scholarly journals The new method of pelvic packing against continuing intrapelvic bleeding resulting from the unstable pelvic ring fractures

2019 ◽  
pp. 76-80
Author(s):  
K. A. Egiazaryan ◽  
D. I. Gordienko ◽  
D. A. Starchik ◽  
A. M. Lysko
Keyword(s):  
Clinical Case ◽  
Causes Of Death ◽  
Pelvic Ring ◽  
New Method ◽  
Concomitant Injuries ◽  
Pelvic Packing ◽  
Balloon Tamponade ◽  
Pelvic Ring Fractures ◽  
Common Causes ◽  
The Common

Unstable pelvic ring fractures are one of the common causes of death of patients with concomitant injuries. The existing methods applied to treat such conditions can cause a number of complications and have contraindications. We have described a successful clinical case of intrapelvic hemorrhage arrest in a patient with multiple injuries. in this case, we applied the new method combining minimally invasive angioembolization and easily applicable and effective balloon tamponade.

scholarly journals Paramedics’ perceptions and educational needs with respect to palliative care

2015 ◽  
Vol 12 (5) ◽  
Author(s):  
Ian R Rogers ◽  
Freya R Shearer ◽  
Jeremy R Rogers ◽  
Gail Ross-Adjie ◽  
Leanne Monterosso ◽  
...  
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Causes Of Death ◽  
Ethical Issues ◽  
Symptom Control ◽  
Educational Needs ◽  
Palliative Approach ◽  
Common Causes ◽  
The Common ◽  
End Of Life Communication

IntroductionTo identify and measure paramedics’ perspectives and educational needs regarding palliative care provision, as well as their understanding of the common causes of death.MethodsAll St John Ambulance Western Australia paramedics were invited to complete a mixed methods qualitative and quantitative survey using a tool previously validated in studies involving other emergency care providers. Quantitative results are reported using descriptive statistics, while Likert-type scales were converted to ordinal variables and expressed as means +/- SD. Qualitative data was analysed using content analysis techniques and reported as themes. ResultsCompleted surveys were returned by 29 paramedics. They considered palliative care to be strongly focussed on end-of-life care, symptom control and holistic care. The dominant educational needs identified were ethical issues, end-of-life communication and the use of structured patient care pathways. Cancer diagnoses were overrepresented as conditions considered most suitable for palliative care, compared with their frequency as a cause of death. Conditions often experienced in ambulance practice, such as heart failure, trauma and cardiac arrhythmias were overestimated in their frequency as causes of death. ConclusionsParamedics have a sound grasp of some important aspects of palliative care including symptom control and the holistic nature of the palliative approach. They did however tend to equate palliative care with that occurring in the terminal phase and saw it as being particularly applied to cancer diagnoses. Paramedic palliative care educational efforts should focus on ethical issues and end-of-life communication, as well as increasing understanding of the common causes of death and those where a palliative approach might be beneficial.

scholarly journals Clinical case of delivery of a pregnant woman with vasa previa

2020 ◽  
Vol 7 (1) ◽  
pp. 53-56
Author(s):  
E. P. Shevtsova ◽  
N. A. Linchenko
Keyword(s):  
Pregnant Woman ◽  
Umbilical Cord ◽  
High Frequency ◽  
Clinical Case ◽  
Rare Condition ◽  
Birth Process ◽  
Common Causes ◽  
Vasa Previa ◽  
Diagnostic Difficulties ◽  
The Common

Anomalies of the umbilical cord are manifold and pose the greatest danger during the development of labor. Sheath attachment of the umbilical cord is one of the common causes of presentation of umbilical cord vessels. Vasa previa (VP) causes diagnostic difficulties, cannot be corrected during pregnancy and does not affect the birth process, but is characterized by a high frequency of perinatal mortality. This observation demonstrates the need for close attention of obstetrician-gynecologists and ultrasound doctors to such a rare condition as VP. The article discusses the clinical case of successful delivery of a pregnant woman with this pathology.

scholarly journals Management of Hemodynamically Unstable Pelvic Ring Fractures

2020 ◽  
Vol 7 ◽  
Author(s):  
Kim E. M. Benders ◽  
Luke P. H. Leenen
Keyword(s):  
Pelvic Ring ◽  
Treatment Algorithm ◽  
High Energy ◽  
Pelvic Trauma ◽  
Pelvic Fractures ◽  
Origin Time ◽  
Pelvic Packing ◽  
Pelvic Ring Fractures ◽  
Primary Means ◽  
Set Up

Hemodynamically unstable pelvic fractures are challenging high-energy traumas. In many cases, these severely injured patients have additional traumatic injuries that also require a trauma surgeon's attention. However, these patients are often in extremis and require a multidisciplinary approach that needs to be set up in minutes. This calls for an evidence-based treatment algorithm. We think that the treatment of hemodynamically unstable pelvic fractures should primarily involve thorough resuscitation, mechanical stabilization, and preperitoneal pelvic packing. Angioembolization should be considered in patients that remain hemodynamically unstable. However, it should be used as an adjunct, rather than a primary means to achieve hemodynamic stability as most of the exsanguinating bleeding sources in pelvic trauma are of venous origin. Time is of the essence in these patients and should therefore be used appropriately. Hence, the hemodynamic status and physiology should be the driving force behind each decision-making step within the algorithm.

scholarly journals Study of the effect of Baricitinib on the Course of COVID-19

2021 ◽  
pp. 204-213
Author(s):  
Alina Yuryevna Maslova ◽  
Alla Aslanbekovna Tskaeva ◽  
Zuleykha Abdulkerimkizi Ashurova ◽  
AlinaTemrukovna Abazova ◽  
Magomed Muradovich Ismailov ◽  
...  
Keyword(s):  
Causes Of Death ◽  
Standard Treatment ◽  
Lung Ventilation ◽  
Janus Kinase ◽  
Urgent Problem ◽  
Common Causes ◽  
Stavropol Region ◽  
The Common ◽  
Additional Therapy ◽  
Standard Treatment Regimen

The aim of the study was to determine the effect of the inhibitor of janus kinase – baricitinib ("Olumiant") on the course of COVID-19. This drug baricitinib is able to suppress the systemic inflammatory response, which is one of the common causes of death in COVID-19, is an urgent problem of the study. The study was carried out in the Regional Specialized Budget Infectious Diseases Hospital of Stavropol (Russian Federation, Stavropol Region). In a multivariate analysis, it was shown that the use of baricitinib was associated with a decrease in the frequency of the primary endpoint of death/need for invasive lung ventilation. The use of baricitinib was quite safe, but in some patients there was an increase in the level of transaminases. No cases of hypercoagulation have been reported while taking baricitinib. It was found that patients with a normal BMI are more sensitive to therapy than those who are overweight.75% of patients in the first group had a temperature above 38.0oC. However, against the background of taking the standard treatment regimen and baricitinib, it was noted that the temperature stabilized during the day and did not rise again. Against the background of taking baricitinib, the elimination of the phenomena of respiratory failure and the refusal of an oxygen mask occurred 3.1 times more often than without baricitinib. The authors concluded that the use of baricitinib can be considered as an additional therapy for moderate forms of pneumonia in patients over 65 years or in patients with concomitant chronic diseases in order to suppress the reactions of systemic inflammation and the development of serious respiratory and other system lesions caused by COVID-19.

Pelvic Impairments

2018 ◽  
Vol 23 (4) ◽  
pp. 9-10
Author(s):  
James Talmage ◽  
Jay Blaisdell
Keyword(s):  
Pelvic Ring ◽  
Reproductive Organs ◽  
High Impact ◽  
Pelvic Fractures ◽  
Motor Dysfunction ◽  
Impact Event ◽  
Concomitant Injuries ◽  
Rating Process ◽  
Pass Through ◽  
A Minor

Abstract Pelvic fractures are relatively uncommon, and in workers’ compensation most pelvic fractures are the result of an acute, high-impact event such as a fall from a roof or an automobile collision. A person with osteoporosis may sustain a pelvic fracture from a lower-impact injury such as a minor fall. Further, major parts of the bladder, bowel, reproductive organs, nerves, and blood vessels pass through the pelvic ring, and traumatic pelvic fractures that result from a high-impact event often coincide with damaged organs, significant bleeding, and sensory and motor dysfunction. Following are the steps in the rating process: 1) assign the diagnosis and impairment class for the pelvis; 2) assign the functional history, physical examination, and clinical studies grade modifiers; and 3) apply the net adjustment formula. Because pelvic fractures are so uncommon, raters may be less familiar with the rating process for these types of injuries. The diagnosis-based methodology for rating pelvic fractures is consistent with the process used to rate other musculoskeletal impairments. Evaluators must base the rating on reliable data when the patient is at maximum medical impairment and must assess possible impairment from concomitant injuries.

Suicidal Death Autopsy Analysis at Dhaka Medical College

1970 ◽  
Vol 40 (1) ◽  
pp. 18-21 ◽  
Author(s):  
MN Hossain ◽  
Z Rahman ◽  
S Akhter
Keyword(s):  
Forensic Medicine ◽  
Causes Of Death ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medical College ◽  
Autopsy Report ◽  
Common Causes ◽  
Suicidal Death

A cross sectional study was carried out at the department of Forensic Medicine in Dhaka Medical College during the period of January 2008 to December 2009. Data were collected from 3rd copy of the post mortem reports which were preserved in the department of Forensic Medicine with the verbal consent of the doctors who performed autopsy report. During this period total 5114 autopsies were conducted. Out of this 970 cases (19%) were suicidal in nature. It was noticed that all suicidal deaths occurred from 10 years to all age group respectively, but top amongst age group of suicidal deaths occurred in between 21 to 30 years of people. Suicidal deaths are more common in female than male. Suicidal deaths due to hanging is highest, next common causes of death due to organophosphorus compund poisoning. Suicidal deaths by hanging is more in female than male but in poisoning cases male are more lvictimised than female. Objectives of our study are to see the occurrence and methods of suicidal death. DOI: http://dx.doi.org/10.3329/bmj.v40i1.9957 BMJ 2011; 40(1): 18-21

Insufficiency Fractures vs. Low-Energy Pelvic Ring Fractures – Epidemiological, Diagnostic and Therapeutic Characteristics of Fragility Fractures of the Pelvic Ring

2021 ◽  
Author(s):  
Manuel Sterneder ◽  
Patricia Lang ◽  
Hans-Joachim Riesner ◽  
Carsten Hackenbroch ◽  
Benedikt Friemert ◽  
...  
Keyword(s):  
Pelvic Ring ◽  
Diagnostic Testing ◽  
Insufficiency Fracture ◽  
Fragility Fractures ◽  
Relative Increase ◽  
Trauma Centre ◽  
Low Energy ◽  
Insufficiency Fractures ◽  
Type Iv ◽  
Pelvic Ring Fractures

Abstract Background Fragility fractures of the pelvis (FFP) encompass two fracture entities: fracture after low-energy trauma and insufficiency fracture without trauma. It is unclear whether the two subgroups differ in terms of diagnosis and therapy. The aim of this retrospective study was to evaluate insufficiency fractures with regard to defined parameters and to compare specific parameters with the fractures after low-energy trauma. Patients and Methods In the period from 2008 to 2017, 203 patients with FFP were recorded at our clinic (Level 1 Trauma Centre DGU, SAV approval). Of these, 25 had an insufficiency fracture and 178 had a pelvic ring fracture after low-energy trauma. Epidemiological, diagnostic and therapeutic parameters were examined. Results There was a relative increase in the insufficiency fracture within the FFP (2008 – 2009: 5.0% vs. 2015 – 2017: 17.8%). In these patients, osteoporosis tended to be more pronounced than in patients after low-energy trauma (t-value: − 3.66 vs. − 3.13). The diagnosis of insufficiency fractures showed increased use of MRI and DECT (60.9% vs. 26.0%) and a high proportion of type IV fractures after FFP (40.0% vs. 7.9%). In terms of therapy, surgical treatment of the insufficiency fracture was sought more often (68,2% vs. 52,1%), with a tendency towards increased use of combined osteosynthesis procedures (14.3% vs. 7.6%). Conclusion We were able to show that as the number of cases increases, the insufficiency fracture becomes more important within FFP. If these patients tend to have more pronounced osteoporosis, particular attention should be paid to the diagnosis and adequate therapy of the osteoporosis, especially in the case of an insufficiency fracture. In addition to the increased diagnostic testing using MRI and DECT to detect oedema and the increased surgical therapy for this type of fracture, it is also noteworthy that the insufficiency fracture can cause higher-grade fractures after FFP.

scholarly journals Low-Energy Pelvic Ring Fractures: A Care Conundrum

2021 ◽  
Vol 12 ◽  
pp. 215145932098540
Author(s):  
Bailey R. Abernathy ◽  
Lisa K. Schroder ◽  
Deborah C. Bohn ◽  
Julie A. Switzer
Keyword(s):  
Acute Care ◽  
Patient Population ◽  
Pelvic Ring ◽  
Fracture Prevention ◽  
Low Energy ◽  
Care Pathways ◽  
Secondary Fracture ◽  
Secondary Fracture Prevention ◽  
Pelvic Ring Fractures ◽  
Rehabilitative Care

Introduction: A need exists for improved care pathways for patients experiencing low-energy pelvic ring fractures. A review of the current literature was performed to understand the typical patient care and post-acute rehabilitation pathway within the US healthcare system. We also sought to summarize reported clinical outcomes worldwide. Significance: Low-energy pelvic ring fracture patients usually do not qualify for inpatient admission, yet they often require post-acute rehabilitative care. The Center for Medicare and Medicaid Services’ (CMS) 3-day rule is a barrier to obtaining financial coverage of this rehabilitative care. Results: Direct admission of some patients to post-acute care facilities has shown promise with decreased cost, improved patient outcomes, and increased patient satisfaction. Secondary fracture prevention programs may also improve outcomes for this patient population. Conclusions: Post-acute care innovation and secondary fracture prevention should be prioritized in the low-energy pelvic fragility fracture patient population. To demonstrate the effect and feasibility of these improved care pathways, further studies are necessary.

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