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Biomedical subjects

C Mattice

Publications and source records attributed to C Mattice.

7 recordsLinked to original sources
PubMed1995

Failure of methylprednisolone to improve the outcome of spinal cord injuries.

The infusion of methylprednisolone (MP) within 8 hours of injury for spinal cord injuries (SCI) has been advocated to improve the motor function of patients after this catastrophic injury. However, clinical improvement in the outcome of SCI has not been consistently identified, despite the use of MP. We reviewed the outcome of SCI patients with MP to those without MP (No-MP) at two Level I Trauma Centers from 1989-1992. Acute SCI patients were identified from the trauma registries with trauma demographics and hospital data obtained from registry and medical records. Rehabilitation data for Functional Independence Measure (FIM) was obtained from the rehabilitation institute database. Primary outcome parameters were mortality, and for survivors, patient mobility (6 point scale) and FIM scores. There were 145 acute SCI patients: 80 treated with MP and 65 with No-MP. FIM data was available on 45 MP and 25 No-MP patients. There was no difference in the admission trauma score, ICU length of stay (LOS), or hospital LOS between the two groups. The MP patients were significantly younger (30 years vs 38 years, P = < 0.05) and had lower ISS scores (24 vs 31, P = < 0.05). There was no statistically significant difference in mortality (MP, 3.8% vs No-MP, 10.7%) between the two groups. Although admission mobility was not statistically different (MP, 5.99 vs No-MP, 5.90), there was a significantly poorer discharge mobility in the MP group when compared to the No-MP group (MP, 5.16 vs No-MP, 4.67, P = < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Inter-rater reliability for scoring periodic leg movements in sleep.

This study investigated inter-rater reliability for scoring periodic leg movements in sleep (PLMS) and related phenomena. Five highly experienced polysomnographic technologists each scored 24 nocturnal polysomnograms, the majority of which contained an appreciable number of PLMS. Results indicated high inter-rater reliability for some variables but more modest reliability for others. We discuss these findings in terms of efforts of standardization in polysomnographic scoring of sleep disorders.

Aged↗
PubMed1985

Effect of sleep state and position on the incidence of obstructive and central apnea in infants.

Sixty-four infants with a history of apnea were studied to determine the effects of sleeping position and sleep state (rapid eye movement [REM]) v (non-rapid eye movement [NREM]) on the occurrence of central and obstructive apneas. All-night polysomnographic studies were conducted on each infant, and the spontaneous occurrence of central and obstructive apneic events was determined in the prone, supine, and side positions. Sleeping position did not significantly affect the rate or duration of central or obstructive apneas. Furthermore, neither central nor obstructive apneic episodes were significantly altered by sleep state. These data suggest that, in spite of an ostensible predisposition to upper airway obstruction in the supine position and during rapid eye movement sleep, neither sleeping position nor sleep state appears to affect the rate of duration of apneic events.

Age Factors↗
PubMedDate not supplied

Accuracy of the Prehospital Index in identifying major hemorrhage in trauma victims.

PURPOSE: To determine the sensitivity of the Prehospital Index (PHI) in identifying patients with severe blood loss, a one-year review was conducted at a regional trauma facility. METHODS: The study population consisted of 217 consecutive trauma admissions (ages 3 to 88 years). Patients were managed using standard resuscitation techniques; blood transfusions were ordered at the discretion of attending physicians and did not follow any preplanned protocol. Medical records were examined to determine total blood requirements for each patient during the first 12 hours of hospitalization, the emergency department (ED) disposition, and final outcome of treatment. The following clinical variables were analyzed (unpaired t-test) to determine their value as predictors of blood loss: age, gender, mechanism of injury, initial vital signs, revised trauma score, PHI, and injury severity score. RESULTS: Forty-two percent (92 patients) received transfusions during the first 12 hours of hospitalization. The best predictor of blood loss was the Prehospital Index. Of the total group, 45% had a PHI greater than 3; 77% (75/98) of these patients required transfusion and received an average of 7.1 units of packed cells. Fifty-five percent (119/217) had a PHI less than or equal to 3; 86% (102/119) of these patients did not require transfusion. CONCLUSION: The data suggest that patients with PHI scores greater than 3 require close hemodynamic monitoring to rule out significant blood loss and may warrant immediate cross-matching on arrival to the ED.

Adolescent↗
PubMedDate not supplied

Assuring trauma system quality by outcomes reporting in two voluntary regional trauma networks.

1. Providing optimal trauma care for large populations requires the collaboration and cooperation of hospitals providing all levels of care. 2. Those who are seriously injured or who have complex injuries requiring special resources are to be referred in a timely fashion to a trauma center capable of providing optimal care. 3. In two regional trauma networks, 24% of injured patients were referred to a trauma center for definitive care. Overall survival was excellent.

Health Services Research↗