Rumours, Untruths Then Alpelisib

Матеріал з HistoryPedia
Версія від 15:08, 4 червня 2017, створена Drawer9parade (обговореннявнесок) (Створена сторінка: The rate of blunt cardiac injury in paediatric patients varies in the published literature from 0.8 to 43%.10, 11, 12, 13?and?14 None of these studies used card...)

(різн.) ← Попередня версія • Поточна версія (різн.) • Новіша версія → (різн.)
Перейти до: навігація, пошук

The rate of blunt cardiac injury in paediatric patients varies in the published literature from 0.8 to 43%.10, 11, 12, 13?and?14 None of these studies used cardiac TnI as the indicator of myocardial injury. In this pilot study with a convenient sample size, we demonstrated that 16/59 (27%) paediatric multi-system trauma patients admitted to the PCCU had elevated TnI levels, suggesting possible myocardial injury. To our knowledge, this is the largest series of paediatric trauma patients with elevated TnI levels reported. Patients with elevated TnI were more severely injured than patients with normal TnI levels, as they had a significantly higher mean ISS score. Furthermore, paediatric patients with elevated TnI levels were also more likely to have associated thoracic injuries than patients with normal TnI levels (94%), a finding consistent with enough blunt force energy to cause associated lung, pleural, and/or rib injuries. A link between elevated TnI Mannose-binding protein-associated serine protease and injury severity has been reported in adult trauma.18?and?21 The clinical significance of elevated TnI levels check details in adult trauma patients is an area of debate.3, 8, 17, 18, 19, 20, 21?and?22 There is a paucity of work examining this question in the paediatric trauma population. The only paediatric study that we are aware of, reported 5 of 7 paediatric patients with a high likelihood of cardiac contusion had detectable levels of TnI.25 Of those 5 patients, 3 had abnormal ECHOs and 1 had an abnormal ECG. In our study, we demonstrated only 16/59 paediatric trauma patients with elevated TnI. None of these patients had abnormalities on ECG and only 4/16 patients (25%) had abnormal ECHOs. Of the 4/16 patients with abnormal ECHOs, only 1 patient had a clinically significant, albeit mild, decrease in cardiac function. Of the other Alpelisib in vivo patients, 2 had trivial pericardial effusions with normal function and 1 had mild septal hypokinesis with normal function. This data suggests that the clinical relevance of elevated TnI in paediatric trauma patients, similar to adult patients, is somewhat unclear. Our findings are in agreement with others, which suggested elevated TnI levels may be released in minor, clinically insignificant cardiac injuries.20 Indeed, TnI demonstrates sensitivity in even the most trivial of injuries, but is rather non-specific.20 Moreover, it should be noted that in our series of patients with elevated TnI, the median peak was 0.39?��g/L. Although these levels are above published normals for this age group (