Figure 1 - available via license: Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International
Content may be subject to copyright.
-Pendulum-type device for TBI production. 1: Graded angular quadrant for measuring the launching angle; 2: System for supporting the axis, spindle and impact head (element), equipped with a rolling lag; 3: Graded angular quadrant for measuring the comeback angle; 4: Portal supporting structure; 5: Support and positioning systems for the lab rat; 6: Impact head. TBI: Traumatic brain injury.
Source publication
Traumatic brain injury (TBI) represents a public healthcare problem and a major economic burden, all over the world. It is estimated that every year, on the globe, there occur about two million severe TBI and over 42 million mild TBI. The main causes of TBI in civil population are fallings, followed by car accidents. In the last decades, the accele...
Contexts in source publication
Context 1
... device made for TBI production is composed of two lateral portal structures, necessary for the support of the pendulum and rigidity of the structure (Figure 1). ...
Context 2
... the equation considers the α and β angles, the actual calculation was performed by the calculation algorithms, presented below: (11) As can be seen, the energy formula was calculated at each β angle for each α angle, and the graphical results can be seen in the equation below. Calculations are made for the angular deviation between 0-180º: (12) Based on the result matrix above, the spatial graph of the impact energy can be realized (Figure 10, a and b). ...
Context 3
... the same time, the energy contour graph was evaluated according to the α and β angles (Figure 11). ...
Context 4
... microscopic examination showed that the largest lesions of the nervous system tissue from the brain hemispheres were recorded in the frontal lobe, where the traumatic impact was maximum. Here, there could be observed the presence of some complex lesions that affected the neurons (incipient neuronal apoptosis), glial cells (glial moderate reaction -reactive gliosis), blood vessels (vascular congestion, perivascular hemorrhages in the Virchow-Robin spaces, multiple diffuse, intraparenchymal hemorrhages) (Figures 12 and 13). (HE staining, ×100). ...
Context 5
... there could be observed the presence of some complex lesions that affected the neurons (incipient neuronal apoptosis), glial cells (glial moderate reaction -reactive gliosis), blood vessels (vascular congestion, perivascular hemorrhages in the Virchow-Robin spaces, multiple diffuse, intraparenchymal hemorrhages) (Figures 12 and 13). (HE staining, ×100). ...
Citations
... Discussions TBI is a major neurological problem reaching epidemic worldwide proportions nowadays [14,15]. Clinically, TBI occurs in different forms, from mild changes in the state of consciousness, to a deep coma state and death [16], depending on the violence of the individual contact with the traumatic agent. ...
Numerous studies showed that, at present, traumatic brain injury (TBI) is one of the main causes of death in young adults, but also a main cause of disabilities at all ages. For these reasons, TBI are continuously investigated. In our study, we evaluated the histopathological (HP) and immunohistochemical (IHC) changes that occurred in the brain in underage patients after a severe TBI depending on the survival period. We histopathologically and immunohistochemically analyzed a number of 22 cases of children, deceased in Dolj County, Romania, following some severe TBI, undergoing autopsy within the Institute of Forensic Medicine in Craiova between 2015-2020. Patients were divided into three groups depending on the survival period, namely: (i) patients who died during the first 24 hours of the accident; (ii) patients who died after seven days of survival; (iii) patients who died after 15 days of survival. Microscopic examinations of the brain fragments, collected during the necropsy examination, showed that the traumatic agent caused primary injuries in all brain structures (cerebral parenchyma, meninges, blood vessels). However, HP injuries ranged in size and intensity from one area to another of the brain. In patients with a longer survival period, there was observed the presence of smaller primary injuries and larger secondary injuries. There was also observed a growth in the number of meningo-cerebral microscopic injuries, depending on the increase of the survival period.
Objectives
This research aims to study the prognostic role of serum S100 as a predictor of mortality in vascular and traumatic brain injuries.
Methods
This prospective cohort study involved 219 patients. In the blood serum, neuron-specific markers (S100, NSE) and glucose, acid-base state and gas composition of arterial blood were obtained at admission, on the 3rd, 5th and 7th days of patients' stay in the intensive care unit.
Results
The most significant risk factor for an unfavorable outcome is the marker S100 with a cut-off point of 0.2 mcg/l. The analysis results indicate a statistically significant direct relationship between S100 > 0.2 mcg/l and NSE ≥ 18.9 ng/ml compared to other variables, while the chance ratio (OR) is 11.9 (95%CI:3.2927-1.6693;). With blood sugar increase above 7.4 mmol/l, the OR is 3.82 (95% CI: 2.1289-0.5539;); with a Glasgow scale below 13 points, the OR is 3.69 (95% CI: 2.1316-0.4819;); with an increase in pCO2 < 43.5 mm Hg, the OR was 3.15 (95% CI: 1.8916- 0.4062;). The obtained model certainty measure according to pseudo R2 Nagelkerke criterion is 263.5, showing the excellent quality of the mathematical model’s predictive ability. The developed prognostic model, including the dependent variable S100 and independent variables as predictors of a poor outcome of NSE, pCO2, GCS and Hb, reached a cut-off point of 84.51%, AUC - 0.88 with high levels of sensitivity and specificity: 91.89% and 64.14%, respectively.
Novelty
This model can be used to predict the outcome in patients with acute cerebral pathology.
