J Trauma
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We evaluated the effect of revision with dynamic compression plate (DCP) and cancellous bone graft for aseptic nonunion after surgical treatments of humeral shaft fracture. ⋯ DCP with cancellous bone graft is a reliable and an effective treatment for revision of aseptic nonunion of humeral shaft fracture after surgical treatment.
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Different hemodynamic parameters including static indicators of cardiac preload as right ventricular end-diastolic volume index (RVEDVI) and dynamic parameters as pulse pressure variation (PPV) have been used in the decision-making process regarding volume expansion in critically ill patients. The objective of this study was to compare fluid resuscitation guided by either PPV or RVEDVI after experimentally induced hemorrhagic shock. ⋯ In the proposed model of hemorrhagic shock, resuscitation to the established endpoints was achieved within a smaller amount of time and with less volume when guided by PPV than when guided by pulmonary artery catheter-derived RVEDVI.
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Preload parameters in postresuscitation phase are not sufficiently sensitive to guide fluid therapy in critically ill patients. We analyzed modifications in the fluid therapy and vasoactive drugs of critically ill patients that were produced by inclusion of extravascular lung water (EVLW) data in the treatment protocol and evaluated the short-term response. ⋯ Quantification of EVLW in patients who can be considered euvolemic induces important modifications in fluid and vasoactive therapy. These changes generally resulted in a lower volume loading and a positive outcome for the patient.
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Hunting-related accidents occur worldwide during the hunting season. The "true incidence" of hunting-related accidents in Denmark is not illuminated in that no compulsory systematic registration procedure is available. The possible impact of alcohol consumption on the risk of being involved in a hunting accident is not yet known; however, the subject frequently is debated throughout the world. ⋯ The incidence of hunting-related accidents in Denmark seems considerably higher than reported. Compulsory and systematic registration of all hunting-related accidents involving firearms should be introduced in Denmark. Legislation rules regarding alcohol intake during hunting should be considered by the authorities.
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The purpose of this study was to prospectively evaluate a protocol that assesses the efficacy and sensitivity of clinical examination in complement with computed tomographic (CT) scan in screening for cervical spine (c-spine) injury. ⋯ In awake and alert blunt trauma patients, clinical examination is a sensitive screening method for c-spine injury. Clinical examination allows for the majority of blunt trauma patients to have their c-spines cleared safely without radiologic screening. Clinical examination in complement with CT scan is a sensitive and an effective method for identification of c-spine injury in awake and alert patients with symptoms of c-spine injury. CT scan is the sensitive and effective test for screening and diagnosis of c-spine injury in blunt trauma patients with altered mental status.