scholarly journals Comparative analysis between identified injuries of victims of fall from height and other mechanisms of closed trauma

2014 ◽  
Vol 41 (4) ◽  
pp. 272-277 ◽  
Author(s):  
José Gustavo Parreira ◽  
Marina Raphe Matar ◽  
André Luis Barreto Tôrres ◽  
Jacqueline A. G. Perlingeiro ◽  
Silvia C. Solda ◽  
...  

OBJECTIVE: To analyze the lesions diagnosed in victims of falls, comparing them with those diagnosed in other mechanisms of blunt trauma.METHODS: We conducted a retrospective study of trauma protocol charts (prospectively collected) from 2008 to 2010, including victims of trauma over 13 years of age admitted to the emergency room. The severity of injuries was stratified by the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Variables were compared between the group of victims of falls from height (Group 1) and the other victims of blunt trauma (Group 2). We used the Student t, chi-square and Fisher tests for comparison between groups, considering the value of p <0.05 as significant.RESULTS: The series comprised 4,532 cases of blunt trauma, of which 555 (12.2%) were victims of falls from height. Severe lesions (AISe"3) were observed in the extremities (17.5%), in the cephalic segment (8.4%), chest (5.5%) and the abdomen (2.9%). Victims of Group 1 had significantly higher mean age, AIS in extremities / pelvis, AIS in the thoracic segment and ISS (p <0.05). The group 1 had significantly (p <0.05) higher incidence of tracheal intubation on admission, pneumothorax, hemothorax, rib fractures, chest drainage, spinal trauma, pelvic fractures, complex pelvic fractures and fractures to the upper limbs.CONCLUSION: Victims of fall from height had greater anatomic injury severity, greater frequency and severity of lesions in the thoracic segment and extremities.

2020 ◽  
Author(s):  
Carlos Ordoñez ◽  
Carlos García ◽  
Michael W. Parra ◽  
Edison Angamarca ◽  
Mónica Guzmán-Rodríguez ◽  
...  

Purpose: The objective of this study was to evaluate the implementation of a new Single-Pass WBCT Protocol in the management of patients with severe trauma. Methods: This was an observational, prospective study of polytrauma patients who underwent WBCT. Patients were divided into three groups: 1. Blunt trauma hemodynamically stable 2. Blunt trauma hemodynamically unstable and 3. Penetrating trauma. Demographics, WBCT parameters and outcome variables were evaluated. Results: 263 patients were included. Median Injury Severity Score (ISS) was 22 (IQR: 16-22). Time between arrival to the ED and completing the WBCT was under 30 minutes in most patients [Group 1: 28 minutes (IQR: 14-55), Group 2: 29 minutes (IQR: 16-57), and Group 3: 31 minutes (IQR: 13-50); p=0.96]. 172 patients (65.4%) underwent non-operative management. The calculated and the real survival rates did not vary among the groups either [Group 1: TRISS 86.4% vs. RSR 85% (p=0.69); Group 2: TRISS 69% vs. RSR 74% (p=0.25); Group 3: TRISS 93% vs. RSR 87% (p=0.07)]. Conclusion: This new Single-Pass WBCT Protocol was safe, effective and efficient to decide whether the patient with severe trauma requires a surgical intervention independently of the mechanism of injury or the hemodynamic stability of the patient. Its use could also potentially reduce the rate of unnecessary surgical interventions of patients with severe trauma including those with penetrating trauma.


Animals ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 480
Author(s):  
Martina Zappaterra ◽  
Laura Menchetti ◽  
Leonardo Nanni Costa ◽  
Barbara Padalino

This study aimed at documenting whether dromedary camels have a preference for shade and how their behavior would change depending on the presence of shade and variable space allowance. A total of 421 animals kept in 76 pens (66 with shelter (Group 1), and 10 without shelter (Group 2)) at the camel market in Doha (Qatar) were recorded for 1 min around 11:00 a.m. when the temperature was above 40 °C. The number of animals in the sun and shade and their behaviors were analyzed using an ad libitum sampling method and an ad hoc ethogram. The results of a chi-square test indicated that camels in Group 1 had a clear preference for shade (p < 0.001). The majority of Group 1 camels were indeed observed in the shade (312/421; 74.11%). These camels spent more time in recumbency and ruminating, while standing, walking, and self-grooming were more commonly expressed by the camels in the sun (p < 0.001). Moreover, locomotory stereotypic behaviors (i.e., pacing) increased as space allowance decreased (p = 0.002). Based on the findings of this pilot study, camels demonstrated a preference for shade; shade seemed to promote positive welfare, while overcrowding seemed to trigger stereotypy and poor welfare. Overall, our preliminary results are novel and provide evidence that shaded areas are of paramount importance for camel welfare. Further research, involving designed studies at multiple locations is needed to confirm these results.


2013 ◽  
Vol 53 (3) ◽  
pp. 125
Author(s):  
Marlisye Marpaung ◽  
Supriatmo Supriatmo ◽  
Atan Baas Sinuhaji

Background Vitamin A deficiency may increase the risk or bea cause of diarrhea. Many studies have been conducted on theefficacy of vitamin A in the management of acute diarrhea, butthe outcomes remain inconclusive.Objective To determine the effectiveness of vitamin A in reducingthe severity of acute diarrhea in children.Methods We performed a single􀁈blind􀁈randomized controlledtrial in the Secanggang District, Langkat Regency, North ofSumatera, from August 2009 to January 2010 in children aged6 months to 5 years, who had diarrheas. Subjects were dividedinto two groups. Group 1 received a single dose of vitamin A(100,000 IU for subjects aged 6 to 11 month old or with bodyweights :s 10 kg, or 200,000 IU for subjects aged 2: 12 month oldor with body weights> 10 kg). Group 2 received a single doseof placebo. The establishment of severity was based on changesin diarrheal frequency, stool consistency, volume and durationof diarrhea after treatment. We performed independent T􀁈testand Chi square tests for statistical analyses. The study was anintention􀁈to􀁈treat analysis.Results We enrolled 120 children who were randomized intotwo groups of 60 subjects each. Group 1, received vitamin Aand group 2 received a placebo. The results showed significantdifferences between the two groups in stool volume starting onthe first day (95%CI 192.30 to 3237.51; P􀁉O.OOI), as well asdiarrheal frequency (P=O.OOl) and stool consistency (P=O.OOl)on the second day observation and duration of diarrhea followingtreatment (95%CI - 40.60 to - 25.79; P􀁉O.OOI;).Conclusions Vitamin A supplementation is effective in reducingthe severity of acute diarrhea in children under five years of age.[Paediatr lndones. 2013;53:125-31.]


Author(s):  
Daming Zhu ◽  
Yuanyuan Zhang ◽  
Nowwar Mustafa ◽  
Angela Hoban ◽  
Dan Murphy ◽  
...  

Background: We have had a “one call activation system” for primary PCI at our regional academic center since 1999. The ED physician initiated the system with the decision for primary PCI made by cardiologist (interventional or non-interventional) on call. But since July 1, 2009, only interventional cardiologists are involved in the decision making process. Otherwise, the comprehensive strategy remained the same. As we have reported previously, this new strategy resulted in a shortened door-to-balloon (D2B) time. In the present study, we analyzed the D2B timeline intervals to determine where the major gains were achieved. Methods: We conducted a retrospective analysis of 665 consecutive patients presenting to our institution with suspicion of acute STEMI during a 30-month period. Group 1 consisted of patients in the 12 months (July 1 2008-June 30 2009) before and Group 2 consisted of patients in the 18 months (July 1 2009-Dec. 31 2010) after the system change was instituted. Mann-Whitney U test and chi-square test were used for statistical analysis. Results: 218 patients in group 1 were taken to the cath lab of which 180 received primary PCI. 349 patients in group 2 were taken to the cath lab of which 275 received primary PCI. The results were presented in the table. Conclusions: Comprehensive strategy with exclusive involvement of interventional cardiologist resulted in a significant decrement in decision-to-balloon time. The EKG-to-decision time did not decrease, contrary to our expectation.


2015 ◽  
Vol 27 (1) ◽  
pp. 263 ◽  
Author(s):  
R. H. Alvarez ◽  
F. L. N. Natal ◽  
R. M. L. Pires ◽  
K. M. R. Duarte ◽  
C. A. Oliveira

The injection of a low dose of eCG has the potential to induce multiple ovulation and pregnancies in cattle. The present study aimed to evaluate the ovarian response, conception rate and incidence of twin pregnancies of cyclic cows receiving 1 of 2 low doses of eCG. Multiparous Nellore (Bos t. indicus) cows with plasma progesterone levels >1 ng∙mL–1 on at least one of 2 blood samples collected at 10-day intervals (Day –10 and Day 0) received an intramuscular (IM) injection of 2 mg of oestradiol benzoate (EB; Estrogin®, AUSA, São Paulo, Brazil) and a vaginal device (DIP) containing 1 g of progesterone (Primer®, Tecnopec, São Paulo, SP, Brazil) on Day 0. On Day 8, the DIP was removed and cows received an IM injection of 150 μg of cloprostenol (Veteglan®, Hertape Calier, Juatuba, MG, Brazil). At this time, the animals were randomly distributed into 3 groups. Group 1 (n = 30) received an IM injection of 2 mL of saline, whereas groups 2 (n = 41) and 3 (n = 23) received 600 IU and 900 IU of eCG (Novormon® MSD Saude Animal, São Paulo, Brazil), respectively. Twenty-four hours later (Day 9), all groups received 1 mg of EB and were submitted to fixed-time artificial insemination (FTAI) 30 h later (i.e. 54 h after DIP removal). Oestrus observation was performed daily from the time of the withdrawal of the DIP until the day of FTAI. Ovaries were examined ultrasonically at the time of FTAI, the following day and 7 days after FTAI. Pregnancy diagnosis was done by ultrasonography 30 days after FTAI and the incidence of twin or single calves was recorded at birth. Data were analysed by chi-square test. The rate of expression of oestrus was 70.0% (group 1), 82.9% (group 2), and 78.2% (group 3; P = 0.25). Cows that had 2 or more large follicles at the time of FTAI was 0% (group 1), 14.6% (group 2), and 34.8% (group 3; P < 0.05). The ovulation rate of cows in group 1 (80.0%) was higher than cows in groups 2 (48.8%) and 3 (52.2%; P < 0.05). The conception rates for groups 1, 2, and 3 were 50.0, 26.8, and 39.1%, respectively (P < 0.05). Two animals in group 3, one in group 2, and none of group 1 had twin pregnancies on Day 30 after FTAI. Only one of these cows (group 3) had a twin calving. It was concluded that the injection of 600 or 900 IU eCG, in an oestradiol/progestogen FTAI protocol does not result in an increase in the rate of twin calvings, but may negatively affect pregnancy rates of cyclic Nellore cows.Financial support was provided by FAPESP (proc. 2011/13096–0).


2016 ◽  
Vol 8 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Thomas J. Caruso ◽  
Diane H. Steinberg ◽  
Nancy Piro ◽  
Kimberly Walker ◽  
Rebecca Blankenburg ◽  
...  

ABSTRACT Background Mentors influence medical trainees' experiences through career enhancement and psychosocial support, yet some trainees never receive benefits from involved mentors. Objective Our goals were to examine the effectiveness of 2 interventions aimed at increasing the number of mentors in training programs, and to assess group differences in mentor effectiveness, the relationship between trainees' satisfaction with their programs given the presence of mentors, and the relationship between the number of trainees with mentors and postgraduate year (PGY). Methods In group 1, a physician adviser funded by the graduate medical education department implemented mentorships in 6 residency programs, while group 2 involved a training program with funded physician mentoring time. The remaining 89 training programs served as controls. Chi-square tests were used to determine differences. Results Survey responses from group 1, group 2, and controls were 47 of 84 (56%), 34 of 78 (44%), and 471 of 981 (48%, P = .38), respectively. The percentages of trainees reporting a mentor in group 1, group 2, and the control group were 89%, 97%, and 79%, respectively (P = .01). There were no differences in mentor effectiveness between groups. Mentored trainees were more likely to be satisfied with their programs (P = .01) and to report that faculty supported their professional aspirations (P = .001). Across all programs, fewer first-year trainees (59%) identified a mentor compared to PGY-2 through PGY-8 trainees (84%, P &lt; .001). Conclusions A supported mentorship program is an effective way to create an educational environment that maximizes trainees' perceptions of mentorship and satisfaction with their training programs.


2014 ◽  
Vol 2 (11_suppl3) ◽  
pp. 2325967114S0012
Author(s):  
Mehmet Hasan Tatari ◽  
Vugar Guliyev

Objectives: Anterior cruciate ligament (ACL) injury is a common disorder in athletes and in most cases, meniscal tears accompany. These meniscal tears can be the result of the initial trauma or the consecutive injuries in the unoperated patients. The aim of the study was to compare the incidence of meniscal tears in the patients operated because of ACL defficiency in the early or late period after the initial trauma. The age of the patient and meniscal tear pattern were the other subjects compared. Methods: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236). Results: The groups included 42, 72 and 129 patients respectively. Among all groups, it was shown that in 125 cases (% 51.4), a meniscal tear accompanied the ACL tear. In Group 1, 18 cases (% 42.8) had meniscal tears while 29 patients (% 37) in Group 2 and 78 patients (% 60.4) in Group 3 had any kind of meniscal tear. Bucket handle tears constituted 38 % of all tears in Group 1, 53 % in Group 2 and 56 % in Group 3. There was a significant statistical difference between the groups among the presence of meniscal tear and the period between the initial trauma and operation time. When the patients accepted the operation in the first six months after the initial trauma, the incidence of the meniscal injury decreased significantly (chi-square test) (p <0,01). There was no statistical difference between three groups among the percentage of bucket handle tears (variance analysis: p=0,196). The statistical difference was not important between the groups among the age of the patients in relation with the pattern of the meniscal tears (variance analysis: p=0,236) Conclusion: We can say that the incidence of meniscal tears can be decreased if the patients with ACL injury are operated early after the initial trauma. Earlier ACL reconstruction means less meniscal tear.


2021 ◽  
Vol 12 (4) ◽  
pp. 20-26
Author(s):  
A. D. Fabrikant ◽  
T. I. Botasheva ◽  
A. N. Rymashevsky ◽  
Yu. A. Petrov ◽  
N. V. Palieva ◽  
...  

Objective: To study the obstetric pathology and delivery outcomes in pregnant women with gestational diabetes depending on the sex of the fetus.Materials and Methods: A retrospective analysis of 2014 histories of pregnancy and childbirth of women with gestational diabetes (GD) over the period of 2018-2021, was carried out. Two groups were formed based on the sex of the fetus: Group 1 (1012 pregnant women) with male fetuses and Group 2 (1002 pregnant women) with female fetuses. For statistical analysis, the proportions (%) were compared using the Pearson’s χ2 (chi-square) test.Results: It was proved that the male sex of the fetus is a risk factor for the GD and concomitant obstetric complications (placental insufficiency, risk of preterm birth, fetal macrosomia). The prevalence of hypotonic bleeding, defects of the placenta, and placenta increta, and related cases of manual control of the uterine cavity and uterus extirpation in mothers of boys with GD was established. Also, in patients of this group, birth injuries consisting in a rupture of the posterior labial commissure were significantly more often registered as a result of childbirth with a large fetus, while cases of cervical rupture prevailed in women with female fetuses.Conclusions: The revealed dependence of the nature of obstetric complications and the course of labor on the sex of the fetus in pregnant women with GD warrant developing a monitoring system that takes into account the gender of the fetus.


Author(s):  
Sweekriti Mishra ◽  
BM Rashmi ◽  
K Ravishankar ◽  
Sanober Khan ◽  
Anoop Sharma ◽  
...  

Introduction: Since literature provides various schools of thought to achieve Posterior Palatal Seal (PPS) in a maxillary denture, it becomes essential to know the techniques dominating in our curriculum presently. Aim: To determine the prevalence of concepts and also the need for standardisation in establishing PPS among dental colleges of Karnataka. Materials and Methods: A descriptive survey was conducted among teaching faculty of Department of Prosthodontics with varied teaching experience across the dental colleges of Karnataka. A pre-tested questionnaire containing ten close ended questions was distributed to 230 faculty members with MDS qualification in Prosthodontics via e-mail. The faculty responses were divided into three groups based on teaching experience: Group 1 (2-7 years), Group 2 (7-12 years) and Group 3 with more than 12 years of teaching experience. The Chi-Square Goodness of Fit test was used to compare the overall differences in the responses by the study participants; and Independent Chi-Square test to compare the differences in the responses based on teaching experience of the study participants. A value of p<0.05 was considered as statistically significant. Results: The most common method taught for locating vibrating line was Phonation-Nose Blowing-Fovea Palatini (46.0%). Two-line concept of vibrating line was taught (77%) more commonly, where the termination of maxillary denture is on posterior vibrating line (58%). Currently, Boucher’s conventional method without master cast scoring (63%) was the most favoured method to record the seal. This was true mainly with Group 1 (81.9%) and Group 2 (66.7%). In contrast, Group 3 faculty largely advocated Boucher’s conventional technique along with master cast scoring (70%). Overall most of the faculty members (66.5%) did not make the students score the postpalatal area. This was mainly seen in faculty belonging to Group 1 (81.9%) and Group 2 (69.7%). Bulk of Group 3 faculty (75%) taught scoring of the master cast. A large portion of the faculty (60.0%) recommended standardisation in the methods of teaching PPS which was mainly backed by Group 2 (77.3%) and Group 1 (61.7%). Conclusion: This survey indicates that among dental colleges of Karnataka, a majority of faculty of Prosthodontics prefer Boucher’s conventional method without master cast scoring (63%) to achieve maxillary PPS. Nevertheless, teaching concepts differed based on faculty experience. It is emphasised that teaching methods should be standardised and include unambiguous techniques.


2018 ◽  
Vol 25 (11) ◽  
pp. 1643-1648
Author(s):  
Hamid Saeed ◽  
Muhammad Zia Ur Rehman ◽  
Samee Javed Bhatti ◽  
Aamir Furqan

Objectives: The objective is to compare the radiological outcome of closedinterlock intramedullary nailing versus dynamic compression plating in closed tibial fracture.Study Design: Randomized controlled trials. Setting: Department of orthopedics NishtarHospital Multan. Period: 9th July 2016 to March 2017. Methodology: There were 302 patientsdivided in two equal groups of 151. Permission was taken from the ethical committee of NishtarHospital. The 302 patients in age group 20-50 years of both genders meeting the inclusionand exclusion criteria attending the outpatient clinic or admitted to the orthopedics departmentthrough emergency were included in the study. All the data entered and analyzed usingcomputer software SPSS version 10. For quantitative variables like age and duration of fracturemean and standard deviation was calculated. For categorical variables like gender, malunionand infection frequency and percentage were calculated. Chi-square test was applied tocompare the malunion and infection in both groups. A p value 0.05 was considered statisticallysignificant. Results: The 100% (n=302) patients were divided into 2 groups equally, 151 ineach, i.e. intramedullary nail (group 1) and dynamic compression plating (group 2). The mainoutcome variables of this study were the malunion and infection. It was observed that malunionpresented as 57% (n=86) and 70.9% (n=107) in group 1 and group 2 respectively. It was alsoobserved that infection presented as 23.2% (n=35) and 37.1% (n=56) in group 1 and group 2respectively. After applying chi-square test, it was noted that malunion associated with groupshaving p-value 0.012. But it was not associated with gender, stratified age and duration offracture having p-values 0.497, 0.800 and 0.218 respectively. Similarly, after applying chi-squaretest, it was noted that infection associated with gender and groups having p-values 0.007 and0.008 respectively. But it was not associated with stratified age and duration of fracture havingp-values 0.565 and 0.344 respectively. Conclusion: Closed interlock intramedullary nailinghas malunion and infection rates less than dynamic compression plating. So closed interlockintramedullary nailing is preferred method of closed tibia diaphyseal fracture treatment.


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