Comparison of the predictive value of the Helsinki, Rotterdam, and Stockholm CT scores in predicting 6-month outcomes in patients with blunt traumatic brain injuries

PURPOSE

Despite advances in modern medicine, traumatic brain injuries (TBIs) are still a major medical problem. Early diagnosis of TBI is crucial for clinical decision-making and prognosis. This study aims to compare the predictive value of Helsinki, Rotterdam, and Stockholm CT scores in predicting the 6-month outcomes in blunt TBI patients.

METHODS

This cohort study was conducted on blunt TBI patients of 15 years or older. All of them were admitted to the surgical emergency department of Shahid Beheshti Hospital in Kashan, Iran from 2020 to 2021 and had abnormal trauma-related findings on brain CT images. The patients' demographic data such as age, gender, history of comorbid conditions, mechanism of trauma, Glasgow coma scale, CT images, length of hospital stay, and surgical procedures were recorded. The Helsinki, Rotterdam, and Stockholm CT scores were simultaneously determined according to the existing guidelines. The included patients' 6-month outcome was determined using the Glasgow outcome scale extended. M Data were analyzed by SPSS software version 16.0. Sensitivity, specificity, negative/positive predictive value and the area under the receiver operating characteristic curve were calculated for each test. The Kappa agreement coefficient and Kuder Richardson-20 were used to compare the scoring systems.

RESULTS

Altogether 171 TBI patients met the inclusion and exclusion criteria, with the mean age of (44.9 ± 20.2) years. Most patients were male (80.7%), had traffic related injuries (83.1%) and mild TBIs (64.3%). Patients with lower Glasgow coma scale had higher Helsinki, Rotterdam, and Stockholm CT scores and lower Glasgow outcome scale extended scores. Among all the scoring systems, the Helsinki and Stockholm scores showed the highest agreement in predicting patients' outcomes (kappa = 0.657, p < 0.001). The Rotterdam scoring system had the highest sensitivity (90.1%) in predicting death of TBI patients, whereas the Helsinki scoring system had the highest sensitivity (89.8%) in predicting the 6-month outcome in TBI patients.

CONCLUSION

The Rotterdam scoring system was superior in predicting death in TBI patients, whereas the Helsinki scoring system was more sensitive in predicting the 6-month outcome.

Effects of leached components from silorane and methacrylate-based dental composites on the male mice reproductive system

BACKGROUND

This study aimed to investigate the potential toxic effects of leached components from either a methacrylate-based composite (Filtek Z250) or a silorane-based composite (Filtek P90) on the male mice reproductive system.

METHODS

Sixty adult Syrian male mice were divided into six groups. In test groups, leached components from composite specimens in artificial saliva or 75% aqueous ethanol solution were administered intragastrically daily for 28 days. The mice were then euthanized and the following reproductive parameters recorded: body weight changes; weight of paired testes; testis volume; Gonadosomatic Index (GSI); sperm motility; sperm viability; daily sperm production and epididymal sperm count.

RESULTS

There were no significant differences in body weight changes, weight of paired testes, GSI, testis volume, epididymal sperm count, and daily sperm production between groups. Sperm motility and sperm viability were significantly lower in all the test groups in comparison to the control groups. In addition, they were significantly lower in the test groups in which composite samples were immersed in aqueous ethanol solution.

CONCLUSIONS

Within the limitations of this study, the present data indicate that leached components from dental composites could affect sperm quality and therefore could potentially cause adverse effects on the male mice reproductive system.

Evaluation of Bis-GMA/TEGDMA monomers leaching from a hybrid dental composite resin

AIM

Postcuring elution of unreacted monomers has harmful effects on mechanical characteristics and biocompatibility of resin composite restorations. The purpose of this study was to evaluate the amount of eluted Bis-GMA and TEGDMA monomers from a hybrid dental composite cured with LED or halogen curing unit after immersing in saliva or water.

METHODS

Thirty-six composite disc specimens (Hybrid Filtek Z250,3M-ESPE, USA) were made and divided in four groups. After polymerization with LED or halogen curing units, samples were immersed in water or saliva for 24 hours. The amounts of each monomer (Bis-GMA and TEGDMA) released in different mediums were detected by high-performance liquid chromatography (HPLC). Data were analyzed with two-way ANOVA and one-way ANOVA tests.

RESULTS

The samples were immersed in water, in both curing methods, released significantly more Bis-GMA than TEGDMA (P<0.05). The total monomers eluted was higher in samples cured with halogen curing unit than LED (P=0.001); in addition, saliva caused elution of more monomer than water (P=0.007).

CONCLUSION

In conclusion, chemical property of monomers, power of curing light unit and the type of immersion media play key roles in the quantity of eluted monomers from composite resins. Saliva and halogen curing unit can cause greater monomer leaching from hybrid resins composite.