No abstract

A comprehensive diagnostic evaluation was administered to 162 closed head-injured patients within 1 to 21 days (mean, 7.5 days) after injury. Each evaluation consisted of (1) power spectral analyses of electroencephalogram (EEG) recorded from 19 scalp locations referenced to age-matched norms, (2) brainstem auditory evoked potentials, (3) computed tomography (CT)-scan, and (4) Glasgow Coma Score (GCS) at time of admission (GCS-A) and at time of EEG test (GCS-T). Functional outcome at one year following injury was assessed using the Rappaport Disability Rating Scale (DRS), which measures the level of disability in the six diagnostic categories of (1) eye opening, (2) best verbal response, (3) best motor response, (4) self-care ability for feeding, grooming, and toileting, (5) level of cognitive functioning, and (6) employability. The ability of the different diagnostic measures to predict outcome at one year following injury was assessed using stepwise discriminant analyses to identify patients in the extreme outcome categories of complete recovery versus death and multivariate regression analyses to predict patients with intermediate outcome scores. The best combination of predictor variables was EEG and GCS-T, which accounted for 74.6% of the variance in the multivariate regression analysis of intermediate outcome scores and 95.8% discriminant accuracy between good outcome and death. The best single predictors of outcome in both the discriminant analyses and the regression analyses were EEG coherence and phase. A gradient of prognostic strength of diagnostic measures was EEG phase greater than EEG coherence greater than GCS-T greater than CT-scan greater than EEG relative power. The value of EEG coherence and phase in the assessment of diffuse axonal injury was discussed.

Fifteen adult patients, admitted to Baragwanath Hospital ICU with septic shock after adequate fluid loading and on no other inotropic agents, were given adrenaline in incremental doses. Oxygen transport and haemodynamic variables were monitored with each dose increment until a systolic blood pressure of 120 mmHg was obtained. This was reached on an average dose of adrenaline of 0.16±0.02 μg/kg/min. Mean arterial blood pressure increased by 22±2 mmHg mainly due to an increase in cardiac index (1±0.2 l/min/m2) and systemic vascular resistance index (130±41 dyn.s.cm.-5m-2) with a small increase in heart rate of 8±3 beats per minute. Oxygen delivery was increased with no significant increase in oxygen consumption and lactate levels increased. Adrenaline is therefore an effective initial inotropic agent. Patients may respond to lower doses than when used concurrently with other inotropic agents but there was still a significant dose variation in response. We cannot, however, exclude a deleterious effect on oxygen utilization.

This article presents the research studies aimed at identifying the behavior of expanded polystyrene with the addition of graphite in the conditions of exposure to solar radiation. For this purpose, a series of in situ tests and laboratory studies were carried out. Three types of material were tested, i.e. expanded polystyrene (EPS) (white polystyrene), polystyrene with the addition of graphite (gray polystyrene) and two-layer polystyrene (gray bottom layer and white top layer). Temperature distributions on the surfaces of the panels in field and laboratory conditions were determined. The distributions of temperature were recorded at varied wind impact (field conditions and laboratory conditions) and at varied impact of solar radiation (laboratory conditions). Based on the conducted experiments, differences in temperature distribution on the surfaces of the tested panels were determined. In addition, geometric changes and deformation levels of the tested white and gray expanded polystyrene panels exposed to artificial sun radiation were determined in laboratory conditions.