Cir Cir
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Observational Study
[Craniocerebral gunshot wounds in civilian population: Analysis of experience in a single center in Monterrey, México].
Gunshot wounds in civilian population of México were quite rare. Currently, conflicts amongst organized crime groups are carried out with weapons, which are considered as exclusive use by the natiońs army. ⋯ GCS upon admission and state of the pupils are the most influential factors in the prognosis. Patients with a GCS > 8 < 13 points upon admission, normal pupillary response, without ventricular compromise can benefit with early and aggressive surgical treatment.
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Flail chest is managed with mechanical ventilation or inhalation therapy, and analgesia. Mechanical ventilations carry risks by themselves and disengage with the external fixators so they must be operated to improve lung ventilatory mechanics and cleaning. Little has been published on the use of bioabsorbable material and its evolution in the setting of flail chest. ⋯ Flail chest has a high (16.3%) mortality when no management provides the pathophysiology of the condition (pain, poor mechanical ventilation, alveolar edema-pulmonary contusion). The use of bioabsorbable material has no side effects attributable to material which is another option for rib fixation.
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Observational Study
[Ultrasound-guided continuos infraclavicular block for hand surgery: technical report arm position for perineural catheter placement].
Continuous perineural infusion of local anesthetic provides better postoperative analgesia than intravenous administration of opioids or NSAIDs in upper limb surgery. The infraclavicular approach is a good option due to the muscular stability to catheter; the abduction of the arm apparently makes more superficial the brachial plexus and which elevates clavicle cephalad. ⋯ Arm abduction allows better scanning facilitates the infraclavicular puncture and catheter introduction.
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Comparative Study Controlled Clinical Trial
[Interscalene block for total shoulder arthroplasty: comparative study (ultrasound vs. neurostimulation)].
Modern anesthesiology has integrated the use of ultrasonography as a tool that has displaced neurostimulation as a technique for locating peripheral nerves. The aim of this study was to determine which procedure is more effective for guiding interscalene block for total shoulder arthroplasty. ⋯ Ultrasound-guided interscalene nerve block is the technique of choice in elective total shoulder arthroplasty.
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Comparative Study
[Preoperative embolization with microspheres of giant supratentorial meningiomas: 5-year experience].
Preoperative embolization of hypervascular tumours such as meningiomas has proven to be a favorable factor for resection of the latter because it diminishes intraoperative bleeding and the need for blood transfusions. ⋯ Embolization with microspheres improves resection rate evaluated by the Simpson scale in patients with giant supratentorial meningiomas.