RESUMO
BACKGROUND: To determine factors predicting outcome of patients with severe head injury, the authors retrospectively analyzed 81 patients, 3 to 70 years of age, who were treated by hypothermia. METHOD: The initial Glasgow Coma Scale scores of the 81 patients ranged from 3 to 8. Outcome in each case was determined at six months after injury and was retrospectively analyzed with respect to patient characteristics, initial clinical status, laboratory data, computed tomographic findings, data from monitoring, intra-operative findings, and treatment methods. The significance of clinical and neuroradiological factors for predicting unfavorable outcome was analyzed by univariate logistic regression. Stepwise multiple logistic regression analysis was then used to identify independent predictors of outcome. FINDINGS: Favorable outcome was observed in 27 of 81 patients treated by hypothermia. Independent factors predicting unfavorable outcome included pupillary abnormality on admission and brain bulging during surgery. INTERPRETATION: Therapeutic effectiveness of hypothermia was thus limited in patients who presented with these grave symptoms.
Assuntos
Edema Encefálico , Traumatismos Craniocerebrais/patologia , Hipotermia Induzida , Distúrbios Pupilares/etiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Traumatismos Craniocerebrais/classificação , Traumatismos Craniocerebrais/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Distúrbios Pupilares/patologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Resultado do TratamentoAssuntos
Cistos Odontogênicos/patologia , Palato/patologia , Adulto , Idoso , Feminino , Humanos , Masculino , Doenças Maxilares/patologia , Pessoa de Meia-IdadeRESUMO
A new nonsteroidal anti-inflammatory agent, fentiazac, was used for analgesia after tooth extractions and minor oral surgery in two Japanese dental hospitals. The drug was administered as a single oral dose of either 50 mg or 100 mg. The 50-mg dose provided rapid analgesic effect, but its effect lasted only two to three hours in a number of patients. At a dose of 100 mg, fentiazac proved effective for 85% of 53 patients, usually providing marked reduction of disappearance of pain within one hour or less. Among patients in whom pain reappeared, the mean time for recurrence was four hours, indicating a satisfactory duration of analgesic effect. One side effect--loss of appetite--was reported by one patient in the entire series of 71 subjects. It is concluded that fentiazac is a highly effective analgesic agent with a wide margin of safety for use after dental procedures that produce pain.
