Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
-
Ulus Travma Acil Cerrahi Derg · Jul 2024
Randomized Controlled Trial Comparative StudyComparison of the effects of axillary brachial plexus block, inhalation anesthesia, and total intravenous anesthesia on tourniquet-induced ischemia-reperfusion injury in upper extremity surgery.
Post-ischemia reperfusion can lead to oxidative stress and an increase in oxidative markers. Employing preventive strategies and antioxidant agents may help mitigate ischemia-reperfusion injury (IRI). The use of a tourniquet in extremity surgery has been associated with IRI. This study aims to investigate the impact of three different approaches- brachial plexus block, total intravenous anesthesia (TIVA), and inhalation anesthesia-on IRI during upper extremity surgery using a tourniquet. ⋯ Axillary anesthesia results in a sympathetic block, promoting better perfusion of the upper extremity. This study demonstrated lower levels of oxidative stress markers with axillary plexus block. Therefore, these results suggest that the axillary block has the potential to mitigate IRI.
-
Ulus Travma Acil Cerrahi Derg · Jul 2024
Mid- to long-term outcomes of proximal humerus fractures treated with open reduction, plate fixation, and iliac bone autograft augmentation.
Open reduction and internal fixation (ORIF) using locking plates is a widely adopted treatment for displaced proximal humerus fractures. Various augmentation techniques have been developed to enhance the stability of plate fixation. Among these, iliac bone autograft is notable for its advantages over allografts, such as ready availability and the elimination of costs and risks associated with disease transmission. Despite its potential benefits, data on the outcomes of iliac bone autograft augmentation (IBAA) are still limited. This study aims to present the mid- to long-term results of treating proximal humerus fractures with ORIF using locking plates and IBAA. ⋯ Our findings suggest that ORIF with IBAA is an effective method for managing three- or four-part proximal humerus fractures, yielding excellent outcomes.
-
Ulus Travma Acil Cerrahi Derg · Jul 2024
Predictive factors for acute kidney injury and amputation in crush injuries from the Kahramanmaraş earthquakes.
Crush syndrome (CS) is characterized by high morbidity and mortality due to severe electrolyte disorders, circulatory dysfunction, and multiple organ failure, secondary to severe rhabdomyolysis and reperfusion injuries. Acute kidney injury (AKI) related to crush syndrome is one of the life-threatening complications and is the most frequent cause of death following earthquakes, other than trauma. We conducted a retrospective study to identify predictive parameters from clinical and laboratory data that aid in recognizing CS, assessing its severity, and evaluating acute kidney injury and amputation indications in patients. ⋯ The study analyzed the effectiveness and predictability of clinical and laboratory findings concerning amputation and acute kidney injury in crush syndrome resulting from earthquakes. Effective amputation management is a crucial factor influencing prognosis and survival in patients with earthquake-induced crush syndrome.
-
Ulus Travma Acil Cerrahi Derg · Jul 2024
A method for predicting mortality in acute mesenteric ischemia: Machine learning.
This study aimed to develop and validate an artificial intelligence model using machine learning (ML) to predict hospital mortality in patients with acute mesenteric ischemia (AMI). ⋯ Independent risk factors for mortality were identified in patients with AMI. An efficient and rapid method using various ML models to predict mortality has been developed.
-
Ulus Travma Acil Cerrahi Derg · Jul 2024
Deaths due to tired bullet injuries: Evaluation from medical, legal, and social perspectives.
In Türkiye, as in other parts of the world, there is a rising trend in individual armament and firearm violence, resembling an epidemic. When fired into the air, bullets eventually lose the initial speed with which they left the barrel and begin to accelerate downwards under the influence of gravity as they fall to the ground. At this point, these projectiles are referred to as 'tired bullets,' which cause serious injuries and fatalities. This study evaluates autopsy cases of deaths due to tired bullet injuries. We aimed to raise social awareness and contribute to the literature by exploring the forensic, legal, and social dimensions of tired bullet injuries. ⋯ Tired bullet injuries represent a significant public health issue that necessitates comprehensive preventative measures addressing medical, legal, and social dimensions. There should be national and international campaigns led by the media, involving all public institutions, organizations, and non-governmental organizations to promote individual disarmament, highlight the dangers of firearms, and stress the importance of these initiatives.