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“Background: Brain tissue oxygenation (PbtO(2))-guided management facilitates treatment of reduced PbtO(2) episodes potentially conferring survival and outcome advantages in severe traumatic brain this website injury (TBI). To date, the nature and effectiveness of commonly used interventions in correcting compromised PbtO(2) in TBI remains unclear. We sought to identify the most common interventions used in episodes of compromised PbtO(2) and to analyze which were effective.

Methods: A retrospective 7-year review of consecutive severe TBI patients

with a PbtO(2) monitor was conducted in a Level I trauma center’s intensive care unit or neurosurgical registry. Episodes of compromised PbtO(2) (defined as < 20 mm Hg for 0.25-4 hours) were identified, and clinical interventions conducted during these episodes were analyzed. Response to treatment was gauged on how rapidly (Delta T) PbtO(2) normalized (> 20 mm Hg) and how great the PbtO(2) increase

find more was (Delta PbtO(2)). Intracranial pressure (Delta ICP) and cerebral perfusion pressure (Delta CPP) also were examined for these episodes.

Results: Six hundred twenty-five episodes of reduced PbtO(2) were identified in 92 patients. Patient characteristics were: age 41.2 years, 77.2% men, and Injury Severity Score and head or neck Abbreviated Injury Scale score of 34.0 +/- 9.2 and 4.9 +/- 0.4, respectively. Five interventions: narcotics or sedation, pressors, repositioning, FIO(2)/PEEP increases, and combined sedation or narcotics + pressors were the most commonly used strategies. Increasing the number of interventions resulted in worsening the time to PbtO(2) correction. Triple combinations resulted in the lowest Delta ICP and dual combinations in the highest Delta CPP (p < 0.05).

Conclusion: Clinicians use a limited number of interventions when correcting

compromised PbtO(2). Using strategies employing many interventions administered closely together may be less effective in correcting PbO(2), selleck screening library ICP, and CPP deficits. Some PbtO(2) deficits may be self-limited.”
“Objective. The application and subsequent investigations in the use of varied osteogenic growth factors in bone regeneration procedures have grown dramatically over the past several years. Owing to this rapid gain in popularity and documentation, a review was undertaken to evaluate the in vivo effects of growth factors on bone regeneration.

Study Design. Using related key words, electronic databases (Medline, Embase, and Cochrane) were searched for articles published from 1999 to April 2010 to find growth factor application in bone regeneration in human or animal models.

Results. A total of 63 articles were matched with the inclusion criteria of this study. Bone morphogenetic protein 2 (BMP-2) was the most studied growth factor. Carriers for the delivery, experimental sites, and methods of evaluation were different, and therefore articles did not come to a general agreement.