The authors' data suggest that statins may induce an antiinflammatory effect and may promote recovery after TBI. The role of statins in TBI therapy should be confirmed in larger clinical trials.

The serum levels of calcium on day three could be useful for the prediction of mortality in patients with moderate and severe TBI.

No abstract

Objectives: To identify the variables that predict the failure to treat amoebic liver abscesses. Methods: We prospectively carried out a case-control study on a cohort of patients who had been diagnosed with amoebic liver abscesses using clinical, ultrasonic, and serologic methods. Patients with pyogenic abscesses, negative ELISA tests for amoebiasis, immunosuppression status, or previous abdominal surgery were excluded. All patients received metronidazole, and those who demonstrated 4 days of unfavorable clinical responses received percutaneous or surgical draining of the abscess. Demographic, laboratory, and ultrasonographic characteristics were assessed as prognostic indications of failure. Results: Of 40 patients with amoebic liver abscess, 24 (mean age: 36.7611.2 years) responded to medical treatment and 16 (41.8611.6 years) required drainage, including 14 patients who underwent percutaneous drainage and two patients who required surgery. The albumin level, abscess volume, abscess diameter, and alkaline phosphatase level were all statistically significant (P,0.05) on the bivariate analysis. The highest (.99%) sensitivity and negative predictive value were observed for an abscess volume .500 ml and diameter .10 cm, while the best specificity and positive predictive value were achieved with the combination of low serum albumin level, high alkaline phosphatase level, and large abscess volume or diameter. Conclusions: The prognostic indications of the failure to treat amoebic liver abscesses include low albumin, high alkaline phosphatase, and large abscess volume or diameter. The combination of these variables is a useful and easy tool for determining appropriate therapy.

Background: Toxic or fulminant colitis due to Entamoeba histolytica infrequently presents but is very serious. Unfortunately, there are numerous contradictory factors related to mortality. Methods: We analyzed several cases of E. histolytica infection to determine the factors related to mortality. We included patients .15 years of age who were histopathologically diagnosed with amoebic toxic colitis and treated from January 2000 through December 2006. We evaluated demographic, clinical, laboratorial, surgical, and histopathological characteristics. Results: We examined 24 patients and recorded 12 deaths (50%). Twenty patients underwent surgery within a mean time of 24 hours (range: 8-120 hours). Tenesmus and intestinal perforation were determined to be statistically significant (P,0.05) by univariate analysis. Three models of logistic regression were able to determine three statistically significant factors that affected mortality: (1) tenesmus and a lymphocyte count ,1.5610 3 cell/ml; 2) depth of invasion beyond the mucosa and a lymphocyte count ,1.5610 3 cell/ ml; 3) time spent with symptoms and perforation. Conclusions: The mortality rate determined in this study is similar to previously reported series. A low lymphocyte count, significant depth of invasion, and intestinal perforation were determined to be the factors related to increased mortality, while tenesmus and limited amount of time spent with symptoms were associated with survival. Quick diagnosis and appropriate treatment are important factors that reduce mortality.