RESUMO
BACKGROUND: We investigated low-grade, hemodynamically normal BHI associated with any of three interventions indicating ICU observation. METHODS: BHI between 01/01/96-6/30/14 were reviewed. Two groups included: Group A (BHI grades 1-3) with normal initial systolic BP and Group B (all other BHI). Interventions necessitating ICU observation were defined with three criteria: PRC transfusion within 24 h, angiography, or laparotomy. Between group and Group A subgroup outcomes were reported. RESULTS: Group A (n = 1088) had lower ISS, LOS, PRCs transfused, and mortality (p < 0.01) than Group B (n = 636). For any of the criteria indicating ICU admission, Group A had a NPV, sensitivity and specificity of 67.9%, 30.3%, and 75.3% respectively; isolated BHI (n = 188) sensitivity, specificity and NPV were 17.8%, 88.1%, and 77.3%. Laparotomy specifically for BHI was 2.0% for Grade I/II, 4.3% for Grade III subgroups. CONCLUSIONS: Hemodynamic stability is insufficient as a sole criterion for safe admission of low-grade BHI to a non-ICU environment.
Assuntos
Unidades de Terapia Intensiva , Fígado/lesões , Monitorização Fisiológica , Ferimentos não Penetrantes/diagnóstico por imagem , Ferimentos não Penetrantes/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia , Transfusão de Sangue/estatística & dados numéricos , Criança , Feminino , Hemodinâmica , Humanos , Laparotomia , Masculino , Pessoa de Meia-Idade , TexasRESUMO
Several disubstituted arylene- and chloroambucil-polyamine conjugates were synthesized and evaluated for their ability to target cells via their polyamine transport system (PAT). As compared to the monosubstituted analogues, the disubstituted arylene systems were superior PAT targeting agents. Using a Chinese hamster ovary (CHO) cell line (PAT active) and its CHO-MG mutant (PAT inactive), the series was screened for their PAT targeting ability. The data were expressed as a CHOMG/CHO IC 50 ratio. Indeed, the disubstituted systems gave high IC 50 ratios (e.g., ratio > 2000), which indicated high selectivity for the PAT. The chloroambucil adducts were less toxic than the corresponding arylmethyl compounds. In this regard, having the proper recognition element (i.e., homospermidine) and cytotoxic "cargo" were deemed paramount for successful drug delivery via the PAT.