Methods:

The LUMA fiberoptic ARN-509 purchase light wire (Acclarent Inc.) and Vortex sinus irrigation catheter (Acclarent Inc.) were used to perform antral lavage as an adjunct in the treatment of pediatric sinusitis. Discussion: We found this method to have multiple advantages over other techniques of lavage. These advantages include: 1) confirmation of position in the maxillary sinus by transillumination, 2) improvement of the safety and accuracy of the lavage, 3) ability to balloon dilate the natural ostium and ethmoid infundibulum or to obtain cultures at the time of lavage if clinically warranted or indicated by CT evidence, 4) avoidance of radiation from the use of fluoroscopy associated with other balloon sinuplasty equipment and techniques, and 5) no alteration of normal anatomy.

Conclusion: We found this technique to give the surgeon a reliable, safe, versatile, and efficacious alternative before consideration of more invasive procedures in Use pediatric population with chronic sinusitis. (C)

2010 Elsevier Ireland Ltd. All rights reserved.”
“Background: Studies evaluating traumatic brain injury (TBI) patients have shown an association between EGFR inhibitor prehospital (PH) intubation and worse outcomes. However, previous studies have used surrogates, e. g., Glasgow Coma Scale (GCS) score <= 8 and Abbreviated Injury Severity Scale (AIS) score >= 3, which may overestimate the true presence of TBI. This study evaluated the impact of PH intubation in patients with

PH GCS score <8 and radiographically proven TBI.

Methods: Trauma patients routed to a Level I trauma center over a 3-year period with blunt injury and PH GCS score <= 8 were included. PH and in-hospital records were linked and head computed tomography scans were assigned a Marshall Selumetinib mw Score (MS). Patients with TBI (MS >1) were categorized into groups based on intubation status (PH, emergency department [ED], and no intubation). Comparisons were made using analysis of variance and chi(2) statistics. Mortality differences, crude and adjusted risk ratios (RRs), and 95% confidence intervals (CIs) were calculated using proportions hazards modeling.

Results: Of 334 patients with PH GCS score <= 8, 149 (50%) had TBI by MS. Among the TBI patients, 42.7% of patients were PH intubated, 47.7% were ED intubated, and 9.4% were not intubated during the initial resuscitation. Intubated patients had lower ED GCS score (PH: 4.1 and ED: 5.9 vs. 14.0; p < 0.0001) compared with patients not intubated. Also PH intubated patients had higher mean Injury Severity Score (38.0 vs. 33.7 vs. 23.5, p < 0.001) when compared with ED intubated and nonintubated patients. None of the nonintubated patients had a MS >2. Mortality for TBI patients who required PH intubation was 46.9% and 41.4% among ED-intubated patients. The crude RR of mortality for PH compared with ED intubation was 1.13 (95% CI, 0.