• • Part of the book series (AISC, volume 772) Abstract CT scan is strongly recommended for a patient affected by head trauma, but he/she must absorb a certain amount of radiations. For this reason, the physician tries to avoid such a practice for pediatric patients. The symptoms analysis, visual/tactile inspection, and reactions to appropriate stimuli from the physician could induce him/her to put the patient in a period of observation instead of performing an immediate CT scan. As a consequence, the correct evaluation of those symptoms is a crucial task.

For this reason, the Pediatric Glasgow Coma Scale (PGCS) plays a fundamental role, because it is a numeric scale regarding the patient’s mental status. It is computed as the sum of the score for the eye, motor and verbal response evaluated by the physician. In this paper, the Principal Component Analysis (PCA) is performed on the PGCS of the Trauma Brain Injury (TBI) dataset collected by the PECARN (Pediatric Emergency Care Applied Research Network).

The PCA is performed in all cases when the sum of the three partial scores results in a value less than 14, because a patient with PGCS = 15 is not considered at risk. Under this constraint, the PCA reveals that each partial GCS give the same contribution to the first principal component, but a scale variation is introduced. Cite this paper as: Gambino O., India A., Sciandra M., Pirrone R. (2019) A PCA Interpretation of the Glasgow Coma Scale in the Trauma Brain Injury PECARN Dataset.

Download signpost maths 10 52 pdf free. Child’s Glasgow Coma Scale Revised BPNA 2001. The Child’s Glasgow Coma Scale has evolved from adaptations to Jennett and Teasdale’s Glasgow Coma Scale (1), by James and Trauner (2), Eyre and Sharples and by Tatman, Warren and Whitehouse (3), and paediatric nurse colleagues, Kirkham. GCS.PDF Author: Unknown.

In: Barolli L., Javaid N., Ikeda M., Takizawa M. (eds) Complex, Intelligent, and Software Intensive Systems. Advances in Intelligent Systems and Computing, vol 772.

Springer, Cham • First Online 19 June 2018 • DOI • Publisher Name Springer, Cham • Print ISBN 978-3-319-93658-1 • Online ISBN 978-3-319-93659-8 • eBook Packages • •.

Background Danger associated molecular patterns (DAMPs) are nuclear or cytoplasmic proteins that are released from the injured tissues and activate the innate immune system. Mitochondrial DNA (mtDNA) is a novel DAMP that is released into the extracellular milieu subsequent to cell death and injury. We hypothesized that cell death within the central nervous system in children with traumatic brain injury (TBI) would lead to release of mtDNA into the cerebrospinal fluid (CSF) and has the potential to predict the outcome after trauma. Results The median age for patients with TBI was 6.3 y and 62% were male. The common mechanisms of injury included motor vehicle collision (35.8%) followed by falls (21.5%) and inflicted TBI (19%); 6 children (14.2%) died during their ICU course. The mean CSF mtDNA concentration was 1.10E +05 ± 2.07E+05 and 1.63E+03 ± 1.80E+03 copies/µL in the pediatric TBI and control population respectively.

Furthermore, the mean CSF mtDNA concentration in pediatric patients who later died or had severe disability was significantly higher than that of the survivors (1.63E+ 05 ± 2.77E+05 vs. 5.05E+04 ± 6.21E+04 copies/µL) ( p. Introduction Severe traumatic brain injury (TBI) accounts for 25% of all TBI and exacts a considerable societal and economic toll (, ).

According to the Centers for Disease Control and Prevention, TBI accounts for an estimated 7400 deaths in children 0–19 years of age annually (). The pro-inflammatory cytokine response after TBI has been fairly well characterized (–) and recently the role of damage-associated molecular patterns (DAMPs, also known as alarmins) has also been recognized.

The pattern recognition receptors (PRRs) present on the microglia and astrocytes can sense cellular damage and stress in the absence of infection due to the presence of DAMPs. DAMPs are rapidly released into the extracellular milieu following injury and modulate the innate immune system. Some examples of DAMPs include nuclear and cytoplasmic proteins e.g., high mobility group box 1 (HMGB1), heat shock proteins, the S100 family of calcium-binding proteins, histones, and interleukin 1 (IL-1) family members (, ). HMGB1 is a prototypical danger associated molecular patterns (DAMP) molecule that activates the innate immune system in response to tissue injury due to trauma, ischemia/reperfusion or infection (). HMGB1 exerts pro-inflammatory properties through its effects on Toll-like receptor (TLR) -2, -4 and the receptor for advanced glycation end products (RAGE) (, –), and it has been identified as a late mediator of LPS-induced mortality in mice (, ). Previously, we reported that cerebrospinal fluid (CSF) levels of HMGB1 are markedly increased in children after severe TBI. We also demonstrated that peak HMGB1 levels are inversely and independently associated with Glasgow Outcome Scale (GOS) scores.