Articles: trauma.
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The role of total hip arthroplasty (THA) for fracture in octogenarians remains unclear. Over a two-year period, 354 patients aged > 80 years were admitted with a displaced intracapsular hip fracture. Using defined clinical guidelines, 38 patients underwent THA with a median age of 84 years, mean follow-up of 20 months. ⋯ There were no dislocations or periprosthetic fractures and patient survival was 97% at 30 days and 87% at one year. There was one revision for deep infection. This study demonstrates that THA for selected octogenarians can be performed safely, allows the majority of patients to return to independent living and has a low complication rate.
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There is a pressing need for low-cost intervention models to promote mental health among children in the wake of natural disasters. This article describes an evaluation of one such model: the Happy/Sad Letter Box (HSLB) Project, a mental health promotion intervention designed to minimize trauma in children, resulting from the Indian Ocean tsunami of 26 December 2004. The HSLB Project was implemented in 68 schools in Sri Lanka's Hambantota District from April 2005 forward. ⋯ The Nairobi Call to Action [WHO (2009) Nairobi Call to Action for Closing the Implementation Gap in Health Promotion. Geneva: World Health Organization] emphasized the importance of mainstreaming health promotion into priority programme areas, specifically including mental health. The HSLB Project represents the integration of health promotion practice into disaster preparedness mental health infrastructure.
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Pleural Disease/Pleural Effusion PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Chylothorax is a type of pleural effusion (PE) that occurs infrequently. Chylous fluid appearance is not always present, and the routine inclusion of cholesterol and triglyceride levels is probably necessary. ⋯ The following authors have nothing to disclose: Patricia Castro Acosta, Deisy Barrios Barreto, Paola Arrieta Narvaez, Esteban Perez Rodriguez, Salvador Diaz Lobato, Patricia Lazo Meneses, Carolina GoteraNo Product/Research Disclosure Information.
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Evaluating the cervical spine in the obtunded trauma patient is a subject fraught with controversy. Some authors assert that a negative computed tomography (CT) scan is sufficient. Others argue that CT alone misses occult unstable injuries, and magnetic resonance imaging (MRI) will alter treatment. This study examines the data in an urban, county trauma center to determine if a negative cervical spine CT scan is sufficient to clear the obtunded trauma patient. ⋯ In the obtunded trauma patient with a negative cervical spine CT, obtaining an MRI does not appear to significantly alter management, and no unstable injuries were missed on CT scan. This should be taken into consideration given the current efforts at cost-containment in the health care system. It is one of the larger studies published to date.
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Contemporary war-related studies focus primarily on adults with few reporting the injuries sustained in local pediatric populations. The objective of this study is to characterize pediatric vascular trauma at US military hospitals in wartime Iraq and Afghanistan. ⋯ This study is the first to report vascular trauma in a pediatric population at wartime. Vascular injuries involve a high percentage of extremity and torso wounding. Torso vascular injury in children is four times lethal relative to other injury patterns, and therefore should be considered in operational planning both in the military and civilian setting regarding pediatric vascular injuries.