DC reduces ICP in pediatric patients with traumatic brain injury. The mortality rate is low and long-term prognosis in survivors is good. Complications related to surgery are frequent. Wide craniectomy with duraplasty seems to be the most common technique. Defining the most appropriate indications and timing for DC in pediatric patients should be the objective of future prospective studies.
The authors review eight cases of thalamic tumors in children. Radical surgery was performed in seven cases. All cases were diagnosed by computed tomographic scanning, and histological diagnosis showed seven benign astrocytomas and one malignant astrocytoma. All patients are still alive. The treatment of these tumors is discussed.
A case of tension pneumocephalus that occurred after ventriculoperitoneal shunting is presented. We have reviewed 12 cases of pneumocephalus in association with ventriculoperitoneal shunt placement. This phenomenon occurs when air is forced through the shunt or enters through the cranial base because of: iatrogenic postsurgical connection, congenital fistula, trauma, or thinning of the cranial base. Ways of preventing and treating this problem are outlined.
Background: CD4+ lymphocyte count, measured through flow cytometry, is necessary for the following up of HIV-infected patients in antiretroviral therapy, however, the access to this test is limited in low-income countries. The objective of this investigation is to develop a mathematical methodology that allows to temporarily predict CD4+ values greater than 500, between 200 and 500, lesser than 200 for each patient.
Methods: values of the populations of CD4+ lymphocytes greater than 500, between 200 and 500 and lesser than 200 cells and leukocytes in 250 patients were taken in sequential dates and combinations of the ranges. Temporal series of 12 prototypical patients were analyzed in search of predictive patterns, and then, these patterns were applied in the remaining patients in a blind study, finding the probability of success of the methodology for each range and its combinations, as well as sensitivity and specificity values.
Results: five patterns with predictive percentages greater than 99% were found for the distinct conditions of the methodology, with values of sensitivity and specificity of 99%.
Conclusions: through a predictive theoretical simplification a temporal self-organization was established for the measurements of leukocytes and CD4+ lymphocytes, which could be useful to improve the surveillance and survival of patients.
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