scholarly journals Renal Trauma in the West of Ireland — A Regional Review

2009 ◽  
Vol 9 ◽  
pp. 137-143 ◽  
Author(s):  
O. A. Raheem ◽  
M. S. Floyd ◽  
R. G. Casey ◽  
I. M. Cullen ◽  
M. O. Corcoran ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Renal Trauma ◽  
The West ◽  
Patient Demographics ◽  
Emergency Department Management ◽  
Improve Patient ◽  
Renal Injuries ◽  
West Of Ireland

There is a paucity of data regarding renal trauma. The majority of cases of renal trauma are amenable to conservative management. We sought to streamline the management of renal trauma in the west of Ireland. Patients presenting with a computerised tomogram–confirmed renal injury were assessed over 5 years. Patient demographics, injury details, initial emergency department management, definitive management, and follow-up were assessed. Renal trauma was graded in a blind fashion (I-V). Twenty-five patients were identified; male:female (23:2). The mean age was 26 years. The majority of renal traumas were managed conservatively (92%); 8% patients underwent nephrectomy. The common mechanisms of renal injuries were road traffic accidents (44%). The majority of cases of renal injuries occur as a result of blunt trauma and can be conservatively treated. Two nephrectomies (8%) were performed. We believe this study potentially can be beneficial as part of an all-Ireland trauma database to improve patient outcome.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

scholarly journals Titanium Clamps for a Simple Low-Profile Autologous Osteosynthesis in the Reconstruction of Posttraumatic Craniofacial Convexital Skeletal Disruption

2017 ◽  
Vol 10 (1) ◽  
pp. 29-34 ◽  
Author(s):  
AmosOlufemi Adeleye ◽  
ToluyemiAdefolarin Malomo
Keyword(s):  
Traffic Accidents ◽  
Road Traffic ◽  
Low Cost ◽  
Low Resource ◽  
Low Profile ◽  
The Aesthetic ◽  
Craniofacial Defects ◽  
Profile Technique ◽  
Prospective Database

Attempts at reconstruction of posttraumatic craniofacial defects (PTCDs) can be a challenge in low-resource practice areas of the world where the needed biomaterials are logistically beyond reach. A simple low-profile technique of autologous osteosynthesis for PTCD using the titanium clamps is presented in this report. In addition, a 6-year prospective database on a consecutive cohort of patients who underwent this procedure was analyzed for clinical, functional, and aesthetic outcomes, both in-hospital and at midterm follow-up. The clinical data of 18 patients, all males, mean age 31.3 years (standard deviation, 9.7), were analyzed. Road traffic accidents (RTAs) were the cause of trauma in 14 of 18 patients (78%) and motorcycle crash, none helmeted, in 10 of the 18 patients (71% of RTAs). Out of 18 cases, 17 were open fractures; 89% suffered mild head injury, and associated brain injury on CT scan included pneumocephalus in 6 (5 of them significant); acute extradural hematoma in 4 and subdural in 2, and brain contusions in 9. The surgery was successful in all the cases: operative time <3 hours in 10 cases (56%), the in-hospital outcome was good in 95%. The median follow-up time was 24 months, in 6 of the 18 cases for ≥36 months. There was no case of surgical site infection in the perioperative or the follow-up period to date. The aesthetic outcome was also acceptable. This surgical technique for the reconstruction of PTCD appears effectual. Although its low cost makes it very attractive therein, it appears to be actually also recommendable even outside the low-resource developing countries.

Blunt renal trauma in children: Healing of renal injuries and recommendations for imaging follow-up

1994 ◽  
Vol 24 (8) ◽  
pp. 573-576 ◽  
Author(s):  
H. Abdalati ◽  
D. I. Bulas ◽  
C. J. Sivit ◽  
M. Majd ◽  
H. G. Rushton ◽  
...  
Keyword(s):  
Renal Trauma ◽  
Renal Injuries

scholarly journals Comparison of road traffic accidents presenting to the emergency department of a teaching hospital before and during lockdown

2021 ◽  
Vol 8 (9) ◽  
pp. 4297
Author(s):  
Siddharth Rao P. S. ◽  
Sumayya Nazneen Sayyada ◽  
Souri Reddy Pyreddy
Keyword(s):  
Teaching Hospital ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Tertiary Care ◽  
Mass Casualties ◽  
Road Traffic Accidents ◽  
Patient Demographics ◽  
Disproportionate Number ◽  
Type Of Injury ◽  
The Impact

Background: Road traffic accidents (RTAs) are a major cause of misery, disability and death globally, with a disproportionate number occurring in developing countries. With COVID-19 reaching pandemic proportion, a nationwide lockdown was announced on 24 March 2020 which resulted in the complete closure vehicular movement. This study aimed to assess the impact of lockdown on the number of RTAs brought to our rural tertiary care teaching hospital situated on National highway number 65.Methods: Medico-legal records were reviewed retrospectively at Kamineni institute of medical sciences hospital. The cases were classified into two groups. The pre-lockdown group included cases reporting to casualty from 1 April 2019 to 31 July 2019. The lockdown group included cases reporting to casualty from 1 April 2020 to 31 July 2020. Patient demographics, type of injury, time of injury, mode of injury were collected for all cases and analysed using simple mathematical tools.Results: There was a significant decrease in the total number of RTAs during lockdown phases 1 and 2 and during unlocking phases 1 and 2 by 52.1%. Bike skid was the most common mode of injury. The highest number of RTAs was observed between 6 am to 6 pm and the most commonly affected gender was male especially in the age group of 15-45 years.Conclusions: RTA numbers can be reduced by strict implementation of traffic rules and better road infrastructure. One positive effect of the measures implemented to control the spread of COVID-19 was the reduction of traffic accidents and mass casualties.

scholarly journals Impact of the SARS-COV-2 Outbreak on Epidemiology and Management of Major Trauma in France: Registry-Based Study. The COVITRAUMA Study

2021 ◽  
Author(s):  
Jean-Denis Moyer ◽  
Arthur James ◽  
Clément Gakuba ◽  
Mathieu Boutonnet ◽  
Emeline Angles ◽  
...  
Keyword(s):  
Health Care ◽  
Hospital Care ◽  
Traffic Accidents ◽  
Major Trauma ◽  
Road Traffic ◽  
Trauma Patients ◽  
Road Traffic Accidents ◽  
Patient Demographics ◽  
The Difference ◽  
Pandemic Wave

Abstract BackgroundEvidence increases to suggest that the reallocation of health care resources during considerable the COVID-19 pandemic impacts considerably any health system. This study describes the epidemiology and the outcome of major trauma patients admitted to centers in France during the first wave of the COVID-19 outbreak. MethodsThis retrospective observational study included all consecutive trauma patients aged 15 years and older admitted into 15 centers participating to the TraumaBase® registry in France during the first wave of the SARS-CoV-2 pandemic in France. ResultsOver a 4 years-study period, 5762 patients were admitted between the first week of February and mid-June. This cohort was split between patients admitted during the first 2020 pandemic wave in France (pandemic period, 1314 patients) and those admitted during the corresponding period in the three previous years (2017-2019, 4448 patients). Patient demographics changed substantially during the pandemic and more specifically during the lockdown period specially with a reduction in both absolute numbers admitted and the proportion of road traffic accidents (348 annually 2017-2019 [55.4 % of trauma admissions] vs 143 [36.8 %] in 2020 p<0.005). Mortality during the pandemic period and the difference between predicted and observed mortality was not different compared to the non-pandemic years. ConclusionsDuring this first wave of COVID-19 in France, management of trauma patients admitted to regional Traumacenters was not significantly altered, despite medical resources being reallocated and reorganized. Mortality as well as prehospital and in hospital care remained stable throughout the period of the first pandemic wave despite a massive increase in demand for acute care beds.

Management of renal injury in a UK major trauma centre

Trauma ◽  
2018 ◽  
Vol 22 (1) ◽  
pp. 26-31
Author(s):  
Robert Torrance ◽  
Abigail Kwok ◽  
David Mathews ◽  
Matthew Elliot ◽  
Andrew Baird ◽  
...  
Keyword(s):  
Renal Injury ◽  
Major Trauma ◽  
Trauma Centre ◽  
University Hospital ◽  
Research Network ◽  
Renal Trauma ◽  
High Grade ◽  
Major Trauma Centre ◽  
Renal Injuries

Introduction This study reviews the type, severity, management and follow-up of renal trauma presenting to a major trauma centre in the northwest of England in the four years following inception of the major trauma centre. Given the recent introduction of major trauma centres nationally, research is needed within every specialty to ensure that the centralisation of services benefits all patients affected by these changes. Methods Patients presenting to Aintree University Hospital with renal trauma between June 2012 and June 2016 were identified using the Trauma Audit and Research Network (TARN) database. The data gathered retrospectively for each patient included mechanism of injury, injury severity score, American Association for the Surgery of Trauma (AAST) grading, management of injury, and follow-up. Results Out of a total of 2595 trauma patients, 33 renal injuries were identified. The 31 patients who received imaging were classified according to AAST grading, with 8 Grade I (25.8%), 4 Grade II (12.9%), 8 Grade III (25.8%), 4 Grade IV (12.9%), and 7 Grade V (22.6%) injuries. Twenty-five out of the 30 surviving patients received conservative treatment, three patients received angioembolisation (AE), one patient received a laparotomy with renal suturing, and one patient required a nephrectomy. Of these 30 surviving patients, seven received urology follow-up in clinic (23%). Conclusion The findings appear to support the growing trend towards the conservative management of high-grade renal injuries, and provide further evidence for the value of AE in renal trauma. The success of AE in this study appears to support the centralisation of services in renal trauma; however, the low nephrectomy rate could be interpreted as suggestive of the opposite. The study revealed that improvements to follow-up are needed, and that further research should seek to inform the optimal radiological follow-up of high-grade renal injury.

scholarly journals The management of pretibial lacerations

2017 ◽  
Vol 99 (8) ◽  
pp. 637-640 ◽  
Author(s):  
P Singh ◽  
M Khatib ◽  
A Elfaki ◽  
N Hachach-Haram ◽  
E Singh ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Chronic Wounds ◽  
Injury Severity ◽  
Road Traffic ◽  
Statistical Significance ◽  
The Elderly ◽  
P Value ◽  
Management Options ◽  
Patient Demographics ◽  
Physical Status Classification

Introduction Pretibial lacerations are common injuries, often presenting in the elderly and infirm. Unclear management pathways often result in inappropriate care. We identify patient demographics, morbidity risk factors, injury severity and management options. Materials and methods This retrospective study involved analysing databases and hardcopy notes for patients admitted with pretibial lacerations to Addenbrooke’s Hospital, January to December 2012. Microsoft Excel and Fishers exact test were used to analyse the data with a P-value of less than 0.05 representative of statistical significance. Information on patient demographics, site of lesion, preoperative symptoms, management, operative details and clinical outcomes were collected. Results A total of 36 patients were identified; the mean age was 79 years (± 16 years, 1 standard deviation) with a three to two female to male preponderance; 57% of injuries were caused by mechanical fall, 33% traumatic blunt impact and 7% road traffic accidents. American Society of Anesthesiologists physical status classification was 43% level III, 40% II, 9% I and 9% IV. Dunkin classification of severity was 33% grade III, 30% grade I, 24% grade IV and 12% grade II. Median inpatient duration was 11 days for surgically managed compared with 15 days for conservatively managed patients. Discussion Pretibial lacerations tend to affect the elderly. Management is compounded by polypharmacy and comorbidities. If inadequately managed, such injuries can adopt characteristics of chronic wounds, with lengthy inpatient stays. Surgical intervention may be appropriate where injuries are severe and the patient stable enough for theatre. Conclusions We believe that surgical management with autologous tissue repair, with minimal delay between presentation and theatre, is warranted for extensive injuries wherever possible, with conservative management used for predominantly less extensive pretibial lacerations.

A Differential Approach to the Choice of Treatment of Facial Bone Fractures in the Children

10.12737/3564 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-5
Author(s):  
Тихонов ◽  
E. Tikhonov ◽  
Харитонов ◽  
D. Kharitonov ◽  
Гаршина ◽  
...  
Keyword(s):  
High Speed ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Bone Fractures ◽  
Facial Bone ◽  
Differential Approach ◽  
Fractures In Children ◽  
Choice Of Treatment ◽  
Post Traumatic

The choice of treatment of facial bone fractures in the early age remains a challenge for dentists and maxillofacial surgeons due to the peculiarities of child organism. The purpose of this study was to develop a differential approach to the choice of treatment of children´s facial bone fractures taking into account the age of a child, location of injury and possible complications. This paper presents the analysis of current epidemiological situation regarding to facial bone fractures in children in Voronezh city and Voronezh region. It is shown that the most common injuries is a fall from a height of its own growth, i.e. low-trauma; at the same time the number of high-speed traumas, such as road-traffic accidents, high falls, has decreased. The analysis was carried out 58 cases of facial bone fractures in a group of children from 1 month to 16 years being treated in Maxillofacial Department of Voronezh Regional Pediatric Hospital №2. The developed model of differential choice of treatment of facial bone fractures in children allows to choosing the method taking into account a child age, location of injury and severity, as well as possible consequences of surgery. The clinical monitoring has proved the efficacy of the model which gives an opportunity to decrease post-traumatic complications associated with growth and occlusion deformations as well as complications of inflammatory genesis. It was convincingly shown the need for follow-up care of children with facial fracture that the doctor-orthodontist should continue. The presented data of this study about correlation between surgical and conservative treatment of facial bone fractures in children coincide with the worldwide statistics showing the current tendency to a wide application of mini-invasive methods of fractures fragments immobilization.

Surgical Reconstruction for Major Renal Trauma: Follow-Up Results

1998 ◽  
Vol 65 (4) ◽  
pp. 553-555
Author(s):  
C. di Stefano ◽  
G.P. Incarbone ◽  
F. Arena ◽  
G. Calbiani ◽  
G. Ugolotti ◽  
...  
Keyword(s):  
Renal Function ◽  
Reconstructive Surgery ◽  
Quantitative Assessment ◽  
Renal Trauma ◽  
Surgical Reconstruction ◽  
Radionuclide Scintigraphy ◽  
Differential Renal Function ◽  
Renal Reconstruction ◽  
Renal Injuries

The management of major renal trauma is still controversial and there are few studies about preservation of renal function after surgical reconstruction. We report our results on 10 patients who underwent renal reconstruction and quantitative assessment of differential renal function by radionuclide scintigraphy (99m-TC DMSA); mean follow-up was 6.6 years. Function was 25% or more in 9 reconstructed kidneys: this value is considered an adequate preservation of renal function. We consider reconstructive surgery an appropriate method to manage major renal injuries.

Anxiety and depression on the liver transplant waiting list: a case for psychological prehabilitation?

2020 ◽  
Vol 18 (Sup6) ◽  
pp. S22-S27
Author(s):  
Oliver Tavabie ◽  
Paul McKie ◽  
Ian Webzell ◽  
Racquel Beckford ◽  
Krishna Menon ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Previous Treatment ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Patient Demographics ◽  
Psychological Therapies ◽  
Liver Transplant Waiting List ◽  
Underlying Chronic Liver Disease ◽  
Improve Patient

Introduction: Anxiety and depression in patients awaiting liver transplantation are associated with worse clinical outcomes. However, optimising patient mental health is not routinely addressed in pre-transplant care. Aims: To understand the prevalence of anxiety and depression in patients awaiting transplantation and their access to pharmacological and psychological therapies. Methods: Patients awaiting transplantation were offered screening for anxiety and depression using the Hospital Anxiety and Depression Screening (HADS) tool. Data pertaining to patient demographics and previous treatment for anxiety and depression were recorded and analysed. Findings: Over 50% of patients recorded abnormal scores for anxiety and depression. Of the 19 patients screened, 42% had received treatment for either disorder, and most found the intervention unhelpful due to lack of follow-up appointments and limited understanding of their underlying chronic liver disease. There was a significant association between female sex and screening positive for depression. Conclusion: Anxiety and depression are prevalent in patients awaiting liver transplantation. The integration of a psychologist into the transplantation multidisciplinary team may improve patient outcomes.

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