Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Oct 2013
Distinguishing between acute appendicitis and appendiceal mucocele: is this possible preoperatively?
Mucocele of the appendix is an infrequent event, characterized by a cystic dilatation of the lumen. It is often diagnosed clinically from signs and symptoms of acute appendicitis or, if it is asymptomatic, as an incidental finding during ultrasonography, computed tomography, or laparotomy. ⋯ A threshold 10-mm diameter of the appendix under compression is a useful preoperative measurement for differentiating between appendiceal mucocele and acute appendicitis. Microhematuria is simple test that can provide a significant role in supporting the clinical diagnosis of appendiceal mucocele in the emergency department.
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There is a lack of knowledge on respiratory and physical function, mobility and pain following stabilising surgery for 'flail chest'. The purpose of this study was, therefore, to evaluate pain, respiratory function, range of motion and physical function/activity 3 and 6 months after stabilising surgery in patients with 'flail chest' due to trauma. ⋯ Patients who had undergone stabilising surgery due to 'flail chest' showed decreased range of motion 3 and 6 months after surgery. Despite decreased range of motion and remaining pain, the breathing movements are synchronic.
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Eur J Trauma Emerg S · Aug 2013
Impact of fluid therapy on apoptosis and organ injury during haemorrhagic shock in an oxygen-debt-controlled pig model.
Apoptosis, or programmed cell death, seems to play a role in the physiology of shock. The influence of fluid resuscitation on the occurrence of apoptosis during haemorrhage is still unclear. Using an experimental randomised study, the goal of this investigation was to find a relation between different frequently used resuscitation fluids and evidence of apoptosis. ⋯ The different resuscitation fluids used in the treatment of haemorrhagic shock in this experimental model showed no evidence of a different apoptosis rate in the end organs.
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Severe lower limb trauma with significant soft tissue injury can be managed with reconstruction or, if this is impossible, amputation. If amputation is considered, below-knee amputation preserving limb length is optimal for long-term functional outcome. ⋯ The procedure was technically challenging and required follow-up debulking operations. However, the technique provided the significant advantage of immediate sensation of robust glabrous distal stump cover and optimising leg length to enhance functional outcome.