scholarly journals Traumatic Pelvic Ring Injury following Childbirth with Complete Pubic Symphysis Diastasis

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Aaron Seidman ◽  
Kelley Brossy ◽  
Alfred Faulkner ◽  
Jeffrey Taylor
Keyword(s):  
Medical Decision Making ◽  
Nonoperative Management ◽  
Pelvic Ring ◽  
Pubic Symphysis ◽  
Medical Decision ◽  
Pelvic Ring Injury ◽  
Pubic Symphysis Diastasis ◽  
Orthopedic Injuries ◽  
Uniform Treatment

Case. Traumatic pelvic ring injury following childbirth is a rare but debilitating condition. We present a case of a 28-year-old female who sustained a traumatic pelvic ring injury following childbirth with a complete pubic symphysis separation of 5.6 cm treated successfully with nonoperative management. Conclusion. Operative and nonoperative treatments for traumatic pelvic ring injuries following childbirth have been described without universal adoption of a uniform treatment modality. We hope this case study adds to the collection of data to help guide medical decision-making in the future as surgeons encounter patients with similar orthopedic injuries.

Case Study of the Medical Decision-Making System ETL Abnormalities Processing Procedure

2012 ◽  
Vol 433-440 ◽  
pp. 894-899
Author(s):  
Hui Chen Tsai ◽  
Kuo Chung Lin ◽  
Ching Long Yeh
Keyword(s):  
Decision Making ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Process Data ◽  
Customer Complaint ◽  
Decision Making System ◽  
Restoration Mechanism ◽  
Data Content ◽  
Content System

The primary purpose of this research is to resolve the problem of ETL operation failure in execution of ETL (Extraction, Transformation and Loading) by the medical decision-making system due to data content, system factors and defective program design, thereby affect online daily operation of the application system and even customer complaint. This research first research and develop how to record in database, whether successful or not, the number of ETL file conversion program (including tool and self-wrote PL/SQL program) execution process, data status, and execution time; followed by designing control mechanism and write Script for voluminous table restoration for automatic execution by the system; afterwards followed by research and develop system automatic execution of restoration to stop only the affected application programs of the table and design a restoration mechanism. Lastly, through verification, this R&D result would correctly restore the data and table required by ETL procedure.

Pelvic Binder Utilization in Combat Casualties: Does It Matter?

2020 ◽  
Vol 86 (7) ◽  
pp. 873-877
Author(s):  
William J. Parker ◽  
Robert W. Despain ◽  
Adam Delgado ◽  
Carlos J. Rodriguez ◽  
Dean Baird ◽  
...  
Keyword(s):  
Injury Severity ◽  
Pelvic Ring ◽  
Pubic Symphysis ◽  
Combat Trauma ◽  
Blood Component ◽  
Total Blood ◽  
Pubic Symphysis Diastasis ◽  
Pelvic Binder ◽  
Initial Imaging ◽  
Combat Casualties

Introduction The purpose of this study was to evaluate the utilization of pelvic binders, the proper placement of binders, and to determine any differences in blood product transfusions between combat casualties with and without a pelvic binder identified on initial imaging immediately after the injury. Methods We conducted a retrospective review of all combat-injured patients who arrived at our military treatment hospital between 2010 and 2012 with a documented pelvic fracture. Initial imaging (X-ray or computed tomography) immediately after injury were evaluated by 2 independent radiologists. Young-Burgess (YB) classification, pelvic diastasis, correct binder placement over the greater trochanters, and the presence of a pelvic external fixator (ex-fix) was recorded. Injury severity score (ISS), whole blood, and blood component therapy administered within the first 24-hours after injury were compared between casualties with and without a pelvic binder. Results 39 casualties had overseas imaging to confirm and radiographically classify a YB pelvic ring injury. The most common fracture patterns were anteroposterior (53%) and lateral compression (28%). 49% (19/39) did not have a binder or ex-fix identified on initial imaging or in any documentation after injury. Ten patients had a binder, with 30% positioned incorrectly over the iliac crest. ISS (34 ± 1.6) was not statistically different between the binder and the no-binder group. Pubic symphysis diastasis was significantly lower in the binder group (1.4 ± 0.2 vs 3.7 ± 0.5, P < .001). There was a trend toward decreased 24-hour total blood products between the binder and no-binder groups (75 ± 11 vs 82 ± 13, P = .67). This was due to less cryoprecipitate in the binder group (6 ± 2 vs 19 ± 5, P = .01). Conclusions Pelvic binder placement in combat trauma may be inconsistent and an important area for continued training. While 24-hour total transfusions do not appear to be different, no-binder patients received significantly more cryoprecipitate.

Media Coverage of Medical Decision Making at the End of Life: A Belgian Case Study

Death Studies ◽  
2013 ◽  
Vol 38 (2) ◽  
pp. 125-135 ◽  
Author(s):  
Leen Van Brussel ◽  
Paul Van Landeghem† ◽  
Joachim Cohen
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Media Coverage ◽  
Medical Decision Making ◽  
Medical Decision

scholarly journals Use of Evidence in Acute Stroke Decision-Making: Implications for Evidence-Based Medicine

2021 ◽  
Author(s):  
Timothe Langlois-Therien ◽  
Brian Dewar ◽  
Ross Upshur ◽  
Michel Shamy
Keyword(s):  
Decision Making ◽  
Evidence Based Medicine ◽  
Best Practice ◽  
Medical Decision Making ◽  
Medical Decision ◽  
Evidence Based ◽  
Physician Decision Making ◽  
Prescriptive Model ◽  
Based Medicine

Evidence-Based Medicine proposes a prescriptive model of physician decision-making in which “best evidence” is used to guide best practice. And yet, proponents of EBM acknowledge that EBM fails to offer a systematic theory of physician decision-making. In this paper, we explore how physicians from the neurology and emergency medicine communities have responded to an evolving body of evidence surrounding the acute treatment of patients with ischemic stroke. Through analysis of this case study, we argue that EBM’s vision of evidence-based medical decision-making fails to appreciate a process that we have termed epistemic evaluation. Namely, physicians are required to interpret and apply any knowledge — even what EBM would term “best evidence” — in light of their own knowledge, background and experience. This is consequential for EBM as understanding what physicians do and why they do it would appear to be essential to achieving optimal practice in accordance with best evidence.

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