Biochemical Markers with Predictive Value in Polytrauma Patients with Femoral Fractures

Polytrauma represents one of the most challenging aspects of modern medicine, due to its high mortality and morbidity, affecting especially young, active patients. Therefore, research is nowadays directed towards optimising the treatment for these patients, which is extremely difficult, as polytrauma is characterized by a complicated pathophysiology with intricate pathways, potentially generating local and general complications and requiring a multidisciplinary approach. An essential issue for these patients is a careful monitoring algorithm, able to determine an appropriate therapeutic response in due time, so objective, measurable and reproducible elements able to do this have been sought. Since biochemical markers have these properties, and the most important pathogenic element in polytrauma is the Systemic Inflammatory Response Syndrome (SIRS), the authors of this paper evaluate the predictive value of inflammatory markers in order to improve the monitoring algorithm of these patients. The results of this prospective study demonstrate some statistically significant correlations, such as those between lactate (at admission and 24 hours later) and mortality, as well as between IL-6 and early systemic complications, which are of great value because they can concentrate the efforts of the multidisciplinary team and save the life of the poytrauma patient.

Download Full-text

The Impact of External Fixation of Femoral Fractures on Mortality and Morbidity in Polytrauma Patients

Orthofix External Fixation in Trauma and Orthopaedics ◽

10.1007/978-1-4471-0691-3_22 ◽

2000 ◽

pp. 244-248

Author(s):

E. Brug ◽

S. Winckler ◽

M. Püllen ◽

W. Klein

Keyword(s):

External Fixation ◽

Femoral Fractures ◽

Mortality And Morbidity ◽

Polytrauma Patients ◽

The Impact

Download Full-text

Predictive value of IL-1 and IL-6 in polytrauma patients with femoral fractures

10.26226/morressier.58f5b02fd462b80296c9e0d2 ◽

2017 ◽

Author(s):

Doriana Lupescu

Keyword(s):

Predictive Value ◽

Femoral Fractures ◽

Polytrauma Patients

Download Full-text

Neonatal Outcomes at Extreme Prematurity by Gestational Age Versus Birth Weight in a Contemporary Cohort

American Journal of Perinatology ◽

10.1055/s-0040-1722606 ◽

2021 ◽

Author(s):

Elizabeth B. Ausbeck ◽

Phillip Hunter Allman ◽

Jeff M. Szychowski ◽

Akila Subramaniam ◽

Anup Katheria

Keyword(s):

Birth Weight ◽

Umbilical Cord ◽

Gestational Age ◽

Predictive Value ◽

Neonatal Death ◽

Controlled Trial ◽

Neonatal Morbidity ◽

Mortality And Morbidity ◽

Severe Morbidity ◽

Multicenter Randomized Controlled Trial

Objective The aim of the study is to describe the rates of neonatal death and severe neonatal morbidity in a contemporary cohort, as well as to evaluate the predictive value of birth gestational age (GA) and birth weight, independently and combined, for neonatal mortality and morbidity in the same contemporary cohort. Study Design We performed a secondary analysis of an international, multicenter randomized controlled trial of delayed umbilical cord clamping versus umbilical cord milking in preterm infants born at 23 0/7 to 31 6/7 weeks of gestation. The current analysis was restricted to infants delivered <28 weeks. The primary outcomes of this analysis were neonatal death and a composite of severe neonatal morbidity. Incidence of outcomes was compared by weeks of GA, with planned subanalysis comparing small for gestational age (SGA) versus non-SGA neonates. Multivariable logistic regression was then used to model these outcomes based on birth GA, birth weight, or a combination of both as primary independent predictors to determine which had superior ability to predict outcomes. Results Of 474 neonates in the original trial, 180 (38%) were included in this analysis. Overall, death occurred in 27 (15%) and severe morbidity in 139 (77%) neonates. Rates of mortality and morbidity declined with increasing GA (mortality 54% at 23 vs. 9% at 27 weeks). SGA infants (n = 25) had significantly higher mortality compared with non-SGA infants across all GAs (p < 0.01). There was no difference in the predictive value for neonatal death or severe morbidity between the three prediction options (GA, birth weight, or GA and birth weight). Conclusion Death and severe neonatal morbidity declined with advancing GA, with higher rates of death in SGA infants. Birth GA and birth weight were both good predictors of outcomes; however, combining the two was not more predictive, even in SGA infants. Key Points

Download Full-text

Treatment of femoral shaft fractures in polytrauma patients using Mitkovic type internal fixator

Acta chirurgica iugoslavica ◽

10.2298/aci0702033s ◽

2007 ◽

Vol 54 (2) ◽

pp. 33-38 ◽

Cited By ~ 1

Author(s):

P.M. Stojiljkovic ◽

Z.S. Golubovic ◽

M.B. Mitkovic ◽

D.S. Mladenovic ◽

I.D. Micic ◽

...

Keyword(s):

Femoral Shaft ◽

Internal Fixator ◽

Mortality And Morbidity ◽

Femoral Shaft Fractures ◽

Femur Fractures ◽

Shaft Fractures ◽

Polytrauma Patients ◽

Kuntscher Nail ◽

Polytrauma Patient ◽

Bone Vascularization

Polytrauma remains a major social, economic and medicine affliction. Successful surgical treatment of polytrauma patient?s requires an approach predicated on prioritizing injuries. An isolated fractures rarely poses any threat but in association with multiple injuries, a fractures assumes greater significance. Proper management of femur fractures in polytrauma can greatly reduce the mortality and morbidity. In this work the results of the operative treatments of the femoral shaft fractures in polytrauma patients using Mitkovic type internal fixator (14 patients) and Kuntscher nail (9 patients) are compared. The average patients age was 28.43 years (range 16 to 61). Internal fixation using Mitkovic type internal fixator can be method of choose in treatment of femur fractures in polytrauma patient?s. Its application is relatively simple. It doesn?t damage the periosteal and meduullary bone vascularization, which favors osteosynthesis and provides considerable contribution in osteogensis. .

Download Full-text

XPERT MYCOBACTERIUM TUBERCULOSIS/RIFAMPICIN ASSAY: A BOON IN TUBERCULOSIS DIAGNOSTICS

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9i5.13315 ◽

2016 ◽

Vol 9 (5) ◽

pp. 225 ◽

Cited By ~ 2

Author(s):

Sevitha Bhat ◽

Kavya Ramamurthy ◽

Shalini Shenoy ◽

Aseem Rangnekar

Keyword(s):

Mycobacterium Tuberculosis ◽

Predictive Value ◽

High Sensitivity ◽

Mortality And Morbidity ◽

Indicator Tube ◽

Promising Tool ◽

Causes Of Mortality ◽

Conventional Microscopy ◽

Tb Diagnostics ◽

Sensitivity Specificity

ABSTRACTObjectives: Mycobacterium tuberculosis (MTB) remains one of the most significant causes of mortality and morbidity in developing countriesespecially India. India has the highest burden of TB, with an estimated incidence figure of 2.1 million cases out of the 9 million cases of TB globally.Diagnosis of TB relies on conventional microscopy and culture with drawbacks related to sensitivity, specificity, turn around time (TAT). The aim ofthis study was to evaluate the performance of Xpert MTB/rifampicin (RIF) assay (GX) for MTB detection in pulmonary and extrapulmonary clinicalsamples.Methods: A total of 209 clinical specimens (182: pulmonary and 27: extrapulmonary) were processed using auramine smear, culture by mycobacteriagrowth indicator tube and GenXpert.Results: The sensitivity of GenXpert was 62.63% for pulmonary and 55% for extrapulmonary samples. The sensitivity and specificity of GX were100% for the smear positive cases. The sensitivity, specificity, positive predictive value, and negative predictive value of the GX for smear negativecases were 67.8%, 97.5%, 90.4%, and 89.6%, respectively. RIF resistance was detected in 3.8% the samples.Conclusion: GenXpert, with short TAT, high sensitivity, specificity and less technical expertise required is a promising tool in TB diagnostics for thefuture.Keywords: GenXpert, Tuberculosis diagnosis, Molecular method, Rifampicin resistance.

Download Full-text

Determining predictive value of VESPA score for postoperative mortality and morbidity in older cancer patients

Journal of Geriatric Oncology ◽

10.1016/j.jgo.2020.03.011 ◽

2020 ◽

Vol 11 (8) ◽

pp. 1335-1336

Author(s):

Shao-Hua Liu ◽

Fu-Shan Xue ◽

Hai-Jun Hou

Keyword(s):

Cancer Patients ◽

Predictive Value ◽

Postoperative Mortality ◽

Mortality And Morbidity ◽

Older Cancer Patients

Download Full-text

Arzneimittelinteraktionen, die man kennen muss!

DMW - Deutsche Medizinische Wochenschrift ◽

10.1055/a-0160-8413 ◽

2019 ◽

Vol 144 (04) ◽

pp. 264-275

Author(s):

Niels Voigt ◽

Katharina Ort ◽

Samuel Sossalla

Keyword(s):

Cytochrome P450 ◽

Plasma Concentration ◽

Side Effects ◽

Daily Practice ◽

Modern Medicine ◽

Ageing Society ◽

Mortality And Morbidity ◽

Exponential Increase ◽

Number Of Patients ◽

Multiple Drugs

AbstractDrug-drug interactions (DDI) represent a significant problem in modern medicine. The number of patients with multi-morbidity, who take multiple drugs, is constantly increasing (polypharmacy). The related exponential increase in potential DDI is almost incomprehensible. In this article, we review pharmacodynamic DDI and provide clinically relevant examples. In addition, we extensively review pharmakokinetic DDI (e. g. through the cytochrome P450-system or p-glycoproteins) that can modify the plasma concentration of many compounds, thereby also increasing the likelihood of unwanted side effects. Finally we provide tools, which may help clinicians in their daily practice to identify and avoid potential DDI. In the context of an ageing society receiving polypharmacy, a better awareness of DDI and of strategies to prevent them is expected to reduce mortality and morbidity.

Download Full-text

Article Commentary: The Management of Pediatric Polytrauma: Review

Clinical Medicine Insights Trauma and Intensive Medicine ◽

10.4137/cmtim.s12260 ◽

2014 ◽

Vol 5 ◽

pp. CMTIM.S12260

Author(s):

H. Mevius ◽

M. van Dijk ◽

A. Numanoglu ◽

A.B. van As

Keyword(s):

Developing Countries ◽

Emergency Room ◽

Web Of Science ◽

Current Knowledge ◽

Paediatric Population ◽

Crucial Point ◽

Comprehensive Overview ◽

Mortality And Morbidity ◽

Age Appropriate ◽

Polytrauma Patients

Polytrauma is a major cause of mortality and morbidity in both developed and developing countries. The primary goal of this review is to provide a comprehensive overview on current knowledge in the management of pediatric polytrauma patients (PPPs). A database review was conducted based on a search in the Embase, Medline OVID-SP, Web of Science, Cochrane central, and Pubmed databases. Only studies with “paediatric population” and “polytrauma” as criteria were included. A total of 3310 citations were retrieved. Of these, 3271 were excluded after screening, based on title and abstract. The full texts of 39 articles were assessed; further selection left 25 articles to be included in this review. The most crucial point in the management of PPPs is preparedness of the staff and an emergency room furnished with age-appropriate drugs and equipment combined with a systemic approach.

Download Full-text