Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Nov 2020
High-pressure injection injuries to the upper extremity and the review of the literature.
High-pressure injection injuries of the hand are rare severe injuries. This study aimed to present a retrospective analysis of current and possible prognostic factors, treatment modalities and evaluation criteria. ⋯ Early and serial debridement and compartment syndrome evaluation are required. Despite these cautions, amputation may occur. Material, injection force and the time elapsed are the main determinants in prognosis. Aggressive debridement is required in high-pressure injection injuries. However, the adequacy of debridement should be evaluated because it is mostly impossible to completely clean the tissue from diesel or thinner. According to the experience of 10 cases in our series, when clinical and macroscopic debridement adequacy was observed, a decrease in WBC and neutrophil levels was observed simultaneously. For this reason, WBC and neutrophil levels may be an indicator of the adequacy of debridement, although these injuries are very rare, larger series are needed for this interpretation.
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Ulus Travma Acil Cer · Nov 2020
APACHE II or INCNS to predict mortality in traumatic brain injury: A retrospective cohort study.
Some scoring systems, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), are used to predict mortality, but they are not specialized for traumatic brain injury. INCNS is a new scoring system for traumatic brain injury developed by Goa et al. INCNS score evaluates inflammation, nutrition, consciousness, neurological function and systemic condition. The present study aims to evaluate performances of Acute Physiology and Chronic Health Evaluation II (APACHE II) and INCNS to predict mortality in traumatic brain injuries. ⋯ The INCNS scoring system had higher discriminatory power than the APACHE II in predicting the mortality of TBI in the ICU. INCNS can be considered as a usable prognostic model for Turkish people.
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Ulus Travma Acil Cer · Nov 2020
Does a selective surgical approach to malignant bowel obstruction help in palliative care patients?
Malignant bowel obstruction (MBO) is a condition secondary to intra-abdominal metastatic spread of advanced-stage tumors. There is no consensus for the treatment approach of MBO. This study aims to present the results of medical treatment and palliative surgery in patients diagnosed with MBO. ⋯ This study revealed that surgical treatment resulted in better outcomes for life quality parameters in highly selected patients with malignant bowel obstruction evaluated by multidisciplinary team, including palliative care.
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There is still no agreed radiographic rule for the evaluation of blunt thoracic trauma. Emergency physicians want radiography according to their experience and examination findings. Various studies have been carried out on this subject and some of these studies have reached findings that can support the initial steps of the rules of radiography. One of them is the rule of Nexus thorax radiography rules. In this study, we aim to determine the accuracy of nexus thorax radiography rules. ⋯ In the evaluation of blunt thoracic trauma, the rules of nexus thorax radiography are considered useful concerning pathological detection.
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Ulus Travma Acil Cer · Nov 2020
The common comorbidities leading to poor clinical outcomes after the surgical treatment of ankle fracture-dislocations.
The ankle fracture-dislocations are a significant traumatic incident for the bone and the soft tissue surrounding the ankle. Bone stabilization, joint immobilization, anatomic reduction and intervention for soft tissue protection should be performed as early as possible. The present study aims to determine the frequency of major comorbidities that can be seen after surgery in patients with ankle fracture-dislocations and the relationship between the trauma mechanism and clinical status with these comorbidities. ⋯ Clinical and functional results were found to be worse in patients with open ankle fractures, the rate of arthrosis increased with age, and the use of syndesmosis screw had a positive but not a statistically significant effect on clinical and functional outcomes.