scholarly journals Dvovremensko krvarenje kod bolesnika sa povredom slezine

2002 ◽  
Vol 49 (3) ◽  
pp. 55-61 ◽  
Author(s):  
B. Stefanovic ◽  
Aleksandar Karamarkovic ◽  
Z. Loncar ◽  
Sladjana Mijatovic ◽  
B. Stefanovic ◽  
...  
Keyword(s):  
Clinical Problem ◽  
Traumatic Shock ◽  
Severe Trauma ◽  
Lethal Outcome ◽  
Number Of Patients ◽  
Delayed Hemorrhage ◽  
Total Proportion ◽  
Immediate Surgery ◽  
Type Of Injury ◽  
Parameter Values

Although the diagnosis of spleen injuries is not a considerable clinical problem today, subsequent ruptures of this organ may occur in a smaller number of patients (2-5% of total proportion of spleen injuries) following the so-called "free interval". Such injuries are most commonly explained by present hematoma localized in the central spleen, which becomes larger in time, and eventually causes its rupture. This form of lesion may be found both in isolated blunt abdominal injuries and in associated injuries. When it is the question of delayed hemorrhage, our results as well as data obtained from foreign literature, suggest three basic rise factors of the etiology of this type of injury. These are as follows: a) spleen injuries in severe trauma or polytrauma, b) older patients (over 65 years of age), and c) in cases when more than a single blood unit had to be administered for the initial hemodynamic stabilization of a patient. Delayed hemorrhage, which is occult in polytraumatized patients since it is frequently "disguised" by severity of clinical picture and traumatic shock, may subsequently cause sudden fall of hemogram and hemodynamic parameter values, and if immediate surgery is not performed, it may lead to heavy bleeding and lethal outcome of the patient.

scholarly journals Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Daan T. Van Yperen ◽  
Esther M. M. Van Lieshout ◽  
J. Niels Dijkshoorn ◽  
Cornelis H. Van der Vlies ◽  
Michael H. J. Verhofstad
Keyword(s):  
Surgical Procedures ◽  
Hospital Admissions ◽  
Case Series ◽  
Secondary Outcome ◽  
Number Of Patients ◽  
Whole Person ◽  
Type Of Injury ◽  
Clear Increase ◽  
Level 1 Trauma Center ◽  
Head Neck

Abstract Objectives The primary aim of this study was to evaluate the number of patients reported to a hospital with injuries from consumer fireworks in the months December–January in the past 10 years, and to describe the association between the type of fireworks, injury pattern, treatment, and permanent impairment. Methods A multicenter, retrospective, observational case series. Patients were selected from two hospitals in the Southwest Netherlands: a level 1 trauma center and a specialized burn center. All patients with any fireworks-related injuries treated between December 1 and January 31, during 2007 (December) to 2017 (January), were eligible for participation. The primary outcome was the number of patients with any type of injury caused by fireworks. The secondary outcome measures were patient and injury characteristics, treatment details, and whole person impairment (WPI). The percentage WPI expresses a patient’s degree of permanent impairments as a result of fireworks-related injuries. Results Of the 297 eligible patients, 272 patients were included. From 2007 to 2017, between 21 and 40 patients were treated, and no clear increase or decrease was observed in the number of patients and in the number of patients per type of fireworks. Explosive fireworks mainly caused upper extremity (N = 65; 68%) injuries, while rockets (N = 24; 41%) and aerials (N = 7; 41%) mainly affected the head/neck. Decorative fireworks predominantly resulted in burns (N = 82; 68%), and explosive fireworks in soft tissue lacerations (N = 24; 25%), fractures (N = 16; 17%), and amputations (N = 14; 15%). Patients injured by explosive and homemade fireworks were most often admitted to a hospital (respectively N = 24; 36% and N = 12; 80%), and resulted in the highest proportion undergoing surgical procedures (respectively N = 22; 33% and N = 7; 47%). WPI found in this study was between 0 to 95%, with a median of 0%. In 34 (14%) patients, the injuries resulted in a WPI of ≥1%, mostly as a result of explosive fireworks (N = 18; 53%). Conclusion This study found no increase or decrease in the number of patients treated in two specialized hospitals. Explosive and homemade fireworks could be considered as most dangerous, as they result into the most hospital admissions, surgical procedures, and into the most injuries with permanent impairment as a result.

Wounds, Fractures, Orthopaedics

2011 ◽  
Author(s):  
Pawan Gupta
Keyword(s):  
Physical Examination ◽  
Soft Tissue Injuries ◽  
Basic Knowledge ◽  
X Rays ◽  
Number Of Patients ◽  
Before And After ◽  
Life Threatening ◽  
Minor Injuries ◽  
High Degree ◽  
Type Of Injury

A significant number of patients attending the ED are those who are often referred to as ‘minors’, ‘streamers’, ‘walking wounded’, etc. These include patients with minor injuries, wounds, fractures or other soft tissue injuries. Therefore, a basic knowledge of anatomy and its application in various circumstances is mandatory. The injuries mentioned above are rarely life-threatening, but they may be limb-threatening and severely disabling. So it is extremely important to avoid errors in diagnosis and management, and to know when to ask for help at the appropriate time. By following the key principles listed below, you will be able to avoid many problems with such patients: • In the history, a detailed description of the mechanism of injury and the patient’s complaint will help in predicting the type of injury sustained. • A careful and thorough physical examination can point to the site and type of injury, on the basis of which appropriate radiological images can then be requested. • A neurovascular examination must be completed and documented in every limb injury, before and after any reductions, and before and after immobilization. • Appropriate radiological imaging, accompanied by a thorough physical examination, can pick up injuries with a high degree of accuracy. Inadequate radiographic films should not be accepted. • Immobilize the patient if a fracture is clinically suspected even if the X-rays are negative. • In cases of dislocations or subluxations, X-rays should be done before and after reductions, except when a delay could be potentially harmful to the patient (for example, when a severe traumatic deformity of a joint threatens to jeopardize the viability of the overlying skin). • The patient should be able to mobilize safely before being discharged from the ED. • Patients should be given proper aftercare instructions before leaving the ED, including how to look after themselves and to recognize limb-threatening features, the follow-up arrangement, and to return if things go wrong. • Ask for senior help if you are not sure about an injury or its management.

scholarly journals A study on the predictability of acute lymphoblastic leukaemia response to treatment using a hybrid oncosimulator

2017 ◽  
Vol 8 (1) ◽  
pp. 20160163 ◽  
Author(s):  
Eleftherios Ouzounoglou ◽  
Eleni Kolokotroni ◽  
Martin Stanulla ◽  
Georgios S. Stamatakos
Keyword(s):  
Acute Lymphoblastic Leukaemia ◽  
Treatment Response ◽  
Lymphoblastic Leukaemia ◽  
Mechanistic Model ◽  
Response Prediction ◽  
Response To Treatment ◽  
Computational Optimization ◽  
Model Parameterization ◽  
Number Of Patients ◽  
Parameter Values

Efficient use of Virtual Physiological Human (VPH)-type models for personalized treatment response prediction purposes requires a precise model parameterization. In the case where the available personalized data are not sufficient to fully determine the parameter values, an appropriate prediction task may be followed. This study, a hybrid combination of computational optimization and machine learning methods with an already developed mechanistic model called the acute lymphoblastic leukaemia (ALL) Oncosimulator which simulates ALL progression and treatment response is presented. These methods are used in order for the parameters of the model to be estimated for retrospective cases and to be predicted for prospective ones. The parameter value prediction is based on a regression model trained on retrospective cases. The proposed Hybrid ALL Oncosimulator system has been evaluated when predicting the pre-phase treatment outcome in ALL. This has been correctly achieved for a significant percentage of patient cases tested (approx. 70% of patients). Moreover, the system is capable of denying the classification of cases for which the results are not trustworthy enough. In that case, potentially misleading predictions for a number of patients are avoided, while the classification accuracy for the remaining patient cases further increases. The results obtained are particularly encouraging regarding the soundness of the proposed methodologies and their relevance to the process of achieving clinical applicability of the proposed Hybrid ALL Oncosimulator system and VPH models in general.

A Consensus Development Conference on the Practice of Platelet Transfusion in the Netherlands

1990 ◽  
Vol 6 (1) ◽  
pp. 163-174
Author(s):  
W. G. van Aken ◽  
J. A. van der Does ◽  
C. Dudok de Wit ◽  
J. J. E. van Everdingen
Keyword(s):  
The Netherlands ◽  
Good Reason ◽  
Severe Trauma ◽  
Major Surgery ◽  
Consensus Development ◽  
Platelet Concentrates ◽  
Platelet Suspension ◽  
Consensus Development Conference ◽  
The Past ◽  
Number Of Patients

During the past 5 years, hospitals in several countries have experienced a significant increase in the use of platelet concentrates. In the Netherlands, e.g., the number of donor units of platelet concentrates rose from 59,000 in 1981 to almost 97,000 in 1984 at a cost of 5 million guilders (US $2,800,000) annually. This increased utilization has been attributed to such factors as chemo- and radiotherapy, major surgery, severe trauma, and bone marrow transplantation.However, there was concern that in a significant number of patients, platelet concentrates are administered for no good reason, that the effect of platelet transfusions is often not adequately controlled, that insufficient care is taken to prevent side effects (notably alloimmunization), and that the quality control applied to platelet suspension is not optimal.

scholarly journals Spread of COVID-19 in India: A Mathematical Model

2020 ◽  
Vol 5 (3) ◽  
pp. 41-47
Keyword(s):  
Differential Equation ◽  
Mathematical Model ◽  
Asymptomatic Patients ◽  
Number Of Patients ◽  
Entire World ◽  
Nature Of Time ◽  
The Government ◽  
Government Records ◽  
Parameter Values ◽  
The Impact

The COVID-19 pandemic has been the greatest threat to human lives of the entire world since January 2020. In the present article, we discuss a mathematical model regarding the spread of COVID-19 in India. This model is aimed at finding the nature of time dependence of the number of symptomatic patients, officially recorded in the country, during the period from 01 March 2020 to 23 April 2020. The number of persons infected with the coronavirus disease, as declared by the government on a regular basis, is most probably the number of patients who have experienced the symptoms of the disease. The present study is based on a differential equation that has been formed here to find how the number of asymptomatic patients increases with time. The number of symptomatic patients has been estimated from its solution. The nature of its time evolution is found to be quite consistent with the data obtained from government records, for a certain set of parameter values of the model. Using this particular set, we have discussed the impact of imposition of a countrywide lockdown and its withdrawal.

scholarly journals Nadoknada krvi kod tesko povredjenih bolesnika

2010 ◽  
Vol 57 (1) ◽  
pp. 107-113
Author(s):  
S.N. Krstic ◽  
T. Alempijevic ◽  
N. Popovic ◽  
D. Jovanovic ◽  
V. Mihailovic ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Early Death ◽  
Severe Trauma ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Mechanism Of Injury ◽  
Lethal Outcome ◽  
Outcome Severity ◽  
Potential Component ◽  
Extremity Injuries

Haemorrhage remains a leading cause of early death in injured and application of concentrated RBC transfusion in the treatment of multiple injuries is the basis and potential component of saving lives. The aim of this study was to analyze the received amount reimbursed blood in patients with severe trauma, depending on the outcome, severity and mechanism of injury. Collected data on gender, age and age as the mechanism of injury, amount of blood recovered intraoperatively and during the first six days of hospitalization, which were analyzed according to outcome of treatment, ISS, AIS, and APACHE II score. Results showed that patients with lethal outcome received a larger amount of blood, there is a statistically significant correlation with ISS and AIS score for extremity injuries, and that larger amount of blood received patients injured in the traffic accidents, as pedestrians and motorcycle riders / bike, and there is no correlation with APACHE II score. Based on the importance of this topic for further research are necessary in this area in order to more accurately define indications and dosage and method of reimbursement of blood in patient with severe trauma.

A New Proposal for Setting Parameter Values in Restricted Randomization Methods

2007 ◽  
Vol 46 (04) ◽  
pp. 440-449 ◽  
Author(s):  
G. Kundt
Keyword(s):  
New Method ◽  
Restricted Randomization ◽  
Varying Parameters ◽  
Number Of Patients ◽  
Intrinsic Quality ◽  
Parameter Values ◽  
The Impact ◽  
Exact Equality

Summary Objectives: Complete randomization could result in an undesirable imbalance in the number of patients assigned to each treatment, especially in small trials. Therefore, a variety of restricted randomization procedures has been developed. By varying parameters it is possible to appropriately modify the balancing characteristics of these designs. However, there is little information on what are sensible choices for the parameters. Therefore, we suggest a new method for suitable determination of parameter values of restricted randomization rules. Methods: For restriction to be effective, it need not yield exact equality. As the reliability of a test is not very sensitive to slight deviations from equal sample sizes we define that a given maximum tolerable imbalance d can be achieved or exceeded with a given probability p*. By using this condition, parameter values of restricted procedures are determinable. Results: For permuted-block, biased-coin, urn, and big-stick randomization we investigated the impact of parameters on balancing properties. For different extents of restriction and by using the submitted condition, the values of parameters to be chosen are determined. Conclusions: Up to now choice of parameter values has often occurred at random. Now it is possible to determine values of parameters by specifying the tolerable degree of imbalance and the risk to be worse. As a consequence restriction will, as much as possible, not be imposed and not imposed more than necessary in order to preserve the intrinsic quality of randomization.

scholarly journals Gastric mucosal biopsies in non ulcer dyspepsia: A histopathologic study

2015 ◽  
Vol 7 (2) ◽  
pp. 80-84
Author(s):  
Priya Singh ◽  
KC Goswami ◽  
Bharat Bhushan Gupta
Keyword(s):  
Age Groups ◽  
Clinical Problem ◽  
Economic Loss ◽  
Mucosal Inflammation ◽  
Major Health Problem ◽  
Number Of Patients ◽  
Glandular Atrophy ◽  
Non Ulcer Dyspepsia ◽  
H Pylori ◽  
One Year

Background: Non-ulcer dyspepsia (NUD) is a major health problem and one of the most common causes of morbidity and economic loss. The aim of the study was to determine the pattern of gastric mucosal histopathologic alterations and frequency of Helicobacter pylori in patients with NUD.Materials and Methods: Patients presenting to Gastroenterology Out Patient Department over a period of one year with symptoms of dyspepsia but without any endoscopic lesion were taken up for the study and evaluated by obtaining two gastric mucosal biopsy specimens each from antrum and body mucosa. The specimens were processed and examined histologically using the updated Sydney system.Results: Gastric biopsies from 102 patients (63 females and 39 males) with NUD were studied. Histological examination of gastric mucosal biopsies showed that 82.3% of NUD patients had histopathological features of gastritis. Chronic infl ammation was present in 84 (82.3%), activity was seen in 63 (61.7%), glandular atrophy was seen in 10 (9.8%) and intestinal metaplasia was seen in 4 (3.9%) patients with NUD on gastric biopsy. Maximum number of patients with NUD had Sydney score of less than 5 (68.6%).H pylori were identifi ed on gastric mucosal biopsies in 49 (48.0%) patients with NUD based on H & E and Geimsa stained sections.Conclusion: NUD is a clinical problem which occurs in both sexes in all age groups; prevalence being low below 20 years of age. Patients with this condition have a high frequency of gastric mucosal inflammation and H pylori infection.Asian Journal of Medical Sciences Vol.7(2) 2015 80-84

scholarly journals Isolated Medial Subtalar Joint Dislocation during Sports Activities: A Systematic Review of the Literature with Individual Participant Data Analysis

Osteology ◽  
2021 ◽  
Vol 1 (1) ◽  
pp. 48-61
Author(s):  
Carlo Biz ◽  
Giovanni Baldin ◽  
Claudia Cappelletto ◽  
Nicola Luigi Bragazzi ◽  
Pietro Nicoletti ◽  
...  
Keyword(s):  
Systematic Review ◽  
Subtalar Joint ◽  
Rare Condition ◽  
Joint Dislocation ◽  
Patient Feedback ◽  
Number Of Patients ◽  
Individual Participant ◽  
Scale Range ◽  
Meta Analyses ◽  
Type Of Injury

In athletes, one of the most common injuries is a sprained ankle. If the energy of the trauma is particularly high, this type of injury can lead to an isolated medial dislocation of the subtalar joint (STJ), a rare condition poorly described in the literature. The aim of this study was to verify if a reliable conservative treatment and a specific physiotherapy rehabilitation protocol in isolated medial dislocation of the STJ in athletes is described in the literature. A systematic review of the published literature of the last 11 years was performed by applying the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using three databases: Pubmed, Scopus, and Web of Science. The keywords used were “(subtalar OR talocalcaneal) AND dislocation”. We considered only studies that included professional or amateur athletes (athletic patients). We used the American Orthopedic Foot and Ankle Society (AOFAS) scale, range of motion (ROM) of the subtalar and ankle joint, subtalar and talonavicular joint osteoarthritis, and patient feedback to evaluate their outcomes. A total of 12 studies were included in our review, with a total of 26 athletic patients. Sixteen of them had good results with the correlation between the duration of immobilisation and the outcomes. Nevertheless, due to the small number of patients included in the analysed studies on this subject in the literature, there is not yet a univocal clinical protocol to treat the isolated medial subtalar joint dislocation (STJD) warranting further research in the field.

scholarly journals Clinical Analysis of Causes and Countermeasures of Hand Injury During the COVID-19 Outbreak and Work Resumption Period: A Retrospective Study in a Designated Hospital in China

2021 ◽  
Vol 58 ◽  
pp. 004695802110674
Author(s):  
Qianjun Jin ◽  
Haiying Zhou ◽  
Hui Lu
Keyword(s):  
Health Care Providers ◽  
Clinical Analysis ◽  
Hand Injury ◽  
Hand Injuries ◽  
Care Providers ◽  
Workplace Injuries ◽  
Number Of Patients ◽  
The One ◽  
Type Of Injury ◽  
Work Resumption

A total of 95 patients with hand injuries were admitted to the orthopedics department within half a year of the COVID-19 outbreak. Data were collected between January 23, 2020 and July 23, 2020. Data such as patients' demographics, type of injury, location, side of lesions, mechanism of injury, injury site, and surgical management were collected and subsequently analyzed. On the one hand, the total number of emergency visits due to hand injury during the COVID-19 outbreak decreased by 37%, compared to the same period in the previous year. On the other hand, work resumption injuries increased by 40%. Injuries within the resumption period occurred predominantly at work (64.7%) and were significantly higher than the same period in 2019 (37.3%) (P < .001). Machine-related injuries were the most frequent injuries seen in our hospital (58.8%). The majority of cases were from cut injuries (82.4%), with fingers being the most common site of these injuries. Simple fractures and dislocations were also reported during the study. Most injuries were classified as either minor or moderate (90%) during the outbreak. However, during the resumption of work, major injuries were more prevalent (40%). The proportion of major injuries this year’s work resumption stage (40%) has almost doubled compared to the previous year (21.8%, P = .006). The resumption of work following the COVID-19 outbreak is a time of high-risk for hand injuries. The overall number of patients with hand injuries admitted into our department has decreased compared to the corresponding period last year. However, workplace injuries, particularly machine-related ones, considerably increased during the first six months after the COVID-19 outbreak. As a result, the proportion of major injuries drastically increased. Emergency and surgical health care providers should be aware of this pattern of hand injuries during this untypical time in order to effectively prepare and plan services.

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