European journal of trauma and emergency surgery : official publication of the European Trauma Society
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Early recognition of a possible infection and therefore a prompt and accurate diagnostic strategy is essential for a successful treatment of posttraumatic osteomyelitis (PTO). However, at this moment there is no single routine test available that can detect osteomyelitis beyond doubt and the performed diagnostic tests mostly depend on personal experience, available techniques and financial aspects. Nuclear medicine techniques focus on imaging pathophysiological changes which usually precede anatomical changes. Together with recent development in hybrid camera systems, leading to better spatial resolution and quantification possibilities, this provides new opportunities and possibilities for nuclear medicine modalities to play an important role in diagnosing PTO. ⋯ In this overview paper the techniques and available literature results for PTO are discussed for the three most commonly used nuclear medicine techniques: the three phase bone scan (with SPECT-CT), white blood cell scintigraphy (also called leukocyte scan) with SPECT-CT and (18)F-fluorodeoxyglucose (FDG)-PET/CT. Emphasis is on how these techniques are able to answer the diagnostic questions from the clinicians (trauma and orthopaedic surgeons) and which technique should be used to answer a specific question. Furthermore, three illustrative cases from clinical practice are described.
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Eur J Trauma Emerg Surg · Aug 2016
ReviewThe use of Reamer-irrigator-aspirator in the management of long bone osteomyelitis: an update.
Reamer-irrigator-aspirator (RIA) is an innovative device that its indications have recently been expanded to the management of long bone infections. ⋯ The use of RIA for the management of long bone infections is an innovative and promising strategy. High quality studies are needed to shed light in its efficacy compared to conventional methods of management of osteomyelitis of long bones.
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Eur J Trauma Emerg Surg · Aug 2016
Multicenter Study Comparative StudySevere Trauma in Estonia: 256 consecutive cases analysed and the impact on outcomes comparing two regions.
The purpose of this study was to investigate epidemiology of severe injuries in Estonia while comparing outcomes at regional trauma facilities. ⋯ The annual incidence of injuries with ISS > 15 was 256 cases with overall mortality at 20.7 % in Estonia. We observed comparable adjusted outcomes at the major regional trauma facilities. This study contains benchmarking data on severely injured patients in Estonia providing potential for future trauma care evaluation and regional outcome comparisons.
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Eur J Trauma Emerg Surg · Aug 2016
Randomized Controlled TrialThe role of pharmacological steroid therapy in preservation of renal function in severely injured patients requiring massive transfusion.
Glucocorticoids (GC) attenuate the post-insult inflammatory response and have been observed to confer end-organ protection following a variety of ischemic insults. We aim to assess this benefit on renal perfusion and function in injured patients requiring massive transfusion. ⋯ In the absence of larger studies, this study demonstrates that GC likely have no role in preserving renal function in severely injured patients.
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Eur J Trauma Emerg Surg · Aug 2016
Simple scoring system for prediction of mortality in Fournier's gangrene.
To create new scoring system for prediction of hospital mortality for patients with Fournier's gangrene(FG). ⋯ Our scoring system shows adequate discriminatory function for prediction of mortality in patients with FG. Further larger scale studies can improve the performance of our score.