Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Dec 2008
Postoperative Protocol in the Prevention of Fragility Fractures in Patients with Osteoporosis-Related Fractures.
Osteoporosis is a multifactorial disorder that requires advanced diagnostic evaluation tools. It should not be considered to be an inevitable disease entity or as a logical consequence of the physiological ageing process. Osteoporosis can be diagnosed and - more importantly - properly treated. ⋯ Basic measures for fracture prevention, including dietary supplements of calcium and vitamin D, should be recommended and implemented for all patients, whereas only those patients with the diagnosis of a manifest osteoporosis should receive a specific pharmacotherapy. Antiresorptive and anabolic drugs that are licensed for the treatment of men or postmenopausal women with osteoporosis have been shown to effectively reduce the incidence of vertebral and non-vertebral fractures. An evaluation of the treatment efficiency should also be performed, such as routine clinical re-evaluation and the measuring of the bone mineral density by dual X-ray absortiometry, every 18-24 months after the initiation of the pharmacotherapy.
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Eur J Trauma Emerg S · Dec 2008
The Second Most Common Bone Disease: A Review on Paget's Disease of Bone.
Paget disease of bone (PDB) is the second most common metabolic bone disease. It is a chronic disease with a mono- or polyostotic appearance that is characterized by an increased bone turnover. The orthopedic surgeon is often confronted with such symptoms and complications as bone pain, skeletal deformities, and pathologic fractures caused by the "out-of-balance bone remodeling process". ⋯ Patients with PDB are at increased risk for surgical complications, such as blood loss and heterotopic bone formation, if operative treatment is necessary. However, advances in surgical techniques and accompanying medical treatment could potentially improve the overall outcome of these patients. To achieve that goal, careful perioperative interdisciplinary management and monitoring are essential.
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Eur J Trauma Emerg S · Dec 2008
Blunt Left Extrahepatic Bile Duct Injury: Case Report and Literature Review.
Extrahepatic biliary tract injuries following blunt abdominal trauma are very rare and pose a diagnostic and therapeutic challenge. ⋯ In the setting of suspected biliary tract injury, early ERCP is essential to localize a leak and guide management decisions. In the event of a confirmed bile leak, a trial of nonoperative management consisting of endoscopic ductal decompression along with percutaneous drainage may initially be warranted although is not always successful.
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Eur J Trauma Emerg S · Dec 2008
Bogota-VAC - A Newly Modified Temporary Abdominal Closure Technique.
We present Bogota-VAC, a newly modified temporary abdominal closure (TAC) technique for open abdomen condition after abdominal compartment syndrome (ACS). ⋯ The advantage of the presented Bogota-VAC is leak tightness, wound conditioning (soft tissue/fascia), skin protection and facilitation of nursing in combination with highest volume reserve capacity (VRC), thus preventing recurrent increased intra-abdominal and intracranial pressure in the initial phase after decompression of ACS compared to other TAC techniques.
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To assess the current stage of trauma system development and trauma surgery training in Europe. ⋯ Despite the great variation from country to country, three trends in developing trauma care and education can be identified: trauma system development based exclusively on major (life-threatening) trauma care (the old United States model), combining trauma and emergency surgery into a single regionalized system (the acute care surgery model), or maintaining the orthopedic surgery-orientated all-inclusive trauma care model as practiced in most central European countries today. Although each country and region might proceed along their own line depending on local circumstances, some kind of general guidelines and recommendations at least at the European Union level would be urgently needed.