ABSTRACT
The aim of the study was to elucidate a relationship between the development of hypernatremia and the frequency of poor outcomes in children with severe brain injury (SBI). The retrospective study enrolled 77 children (54 boys and 23 girls) aged 1 month to 18 years, who had SBI in the period of January 2008 to September 2009, and were divided into 3 groups after treatment termination. The admission injury severity criterion was Glasgow coma scale (8 scores or less) rating. Group A comprised 51 children with SBI without hypernatremia; Group B included 14 children with SBI and hypernatremia. Group C consisted of 12 children with SBI, hypernatremia, and polyuremia. The latter group was appraised as a group with evolving central diabetes insipidus. A total of 26 (33.8%) patients had hypernatremia. Poor outcomes (Glasgow outcome scores of 1-3) at 30 days were noted in only Groups B and C: comparison of outcomes in Groups B and C showed the higher incidence of poor outcomes in 10 (84%) Group C patients (with hypernatremia and polyuria) and 4 (28%) children in Group B. Comparison of Groups B and C children indicated that the hazard ratio was 0.3. Therefore, the risk of poor outcomes is much higher in the development of central diabetes insipidous in the presence of hypernatremia.
Subject(s)
Brain Injuries/blood , Hypernatremia/blood , Sodium/blood , Adolescent , Antidiuretic Agents/administration & dosage , Antidiuretic Agents/therapeutic use , Brain Injuries/complications , Brain Injuries/physiopathology , Case-Control Studies , Child , Child, Preschool , Deamino Arginine Vasopressin/administration & dosage , Deamino Arginine Vasopressin/therapeutic use , Diabetes Insipidus, Neurogenic/blood , Diabetes Insipidus, Neurogenic/epidemiology , Diabetes Insipidus, Neurogenic/etiology , Diabetes Insipidus, Neurogenic/prevention & control , Female , Glasgow Coma Scale , Humans , Hypernatremia/epidemiology , Hypernatremia/etiology , Hypernatremia/prevention & control , Infant , Intracranial Pressure/drug effects , Intracranial Pressure/physiology , Male , Polyuria/blood , Polyuria/epidemiology , Polyuria/etiology , Polyuria/prevention & control , Predictive Value of Tests , Retrospective StudiesABSTRACT
The paper is concerned with the results of radiation and combined therapy of 122 patients with Stage III-IV laryngeal cancer, divided into 2 groups: 74 controls and 48 patients of the study group. The patients of the study group received radiotherapy in combination with local administration of 5% solution of metronidazole in dimethyl sulfoxide. According to biopsy findings, the average concentration of metronidazole in tumor was 569.5 +/- 196 micrograms/g. Therapeutic results were evaluated by the degree of expression of tumor radiation injury and by direct and short-term results. A statistically significant increase in the frequency of Stage IV tumor radiation injury from 31.1 +/- 5.4% in the control group to 58.3 +/- 7.2% in the study group (P less than 0.05) was revealed. The direct and short-term therapeutic results indicate an increase in tumor radiation injury in the patients of the study group.
