scholarly journals ANALYSIS OF CASES OF CEREBRAL COMMOTION AFTER ROAD ACCIDENTS IN KRASNODAR

2018 ◽  
Vol 25 (3) ◽  
pp. 107-112
Author(s):  
V. A. PORODENKO ◽  
S. A. ANUPRIENKO ◽  
YU. A. SERGEEVA ◽  
V. V. SHUTOVA

Aim. To examine cases of diagnose setting for cerebral commotion after road accidents within Krasnodar city, to justify the diagnose, to analyze the level of harm committed.Materials and methods. A retrospect analysis has been done to 353 expert reports and forensic medical examination acts issued after road accidents which involved medically documented cerebral commotion. Analyzed cases have been detected by continuous sampling. Conditions taken into consideration: sex, age, circumstances, time, type of accident and type of involvement for injured people, localization and type of injury, reasons for cerebral commotion rejection from experts diagnose.Results. As a result, 199 cases have missed cerebral commotion as experts diagnose – 63.3% of these cases missed data for dynamic neurological examination of the person aggrieved, 30.7% of cases didn’t contain objective evidence of cerebral commotion, in 3.5% of cases medical outpatient card was not provided for examination by the investigator, in 2.5% of cases cerebral commotion diagnose was cancelled by clinicians after dynamic patient follow-up. In 39% of cases cerebral commotion was diagnosed in pedestrians, in 20% of cases in car drivers, in 19% of cases car passengers were injured. In nine cases (6%) there was an accident involving motorcyclists and cyclists, 4 (3%) cases were passengers of public transport. 77% of the injured people received medical care in a hospital, 23% – on an outpatient basis. In 78% of cases with cerebral commotion there were injuries of soft tissues of the head, fractures of the skull bones were revealed in 14%. Light damage to health on the grounds of a short-term disorder is established in 45% of cases, harm to health of average severity – in 20%, serious harm – in 31%, harm to health was not determined in 4%.Conclusion. The obtained results indicate that the diagnosis of cerebral commotion is established based on anamnesis and complaints, it doesn't reflect the objective symptoms of concussion. Dynamic monitoring of the course of craniocerebral trauma is not ensured, necessary laboratory and instrumental diagnostics are not carried out. It leads to the impossibility of taking this diagnosis into account when conducting forensic medical examination because of its unreasonableness.

1980 ◽  
Vol 61 (5) ◽  
pp. 37-39
Author(s):  
A. Z. Gimaranova ◽  
R. I. Shakirov ◽  
V. G. Voronova

Nonspecific factors of resistance of the organism of children turned out to be lower in case of localized pneumonia, which can be attributed to the frequent transferred and concomitant diseases and can be considered as the cause of decompensation of protective mechanisms during the period of clinical recovery. When analyzing the developmental histories of children with pneumonia, relapses were found in 30.5% of children after a localized form and in 25.2% after a toxic form. Consequently, follow-up care on an outpatient basis must be carried out regardless of the form of pneumonia transferred.


2020 ◽  
Vol 103 (8) ◽  
pp. 725-728

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)


Author(s):  
Riccardo Scaringi ◽  
Michele Nannelli ◽  
Alessio Franchina ◽  
Giuseppe Lizio ◽  
Luigi V. Stefanelli ◽  
...  

CAD/CAM technology can enhance the dentistry application of ceramic materials that meet the more relevant biocompatibility and aesthetics demands. In implant-borne prosthesis rehabilitation, yttria-stabilized zirconia appeared to be a valid alternative to metal-alloys and titanium, with comparable mechanical properties and even better interaction with bone and soft tissues. The improvement of monolithic CAD/CAM manufacturing allows for a reliable, predictable, and rapid workflow that can correspond to a holistic treatment philosophy associated with zirconia fixtures. This reported clinical case highlights the advantages of this approach in resolving particularly functionally and aesthetically complex situations. A 40-year-old patient with permanent canine impaction and the persistence of a deciduous tooth compromised by caries was successfully rehabilitated with the surgical removal of the enclosed tooth, the seating of a mono-phase zirconia implant after the deciduous extraction and its loading with a zirconia single crown, without any clinical or radiographical alteration up to seven years follow-up.


2021 ◽  
Vol 11 (5) ◽  
pp. 2176
Author(s):  
Krzysztof Dowgierd ◽  
Rafal Pokrowiecki ◽  
Maciej Borowiec ◽  
Marcin Kozakiewicz ◽  
Dominika Smyczek ◽  
...  

Extended postoperative mandibular reconstructions due to orofacial disease involving the temporomandibular joint (TMJ) in immature patients remain a challenge as a result of ongoing growth, which is usually affected by the disease and treatment. Current reconstructive techniques based fully on alloplastic total joint replacement fail to meet fully the anatomical and functional requirements for the masticatory system and speech development. Fourteen children aged 12.6 ± 2.6 with tumors or congenital deformities affecting the mandible and TMJ were included in the study. Radical surgical treatment according to our own protocol was performed through microvascular anastomotic flap reconstruction of the soft tissues and bones, together with total TMJ custom replacements. Follow-up lasted 2–6 years. During the follow-up, increases in the mandible body (13% growth) and ramus (12% growth) were observed, both of which were related (p < 0.001). This is the first report concerning the immediate reconstruction of the mandible with ramus and total TMJ in children and adolescents that combines a free vascularized graft and total individual prosthesis of the TMJ. The presented technique enabled optimal function of the TMJ, growth of the mandible, and further rehabilitation of the patients. The technique was demonstrated to be safe, reliable, and provide good functional and cosmetic outcomes.


Hand Surgery ◽  
2012 ◽  
Vol 17 (03) ◽  
pp. 383-386 ◽  
Author(s):  
Motoki Sonohata ◽  
Hiroko Mine ◽  
Toshiyuki Tsuruta ◽  
Masaaki Mawatari

Isolated volar dislocation of the distal ulna without forearm fracture is very rare; however, this injury is incorrectly diagnosed in approximately 50% of cases. This injury can lead to a significant functional disability if left untreated. This report presents a case of isolated volar dislocation of the distal ulna with an ulnar styloid fracture. The dislocation was subsequently reduced, the styloid was surgically repaired, and the patient was satisfied at the last follow-up. The importance of a proper clinical examination and an accurate radiographic position of the wrist are stressed. Furthermore, clinical evaluation of the distal radioular joint after reduction is important in achieving good results. There are various strategies for the treatment of distal radioulnar joint after reduction, including conservative treatment or surgical treatment. We believe that surgical exploration could have been carried out at an earlier stage had such a lesion been suspected. Additional case reports of other instances of successful treatment are needed to educate orthopaedic surgeons and emergency medical technicians on the nature of this type of injury.


2006 ◽  
Vol 120 (6) ◽  
pp. 497-501 ◽  
Author(s):  
D J McCrystal ◽  
C Bond

Cricotracheal separation (CTS) is an uncommon injury, with a high index of suspicion required to establish the diagnosis. Computerized tomography (CT) plays a role in diagnosis but cannot necessarily be relied upon. Bilateral recurrent laryngeal nerve (RLN) palsies are usually associated with this type of injury. We recently treated a patient with CTS in whom one RLN was intact from the time of the injury and the other nerve recovered within three months. Computed tomography was inconclusive.Early open repair of the injury and frequent follow-up examinations led to successful decannulation after six weeks and excellent short-term voice and airway outcomes.A detailed discussion of this unusual case is followed by a review of the current literature on CTS, with particular emphasis on significant management dilemmas and controversies.Clinical suspicion remains more sensitive than investigations in diagnosing CTS. Permanent bilateral RLN palsies are not inevitable following these injuries.


2021 ◽  
Vol 10 (5) ◽  
pp. 1056
Author(s):  
Giovanni Beltrami ◽  
Gabriele Ristori ◽  
Anna Maria Nucci ◽  
Alberto Galeotti ◽  
Angela Tamburini ◽  
...  

Recently, custom-made 3D-printed prostheses have been introduced for limb salvage surgery in adult patients, but their use has not been described in pediatric patients. A series of 11 pediatric patients (mean age 10.8 years; range 2–13) with skeletal tumors treated with custom-made implants for the reconstruction of bony defects is described. Patients were followed up every 3 months. Functional results were evaluated by the Musculoskeletal Tumor Society Score (MSTS) for upper and lower limbs. The mean follow-up was 25.7 months (range 14–44). Three patients died after a mean of 19.3 months postoperatively—two because of disease progression and the other from a previous malignancy. Three patients experienced complications related to soft tissues. One patient required device removal, debridement, and antibiotic pearls for postoperative infection. Partial osseointegration between grafts and host bone was observed within a mean of 4 months. At the final follow-up, mean MSTS score was 75%. 3D prostheses may yield biological advantages due to possible integration with the host bone and also through the use of vascularized flaps. Further research is warranted.


Author(s):  
Sergey Aleksandrovich Kuzmin ◽  
Lyubov Kuzminichna Grigorieva ◽  
Kargla Amanzhulovna Izbagambetova

In the context of the reform of the Armed Forces of the Russian Federation, the issues of recruiting troops with healthy, physically developed and mentally stable young conscripts are of paramount importance. Only citizens "A" - fit for military service and "B" fit for military service with minor restrictions are subject to conscription. When analyzing the results of medical examination of persons of military age, it was found that over the studied period of time, fitness for military service for health reasons decreased by 3.8% (from 78.3% in 2016 to 74.5% in 2020). However, despite the general decrease in fitness for military service, there is an increase in the fitness for military service "A" by 13.5% (from 23.4% in 2016 to 36.9% in 2020). Every year, during the period of work of the draft commissions, a significant number of citizens (more than 10%) were sent for additional examination to medical organizations. As a rule, the examination of conscripts was carried out on an outpatient basis (up to 85%) and much less often in an inpatient setting (up to 15%). The first place was occupied by diseases of the musculoskeletal system and connective tissue, which accounted for 24.9%. Mental and behavioral disorders ranked second with an indicator of 18.7%. The third place was taken by diseases of the circulatory system - 14.9%. Diseases of the eye and adnexa ranked fourth - 8.2%. Diseases of the digestive system were less common, accounting for only 4.5%. Thus, in total, the listed diseases accounted for 71.2% and were the main ones in determining the fitness of conscripts for military service for health reasons.


2017 ◽  
Vol 89 (2) ◽  
pp. 102 ◽  
Author(s):  
Ali Serdar Gözen ◽  
Paolo Umari ◽  
Walter Scheitlin ◽  
Fuat Ernis Su ◽  
Yigit Akin ◽  
...  

Background&amp;Aim: High grade non-muscle invasive bladder cancer (NMIBC) is common in urological practice. Most of these cancers are or become refractory to intravesical immunotherapy and chemotherapy. Here we evaluated the efficacy of combined local bladder hyperthermia and intravesical mitomycin-C (MMC) instillation in patients with high-risk recurrent NMIBC. Materials and methods: Between February 2014 and December 2015, 18 patients with high risk NMIBC were enrolled. Patients were treated in an outpatient basis with 6 weekly induction sessions followed by monthly maintenance sessions with intravesical MMC in local hyperthermia with bladder wall thermo-chemotherapy (BWT) system (PelvixTT system, Elmedical Ltd., Hod Hasharon, Israel). The follow-up regimen included cystoscopy after the induction cycle and thereafter with regular intervals. Time to disease recurrence was defined as time from the first intravesical treatment to endoscopic or histological documentation of a new bladder tumour. Adverse events were recorded according to CTC 4.0 (Common Toxicity Criteria) score system. Results: Mean age was 72 (32-87) years. 10 patients had multifocal disease, 9 had CIS, 6 had recurrent disease and 2 had highly recurrent disease (&gt; 3 recurrences in a 24 months period). 6 patients underwent previous intravesical chemotherapy with MMC. The average number of maintenance sessions per patient was 7.6. After a mean follow-up of 433 days, 15 patients (83.3%) were recurrence-free. 3 patients had tumour recurrence after a mean period of 248 days without progression. Side effects were limited to grade 1 in 2 patients and grade 2 in 1 patient. Conclusions: BWT seems to be feasible and safe in high grade NMIBC. More studies are needed to identify the subgroup of patients who may benefit more from this treatment.


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