J Trauma
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In 1976 belt usage was made compulsory for front seat passengers in the Federal Republic of Germany. Since 1984, noncompliance incurs a fine of DM 40. In 1984 belt usage was also made compulsory for back seat passengers (noncompliance not being fined). ⋯ Approximately 15 to 20 percentage points of this change are probably due to this measure. Major injuries decreased noticeably as well, in particular injuries to the eyes. Belt usage on back seats is still unsatisfactory (20%), although here too, the effect on injuries of the belt is incontestable, taking into consideration occupant interaction.
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A hemorrhagic-traumatic shock model in 20 domestic pigs (Sus scrofa) was used to evaluate the pharmacologic effect of methylprednisolone in preventing disseminated intravascular coagulation (DIC). Pairs of animals were anesthetized with thiopental and both femoral arteries cannulated. Four ml/kg-1 of blood were withdrawn, frozen, thawed, and returned to the animal. ⋯ Blood samples were analyzed for prothrombin time, partial thromboplastin time, fibrinogen level, and platelet count. The combination of hemorrhagic shock and hemolysis produced DIC and a fatal shock. Pharmacologic doses (30 mg/kg-1) of methylprednisolone significantly prevent the DIC.
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We present a case of a splenic arteriovenous fistula (AVF) occurring postsplenectomy. The splenectomy was performed as a result of severe blunt abdominal trauma. ⋯ Splenic AVF are usually due to rupture of a pre-existing splenic artery aneurysm, post-traumatic, or iatrogenic. Diagnosis and treatment of a splenic AVF are necessary to prevent the development of hepatosclerosis and esophageal varices.
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A patient with traumatic disruption of the thoracic duct resulting in a chylothorax and a 'chyloma' in the left supraclavicular region is described. Supradiaphragmatic ligation of the thoracic duct was necessary for treatment of the chyloma.
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During the 10-year period from 1975 to 1985 20 patients suffering from causalgia were treated. There were 15 men and five women. Ages ranged from 17 to 45 years (mean, 23). ⋯ The diagnosis of causalgia was based on the characteristic clinical picture and was confirmed by sympathetic blocks. All patients were treated by sympathectomy and all had complete dramatic relief in the immediate postoperative period. Followup ranged from 4 months to 10 years (mean, 5.3 yr).