scholarly journals Sternal fractures in children

2021 ◽  
Vol 9 (3) ◽  
pp. 317-325
Author(s):  
Evgeny G. Skryabin ◽  
Sergey V. Naumov ◽  
Pavel B. Zotov ◽  
Mikhail A. Akselrov
Keyword(s):  
Hospital Stay ◽  
Soft Tissues ◽  
Medical Information ◽  
The Body ◽  
Diagnostic Methods ◽  
Long Term Results ◽  
Thoracic Vertebrae ◽  
Average Hospital ◽  
Fractures In Children ◽  
Sternal Fractures

BACKGROUND: Sternal fractures are a rare nosological form of injuries in children. The injuries of the sternum often are accompanied by fractures of the long bones of the skeleton or thoracic vertebrae. Isolated fractures of the sternum in children are rarely diagnosed. The medical information on pediatric sternum injuries is limited by a small number of scientific publications. AIM: Our aim is to study the peculiarities of traumagenesis, clinic, diagnostics, treatment of sternal fractures in children. MATERIALS AND METHODS: Clinical material for the served as experience in providing traumatology assistance to 8 children who received sternal fractures. The average age of the injured children was 11.5 years. 87.5% of the victims were boys. In all patients, sternal fractures had been diagnosed along with other damage to the musculoskeletal system. During the survey, traditional diagnostic methods for emergency traumatology were used. RESULTS: The leading mechanism of injury, i.e., falling from a height of 2 meters and more were found in 62.5% of victims. In all clinical observations, fractures were localized at the level of the body of the sternum. All the children, besides sternal fractures, had uncomplicated fractures of the vertebral bodies. A total of 30 bodies of the vertebrae were compressed. Most often (in 16.75% of cases), the ThV vertebra was compressed. The reliable symptoms of sternal fractures in patients were difficult and painful breathing, local swelling of soft tissues, soreness of the sternum during palpation, and amplification of the pain in the fracture area during pressure applied on half of the chest. Compliance with the strict bed mode on the roller-reclinator under the area of the compreated vertebrae and the exclusion of the axial load on the spine was a favorable fact sufficient and led to pain disappearance in 37 days. In all cases, the sternum fractures did not require any surgery. Fractures of the bodies of the vertebrae in 7 children were also treated conservatively. The Corsets Orlett was used for immobilization, ensuring a reliable degree of fixation. The average hospital stay amounted to 16. The duration of the hospital stay was influenced by the accompanying bone-articular damage to the skeleton. The evaluation of the long-term results was performed in 4 children. The results were interpreted as good. CONCLUSIONS: When applying for emergency traumatology assistance to children with chest injury and spine, it is necessary to purposefully explore the state of the sternum.

A CLINICAL STUDY OF PENETRATING ABDOMINAL TRAUMA WITH SPECIAL REFERENCE TO ITS MANAGEMENT : AN INDIAN SCENARIO

2021 ◽  
pp. 1-3
Author(s):  
Saumya Singh ◽  
Anindya Halder ◽  
Niru Das
Keyword(s):  
Data Collection ◽  
Hospital Stay ◽  
Abdominal Trauma ◽  
Surgical Techniques ◽  
Penetrating Trauma ◽  
Diagnostic Methods ◽  
Gunshot Injury ◽  
Abdominal Injuries ◽  
Average Hospital ◽  
Penetrating Abdominal Trauma

Introduction: The incidence of penetrating abdominal injuries has been on the rise. The common availability of rearms, the lack of proper law, armed conicts, civil violence and road trafc accidents are the major causes of penetrating abdominal injuries. As patient with penetrating abdominal trauma are at risk of harbouring life threatening injuries, early diagnosis and timely intervention is the most important steps to reduce its morbidity as well as mortality. Recently due to improvement of the present healthcare system, the outcome of these injuries is improving. Materials And Methods: A descriptive observational study was carried out on 60 cases of penetrating abdominal injuries. A predesigned pretested schedule was used for data collection. Interview of the study subject and evaluation of all clinical reports was done to obtain the history, clinical ndings, management, complications, mortality and follow up. Before data collection, informed consent was obtained from each and every study subjects. Results: The overall incidence of penetrating abdominal trauma was found to be 2.30% of the total admission of 6217 patients in the department of surgery. The most common cause of penetrating abdominal injury found in this study is stab injury by sharp objects which is followed by gunshot injury. The commonest age group affected was 20 to 30 years which comprises about 41.67%. In this study we found a male preponderance in cases of penetrating injury to the abdomen. In most of the cases the mode is homicidal stab or gunshot injury followed by accidental injuries. Pain, abdominal distension and bleeding from the wound are the main presenting symptom. After initial evaluation with USG (FAST),CTscan abdomen is the most valuable investigation so far. In this series, it is found that the small intestine is the most commonly involved viscera followed by colon, omentum, mesentery and liver respectively. Most common complications after operative intervention was wound infection. The average hospital stay was 6 to 15 days. It has been observed that the post-operative complications, associated injuries and multiple organ injuries are the cause of increased hospital stay. Conclusion: Penetrating trauma can be serious because it can damage internal organs and presents a risk of shock and infection. In the present year, due to overall improvement in the communication and transportation, better monitoring systems and resuscitative measures, improvised diagnostic methods, better availability of blood and blood products, better medications and more skilful surgical techniques, the outcomes of these injuries are improving.

scholarly journals COMPARATIVE EVALUATION OF SURGICAL TREATMENT METHODS OF RIGID FLAT FEET IN CHILDREN WITH DYSFUNCTION OF THE POSTERIOR TIBIALIS TENDON

2020 ◽  
Vol 10 (4(38)) ◽  
pp. 46-52
Author(s):  
O. Shulga
Keyword(s):  
Surgical Treatment ◽  
Compression Ratio ◽  
Soft Tissues ◽  
Diagnostic Methods ◽  
Long Term Results ◽  
Navicular Bone ◽  
Bone Deformity ◽  
Flat Feet ◽  
Subtalar Arthroereisis ◽  
Foot Mobility

Introduction.The rigid form of static flat feet in children occurs in 18-20 % of cases of the musculoskeletal system pathology. Nowadays, neither objective diagnostic methods have been developed, nor algorithms for treating the rigid form of flat feet depending on the severity, deformity of the tarsal bones, foot mobility and dysfunction of the posterior tibialis tendon (PTT) have been found. Objective. To develop objective evaluation methods of rigid flat feet surgical treatment in children depending on the joints’ mobility, compression ratio,  and PTT dysfunction stage. Methods and materials. The effectiveness of the rigid form of static stage II-III  flat feet treatment was analysed in 15 children aged 14 to 18 years, who were divided into control and main groups. Clinical and radiological diagnostic methods were used. Patients of the control group (8 children) were operated using subtalar arthroereisis method. Patients of the main group (7 children) underwent surgery on bones and soft tissues. Results. Surgical treatment showed no effect using subtalar arthroereisis method in cases of the tarsal bone deformity, advanced stage of PTT dysfunction,  and significant impairment of foot mobility. Positive results were also achieved using two-joint arthrodesis with the formation of navicular-tibial ligament with severe foot rigidity, stage III-IV of PTT dysfunction and navicular bone deformity. Conclusion. During treatment of rigid flat feet in children it’s necessary to take into consideration severity, compression ratio of the navicular bone, the mobility index, the stage of the posterior tibialis tendon dysfunction and the angle of its tension. Long-term results indicate the effectiveness of surgery on bones and soft tissues in the treatment of severe rigid flat feet.

Melatonin as adjuvant treatment for coronavirus disease 2019 pneumonia patients requiring hospitalization (MAC-19 PRO): a case series

2020 ◽  
Vol 3 (3) ◽  
pp. 297-310 ◽  
Author(s):  
Rafael Ricafranca Castillo ◽  
Gino Rei A. Quizon ◽  
Mario Joselito M. Juco ◽  
Arthur Dessi E. Roman ◽  
Donnah G De Leon ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Clinical Improvement ◽  
Case Series ◽  
High Dose ◽  
Chest Imaging ◽  
Imaging Findings ◽  
Rt Pcr ◽  
Average Hospital ◽  
Sleeping Problems

 Treatment for coronavirus disease 2019 (COVID19) pneumonia remains empirical and the search for therapies that can improve outcomes continues. Melatonin has been shown to have anti-inflammatory, antioxidant, and immune-modulating effects that may address key pathophysiologic mechanisms in the development and progression of acute respiratory distress syndrome (ARDS), which has been implicated as the likely cause of death in COVID19. We aimed to describe the observable clinical outcomes and tolerability of high-dose melatonin (hdM) given as adjuvant therapy in patients admitted with COVID19 pneumonia. We conducted a retrospective descriptive case series of patients who: 1) were admitted to the Manila Doctors Hospital in Manila, Philippines, between March 5, 2020 and April 4, 2020; 2) presented with history of typical symptoms (fever, cough, sore throat, loss of smell and/or taste, myalgia, fatigue); 3) had admitting impression of atypical pneumonia; 4) had history and chest imaging findings highly suggestive of COVID19 pneumonia, and, 5) were given hdM as adjuvant therapy, in addition to standard and/or empirical therapy. One patient admitted to another hospital, who one of the authors helped co-manage, was included. He was the lone patient given hdM in that hospital during the treatment period. Main outcomes described were: time to clinical improvement, duration of hospital stay from hdM initiation, need for mechanical ventilation (MV) prior to cardiopulmonary resuscitation, and final outcome (death or recovery/discharge). Of 10 patients given hdM at doses of 36-72mg/day per os (p.o.) in 4 divided doses as adjuvant therapy, 7 were confirmed COVID19 positive (+) by reverse transcription polymerase chain reaction (RT-PCR) and 3 tested negative  (-), which was deemed to be false (-) considering the patients’ typical history, symptomatology, chest imaging findings and elevated bio-inflammatory parameters.  In all 10 patients given hdM, clinical stabilization and/or improvement was noted within 4-5 days after initiation of hdM. All hdM patients, including 3 with moderately severe ARDS and 1 with mild ARDS, survived; none required MV. The 7 COVID19(+) patients were discharged at an average of 8.6 days after initiation of hdM. The 3 highly probable COVID19 patients on hdM were discharged at an average of 7.3 days after hdM initiation. Average hospital stay of those not given hdM (non-hdM) COVID19(+) patients who were admitted during the same period and recovered was 13 days. To provide perspective, although the groups are not comparable, 12 of the 34 (35.3%) COVID19(+) non-hdM patients admitted during the same period died, 7/34 (20.6%) required MV; while 6 of 15 (40%) non-hdM (-) by RT-PCR but highly probable COVID19 pneumonia patients also died, 4/15  (26.7%) required MV. No significant side-effects were noted with hdM except for sleepiness, which was deemed favorable by all patients, most of whom had anxiety- and symptom-related sleeping problems previously. HdM may have a beneficial role in patients treated for COVID19 pneumonia, in terms of shorter time to clinical improvement, less need for MV, shorter hospital stay, and possibly lower mortality. HdM was well tolerated. This is the first report describing the benefits of hdM in patients being treated for COVID19 pneumonia.  Being a commonly available and inexpensive sleep-aid supplement worldwide, melatonin may play a role as adjuvant therapy in the global war against COVID19. 

Hand-assisted laparoscopic nephrectomy in morbidly obese patients

2020 ◽  
Vol 99 (6) ◽  
pp. 271-276
Keyword(s):  
Body Weight ◽  
Surgical Technique ◽  
Blood Loss ◽  
Hospital Stay ◽  
Kidney Cancer ◽  
The Body ◽  
Laparoscopic Nephrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Morbid Obese

Introduction: Prevalence of obesity is 30 % in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2. Methods: The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were analyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated. Results: The patient age was 38−67 years; the cohort included 2 females and 5 males, the body weight was 117−155 kg and the BMI was 40.3−501 kg/m2. Surgery time was 73−98 minutes, blood loss was 20−450 ml, and hospital stay was 5−7 days; incisional hernia occurred in one patient. Kidney cancer was confirmed in all cases, 48–110 mm in diameter, and the largest removed specimen size was 210×140×130 mm. One patient died just 9 months after the surgery because of metastatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion: HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

RESULTS OF TREATMENT OF LOCALLY RECURRING SOFT TISSUES SARCOMAS OF EXTREMITIES

2018 ◽  
Vol 64 (3) ◽  
pp. 408-413
Author(s):  
Grigoriy Zinovev ◽  
Georgiy Gafton ◽  
Sergey Novikov ◽  
Ivan Gafton ◽  
Yekaterina Busko ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissues ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Tumor Location ◽  
Long Term Results ◽  
Clinical Feature ◽  
National Medical ◽  
Results Of Treatment ◽  
Kaplan Meier

Background: The most striking clinical feature of soft tissues sarcomas (STS) is their ability to recur. At present disputes about the clinical and morphological factors of STS recurrence such as the degree of malignancy, size, location, depth of tumor location, patient’s age and the presence of previous relapses in the anamnesis do not subside. It also requires clarification of the effect of the volume of tissues removed on the long-term results of treatment of STS as well as indications for the application of various regimes of remote radiation therapy. Materials and methods: Of 1802 registered cases of STS of extremities at the N.N. Petrov National Medical Research Center of Oncology from 2004 to 2016 there were selected data on 213 patients who suffered from at least one relapse of the disease. There was performed an assessment of overall, non-metastatic and disease-free survival using a single-factor (the Kaplan-Meier method) and multivariate analysis (the Cox regression model). Conclusion: The detection of various prognostic factors of locally recurrent STS allows determining the necessary treatment tactics (the vastness and traumatism of surgery and the advisability of radiation therapy).

scholarly journals Reduction of estimated fluid volumes following initiation of empagliflozin in patients with type 2 diabetes and cardiovascular disease: a secondary analysis of the placebo-controlled, randomized EMBLEM trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Atsushi Tanaka ◽  
Michio Shimabukuro ◽  
Hiroki Teragawa ◽  
Yosuke Okada ◽  
Toshinari Takamura ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Repeated Measures ◽  
Medical Information ◽  
Controlled Trial ◽  
Extracellular Volume ◽  
Cardiovascular Outcomes ◽  
Fluid Volume ◽  
The Body

Abstract Backgrounds/Aim Sodium glucose co-transporter 2 inhibitors promote osmotic/natriuretic diuresis and reduce excess fluid volume, and this improves cardiovascular outcomes, including hospitalization for heart failure. We sought to assess the effect of empagliflozin on estimated fluid volumes in patients with type 2 diabetes and cardiovascular disease (CVD). Methods The study was a post-hoc analysis of the EMBLEM trial (UMIN000024502), an investigator-initiated, multi-center, placebo-controlled, double-blinded, randomized-controlled trial designed primarily to evaluate the effect of 24 weeks of empagliflozin treatment on vascular endothelial function in patients with type 2 diabetes and established CVD. The analysis compared serial changes between empagliflozin (10 mg once daily, n = 52) and placebo (n = 53) in estimated plasma volume (ePV), calculated by the Straus formula and estimated the extracellular volume (eEV), determined by the body surface area, measured at baseline and 4, 12, and 24 weeks after initiation of treatment. Correlations were examined between the changes from baseline to week 24 in each estimated fluid volume parameter and several clinical variables of interest, including N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration. Results In an analysis using mixed-effects models for repeated measures, relative to placebo empagliflozin reduced ePV by − 2.23% (95% CI − 5.72 to 1.25) at week 4, − 8.07% (− 12.76 to − 3.37) at week 12, and − 5.60% (− 9.87 to − 1.32) at week 24; eEV by − 70.3 mL (95% CI − 136.8 to − 3.8) at week 4, − 135.9 mL (− 209.6 to − 62.3) at week 12, and − 144.4 mL (− 226.3 to − 62.4) at week 24. The effect of empagliflozin on these parameters was mostly consistent across various patient clinical characteristics. The change in log-transformed NT-proBNP was positively correlated with change in ePV (r = 0.351, p = 0.015), but not with change in eEV. Conclusions Our data demonstrated that initiation of empagliflozin treatment substantially reduced estimated fluid volume parameters in patients with type 2 diabetes and CVD, and that this effect was maintained for 24 weeks. Given the early beneficial effect of empagliflozin on cardiovascular outcomes seen in similar patient populations, our findings provide an important insight into the key mechanisms underlying the clinical benefit of the drug. Trial registration University Medical Information Network Clinical Trial Registry, number 000024502

Magnetic Resonance Imaging in the Diagnosis of Disruption of the Posterior Tibial Tendon

Foot & Ankle ◽  
1987 ◽  
Vol 8 (3) ◽  
pp. 144-147 ◽  
Author(s):  
Ian J. Alexander ◽  
Kenneth A. Johnson ◽  
Thomas H. Berquist
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissues ◽  
Diagnostic Technique ◽  
Clinical Findings ◽  
The Body ◽  
Posterior Tibial Tendon ◽  
Resonance Imaging ◽  
Posterior Tibial ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI), a useful technique of studying soft tissues of the body, can be very effective in assessing the integrity of tendons. Usually a patient with a complete tear of the posterior tibial tendon has characteristic physical findings. In the patient presented, MRI demonstrated a complete disruption of the posterior tibial tendon, despite the absence of the commonly associated clinical findings. In view of the difficulties encountered with attempted tenography of the completely torn posterior tibial tendon, MRI provides a sensitive alternative diagnostic technique.

Computerized Tomography: A Perspective in the Pediatric Patient

PEDIATRICS ◽  
1977 ◽  
Vol 59 (2) ◽  
pp. 305-308
Author(s):  
Derek Harwood-Nash ◽  
Herman Grossman ◽  
Alvin Felman ◽  
John Kirkpatrick ◽  
Leonard Swischuk
Keyword(s):  
Computerized Tomography ◽  
Soft Tissues ◽  
Conventional Radiography ◽  
The United States ◽  
The Body ◽  
Whole Body ◽  
Central Research ◽  
X Ray ◽  
Whole Body Ct

Computerized tomography (CT), a technique conceptualized by Oldendorf in 19611 and developed by Hounsfield2 of EMI-Tronics Inc. (EMI) Central Research Laboratories, has proven to be a successful innovation in neuroradiology. Reviews by Ambrose3 in England and by Baker et al.4 and by New et al.5 in the United States have clearly demonstrated the value of this new modality in neuroradiological diagnosis. In 1975 Houser et al.6 and Harwood-Nash et al.7 provided the initial clinical and radiological data about CT in infants and children. More recently this technique has been extended to the study of tissues and organs in the body other than those in the head. This has been accomplished by modification of the original machine into a whole-body CT system. Early reviews by Ledley et al.8 and by Alfidi et al.9 suggest a significant potential for diagnosis of lesions in the abdomen, pelvis, and thorax. The advantages of CT are that it is less invasive than standard special diagnostic radiological procedures and that for the first time it provides in vivo information regarding the content and the characteristics of tissue composing organs and masses. DESCRIPTION OF EQUIPMENT In conventional radiography an image is made on radiographic film by an attenuated X-ray beam. In passing through a core of tissue, each ray of the beam is attenuated as it is absorbed and scattered by the tissue in its path. The intensity of the transmitted ray depends on the sum total of X-ray attenuation by all the different soft tissues in its path.

The reaction of the soft tissues of the anterior abdominal wall to various suture material

1982 ◽  
Vol 63 (4) ◽  
pp. 72-74
Author(s):  
V. P. Nefedov ◽  
R. M. Ramazanov
Keyword(s):  
Foreign Body ◽  
Abdominal Wall ◽  
Soft Tissues ◽  
Suture Material ◽  
Anterior Abdominal Wall ◽  
The Body ◽  
Reactive Changes ◽  
Healing Processes

The healing processes of sutured wounds of soft tissues in most cases depend on the type and quality of the suture material. Any kind of suture material in the tissues of the body is a foreign body that causes various reactive changes from the tissues. The nature of these changes, all other things being equal, is mainly determined by the type of suture material, its thickness and the method of sterilization of the tissues on which the sutures are applied, the trauma of surgery, the infection of the wound and the irritating effect of the threads on the tissues.

Initial Results On Medium Frequency Electromagnetic Field Penetration In Biological Soft Tissue

2012 ◽  
Author(s):  
Zulkarnay Zakaria ◽  
Mohd Fahajumi Jumaah ◽  
Mohd Saiful Badri Mansor ◽  
Khairi Mat Daud ◽  
Mohd Hafiz Fazalul Rahiman ◽  
...  
Keyword(s):  
Magnetic Field ◽  
Soft Tissue ◽  
Soft Tissues ◽  
Low Cost ◽  
The Body ◽  
Small Scale ◽  
Medium Frequency ◽  
Magnetic Field Penetration ◽  
Magnetic Induction Tomography ◽  
Field Penetration

Terapi merupakan antara teknik perubatan tertua dalam mengekalkan kesihatan badan terutama daripada aliran darah yang tidak baik, strok dan beberapa penyakit yang lain. Teknik ini termasuklah akupuntur, guasa dan juga urutan. Terdapat juga teknik terapi moden seperti terapi warna, terapi ozon, terapi dadah dan banyak lagi. Kertas kajian ini akan mengetengahkan penjana terapi elektromagnet, satu alat yang mempunyai potensi aplikasi terapi dalam bidang perubatan. Alat ini menghasilkan medan magnet berfrekuensi sederhana sebagai sumber terapi. Perkakasan yang berskala kecil berfrekuensi sederhana dan berkos rendah ini telah dibangunkan dan telah diuji pada tisu biologi bagi mengukur tahap ketembusan medan magnet. Ujian ini telah membuktikan bahawa medan magnet yang telah dihasilkan mampu menembusi tisu lembut bersaiz sehingga 2 cm dengan jarak 7 cm daripada sumber. Kebolehan penembusan sistem ini terhadap tisu lembut memberikan peluang yang cerah kepada kajian ini memandangkan medan magnet telah menunjukkan potensi sebagai sebahagian daripada terapi untuk memulihkan migraine, strok, kekejangan dan beberapa yang lain selain boleh diaplikasikan dalam pengimejan tomografi induksi magnet. Kata kunci: Terapi elektromagnet, medan magnet, penembusan, tisu lembut, aplikasi perubatan Therapy is among the oldest medication technique in maintaining the health of the body especially from bad blood circulation, stroke and several others. This technique includes acupuncture, guasa and also massage. There are also modern therapy techniques like colour therapy, water therapy, ozone therapy, drug therapy and others. This paper will highlight electromagnetic therapy generator, a device which has the potential of therapy application in medical field. This device produce medium frequency magnetic field as a therapy source. This small scale medium frequency and low cost hardware that has been developed was tested on the biological tissue for the purpose of measuring the magnetic field penetration. The testing has proven that the generated magnetic field is able to penetrate the soft tissue up to 2 cm with distance from the source up to 7 cm. The capability of the system penetrations through the soft tissues provide the bright future of this research since magnetic field have shown the potential as being part of the therapy for curing migraine, stroke, cramp and several others besides the application in the magnetic induction tomography imaging. Key words: Electromagnetic therapy, magnetic field, penetration, soft tissue; medical applications

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