, and serum hemoglobin), although this model only minimally improved the predictive value provided by ICH volume alone. Voxel-wise analysis found that for patients with lobar ICH, brain regions where acute hematoma was significantly associated with higher acute mortality included inferior parietal lobule and posterior insula; for patients with basal ganglia ICH, a large region extending from cortex to brainstem. Conclusions For patients with lobar ICH, acute mortality is related to both hematoma size and location, with findings potentially useful for therapeutic decision-making. The current findings also underscore differences between the syndromes of acute deep and lobar ICH.
Background and Purpose-Animal data suggest the use of -human chorionic gonadotropin followed by erythropoietin to promote brain repair after stroke. The current study directly translated these results by evaluating safety of this sequential growth factor therapy through a 3-center, single-dose, open-label, noncontrolled, Phase IIa trial. Methods-Patients with ischemic stroke 24 to 48 hours old and National Institutes of Health Stroke Scale score of 6 to 24 started a 9-day course of -human chorionic gonadotropin (once daily on Days 1, 3, and 5 of study participation) followed by erythropoietin (once daily on Days 7, 8, and 9 of study participation). This study also evaluated performance of serially measured domain-specific end points. Results-A total of 15 patients were enrolled. Two deaths occurred, neither related to study medications. No safety concerns were noted among clinical or laboratory measures, including screening for deep vein thrombosis and serial measures of serum hemoglobin. In several instances, domain-specific end points provided greater insight into impairments as compared with global outcome measures. Conclusions-Results
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