RESUMEN
BACKGROUND: Diffuse axonal injury (DAI) is a common type of traumatic brain injury, mostly associated with mild changes on computed tomography (CT) scan. Serum biomarkers might be used in the diagnosis and prognosis of this injury type. Our purpose was to determine temporal profile and predictive values of serum concentrations of protein S100BB and neuron-specific enolase (NSE) after DAI. METHODS: Twenty-eight isolated severe DAI patients (Glasgow Coma Scale score ≤ 8) with normal CT were enrolled in the study. Serum levels of S100BB and NSE were determined at 6 hours, 24 hours, 48 hours, and 72 hours after injury, using enzyme-linked immunosorbent assay. Clinical outcome variables of DAI comprised survival at discharge and Glasgow Outcome scale (GOS) after 3 months and also 2 years. RESULTS: S100BB concentration was maximum in 6 hours after injury (median = 280.75 ng/L) followed by a quick drop. Its value was significantly higher on third day in patients with unfavorable outcome (GOS score = 1-3) versus favorable outcome (GOS score = 4, 5) (p < 0.0001). The values of NSE had mild changes during 3 days; however, these measured values at 72 hours after trauma manifested higher in unfavorable outcome (p < 0.05). CONCLUSIONS: Increased serum concentrations of NSE and S100BB within first 3 days after DAI are associated with poor outcome despite mild CT findings. S100BB level at 72 hours after injury can predict late outcome in DAI patients. LEVEL OF EVIDENCE: Prognostic study, level III.
Asunto(s)
Lesión Axonal Difusa/enzimología , Factores de Crecimiento Nervioso/metabolismo , Fosfopiruvato Hidratasa/metabolismo , Proteínas S100/metabolismo , Adolescente , Adulto , Factores de Edad , Biomarcadores/análisis , Biomarcadores/metabolismo , Lesiones Encefálicas/complicaciones , Lesiones Encefálicas/diagnóstico , Lesiones Encefálicas/enzimología , Estudios de Cohortes , Lesión Axonal Difusa/diagnóstico por imagen , Lesión Axonal Difusa/etiología , Lesión Axonal Difusa/mortalidad , Ensayo de Inmunoadsorción Enzimática , Femenino , Escala de Coma de Glasgow , Humanos , Puntaje de Gravedad del Traumatismo , Masculino , Persona de Mediana Edad , Factores de Crecimiento Nervioso/análisis , Fosfopiruvato Hidratasa/análisis , Valor Predictivo de las Pruebas , Pronóstico , Curva ROC , Estudios Retrospectivos , Medición de Riesgo , Subunidad beta de la Proteína de Unión al Calcio S100 , Proteínas S100/análisis , Sensibilidad y Especificidad , Factores Sexuales , Tasa de Supervivencia , Tomografía Computarizada por Rayos X/métodos , Adulto JovenRESUMEN
BACKGROUND: One of the important factors in the ensuing safety of blood transfusion is to use a sensitive screening assay for detection of blood-born infective agents such as HBV which transmits through transfusion. To improve the detection rate of HBV infection in blood donors, a cross-sectional study was conducted in Rasht, which is the largest city in the north of Iran to explore the possibility of using anti-HBc as a screening test. STUDY DESIGN AND METHODS: A total of 2041 blood samples negative for HBsAg, Anti-HCV, Anti-HIV I, II and RPR were tested to detect anti-HBc and then the positive anti-HBc samples were further checked for the presence of HBV DNA. RESULTS: The prevalence of anti-HBc positive samples was 3.8% and HBV DNA was detected in only one sample. CONCLUSIONS: This study showed that anti-HBc positive blood donors may be a source of HBV transmission and further study for evaluation of HBV DNA in anti-HBc positive blood units is needed.
