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Giovanni Bellanova, Francesco Buccelletti, Riccardo Berletti, Marco Cavana, Giorgio Folgheraiter, Francesca Groppo, Chiara Marchetti, Amelia Marzano, Alessandro Massè, Antonio Musetti, Tina Pelanda, Nicola Ricci, Gregorio Tugnoli, Damiano Papadia, Claudio Ramponi
AIM: Aim of this study is to analyze how the starting of Course of Trauma in our hospital improved survival and organization in management of polytraumatized patients. MATERIAL OF STUDY: We analysed all major trauma patients (Injury Severity Score (Injury Severity Score (ISS)> 15) treated at Emergency Department of the Santa Chiara Hospital between January 2011 and December 2014. The training courses (TC) were named "management of polytrauma" (MP) and "clinical cases discussion" (CCD), and started in November 2013...
2016: Annali Italiani di Chirurgia
Solange Emanuelle Volpato, Jovino Dos Santos Ferreira, Vera Lúcia Paes Cavalcanti Ferreira, David Cavalcanti Ferreira
BACKGROUND: The anemia is a common problem upon admission of the patients in the intensive care unit being the red blood cell transfusion a frequent therapeutic. The causes of anemia in critical patients who under go red blood cell transfusion are several: acute loss of blood after trauma, gastrointestinal hemorrhage, surgery amongst others. Currently, few studies are available regarding the use of blood components in patients at intensive care unit. Although blood transfusions are frequent in intensive care unit, the optimized criteria for handling are not clearly defined, with no available guidelines...
December 2009: Revista Brasileira de Terapia Intensiva
Francisco Ruas, M Cristina Mendonça, Francisco Corte Real, Duarte Nuno Vieira, Helena M Teixeira
This study presents the epidemiology and the postmortem forensic aspects in cases with a carboxihemoglobin (COHb) analysis, from autopsies performed at the Forensic Pathology Department of the Centre Branch of the National Institute of Legal Medicine and Forensic Sciences of Portugal. Between January 2000 and December 2010, 69 COHb analyses were requested in our institution. In approximately 70% of the situations, circumstantial information included a Carbon Monoxide (CO) source at the death scene. More than half of the cases presented thermal lesions, cherry-red lividity, and cherry-red blood and viscera coloration were found in, approximately, 30% of the cases...
May 2014: Journal of Forensic and Legal Medicine
Giovanni Bellanova, Alessandro Motta, Chiara Mazzetti, Michele Motter, Luca Fabris, Giorgio DeVigili, Gerardo Liguori
AIM: Our objective is to describe a case of hypothermic politrauma management in our country. MATERIAL OF STUDY: We report the case of a 29-year-old male who was a beating victim and fell off from 4 meters, and was afterwards found after an unknown time interval. The patient came to our DEA in cardiac arrest and underwent to a aggressive and prolonged resuscitation which included sternotomy and extracorporeal circulation. RESULTS: The patient was discharged in 40th postoperative day without neurologic complications and complete recovery...
July 2013: Annali Italiani di Chirurgia
Małgorzata Mikaszewska-Sokolewicz, Paweł Zatorski, Tomasz Łazowski, Krzysztof Jankowski, Mariusz Piotrowski
Accidents and posttraumatic injuries are one of the most important health and social problems. Most of them require immediate medico-surgical intervention. Accidents are the leading cause of death among young people under age of 40. In 25% of cases they lead to disability. Fall from height causes inter alia blunt chest trauma, and internal organs contusion (e.g. heart and lungs), and may be fatal to substantial number of trauma victims. Excluding criminal injuries, this kind of trauma may occur during accidental fall or deliberate suicide attempt...
July 2012: Anaesthesiology Intensive Therapy
António Nogueira Sousa, José A Paiva, Sara A Fonseca, Frederico J Raposo, Alvaro M Loureiro, Luís F Valente, António M Gonçalves, Abel T Cabral, Luís Almeida
BACKGROUND: The improvement rescue and transport of politrauma patients (PTP) increases the number of patients admitted to the Emergency departments in very severe conditions. The early prediction of later complications and bad outcomes is paramount for a good strategy. The aim of this study was to evaluate the severity of PTP in the Trauma Room (TR) of a Level 1 Hospital, using the ISS, RTS, TRISS scores and define variables associated with bad outcomes, namely ICU admission (ICU), ARDS, MODS and Death...
November 2011: Acta Médica Portuguesa
A V Ciurea, M R Gorgan, A Tascu, A M Sandu, R E Rizea
OBJECT: Children 0-3 years old present a completely different neurotraumatic pathology. The growing and the development processes in this age group imply specific anatomical and pathophysiological features of the skull, subarachnoid space, CSF flow, and brain. Most common specific neurotraumatic entities in children 0-3 years old are cephalhematoma, subaponeurotic (subgaleal) hematoma, diastatic skull fracture, grow skull fracture, depressed ('ping-pong') skull fracture, and extradural hematoma...
August 15, 2011: Journal of Medicine and Life
Paweł Skowronek, Julian Dutka, Michał Skowronek, Łukasz Dutka
UNLABELLED: The authors describe the case of a 21 year old patient who suffered an politrauma injury in a traffic accident (motorcyclist). OBJECTIVES: Presentation of possiblities of treatment femur bone fracture with critical bone loss using intramedullary nail. METHODS: Patients's Injury included: fractures of the femur, temporal bone, and ulna. The patient's Severity Score (ISS) was 24. The dominant trauma fracture was open, comminuted fracture of femur shaft (AO 32-C2, Anderson-Gustilo IIIa) with bone loss stated as critical (loss of femoral shaft over 10 cm, including the loss of more than 50% of the circumference was about 8 cm length, and the loss of the full circumference of more than two branches of the missing bone)...
September 2011: Chirurgia Narzadów Ruchu i Ortopedia Polska
Ernestina Gomes, Daniela Moreira, Daniela Chaló, Cláudia Dias, Elisabete Neutel, Irene Aragão, Altamiro Costa-Pereira
OBJECTIVES: To determine the impact of rurality in epidemiology, injury severity, health care facilities, length of stay, mortality, functional outcome and quality of life in severe trauma patients. METHODS: All trauma patients admitted in our Emergency Room between 2001 and 2007. Data was collected from the prospective Trauma Registry and Follow-Up Registry 6 months after the accident. Patients were divided in three groups according to residence area: R (rural), SU (semi-urban) and U (urban)...
January 2011: Acta Médica Portuguesa
Franco Baldoni, Gregorio Tugnoli
It has been two decades since Maggiore Hospital Trauma Center started its formal activity focused on improving and developing Trauma management and Surgery of Trauma. Whilst evaluating the results of the last year, we can not avoid to look behind at the beginning, comparing the actual activity with the settings we have started from, in 1989. Before this date in our hospital all the Emergency and Trauma Surgery was managed by General Surgeons. However since 1989 few surgeons and ICU anaesthetists started to focus their training and activity on management of Trauma...
January 2010: Annali Italiani di Chirurgia
Lul Raka, Smilja Kalenć, Zrinka Bosnjak, Ana Budimir, Stjepan Katić, Dubravko Sijak, Gjyle Mulliqi-Osmani, Dick Zoutman, Arbëresha Jaka
Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacter baumannii in the Central Intensive Care Unit (CICU) of a University hospital in Kosova using pulse field gel electrophoresis (PFGE). During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised...
December 2009: Brazilian Journal of Infectious Diseases
Domenico Mileto, Stefano Cotrufo, Giuseppe Cuccia, Gabriele Delia, Giovanni Risitano, Michele R Colonna, Francesco Stagno d'Alcontres
INTRODUCTION: Coverage of soft tissue defects in the lower leg is often made by use of free flap, also because of the improving of anaesthesiology techniques in the last decades. However, there are disadvantages in the use of free flaps like the need for a remote donor site, increased operative time, use of a major vessel to the leg, and microsurgical skills. Besides these, trauma in the lower limb are often cause of damage for a major vessels of the leg, so the use of free flaps in these patients may be related to an higher incidence of complications; also associated pathologies, like diabetes and vascular pathology, can increase the incidence of complications when a free flap is utilized...
July 2007: Annali Italiani di Chirurgia
Adnana Talić, Zoran Hadziahmetović
Politrauma is combination of the most complicated injuries caused by very strong forces. We present treatment of politraumatized patient who has injured his abdomen, with clinical and ultrasonic sings of bleeding-liver rupture, fractured pelvis and both arms and legs. All necessary diagnostic procedures have been performed and treatment team has been formed. After one year of psycical therapy, the patient can independently walk.
2007: Medicinski Arhiv
Gregorio Tugnoli, Sergio Ribaldi, Marco Casali, Stefano Massimiliano Calderale, Massimo Coletti, Silvia Villani, Andrea Biscardi, Giovanni Sinibaldi, Maria Chiara Giordano, Franco Baldoni
BACKGROUND: The consequences of low incidence of penetrating injuries in Europe and of the increasing in nonoperative management of blunt trauma are a decrease in surgeons' confidence for managing traumatic injuries. The Corso Teorico Pratico di Chirurgia del Politrauma was developed as model for teaching operative trauma techniques. The aim of this retrospective study is to evaluate the effectiveness of the course and compare it with other similar courses. METHOD: The Corso Teorico Pratico di Chirurgia del Politrauma is a two day course and consists of lecture on trauma topics and porcine operative experience...
January 2007: Annali Italiani di Chirurgia
Fabio Pinto, Paul J Bode, Michele Tonerini, Eugenio Orsitto
The management of trauma patients has become a very relevant issue and one of the major challenges in the western countries. In the assessment of politrauma patients, since the last 2 decades, radiological imaging methods have been increasingly used in order to provide a quick and thorough survey of craniocerebral, cervical, abdominal, pelvic and limb traumatic injuries. Among imaging methods, conventional radiographs (CR) have precise but limited indications. In most European hospitals, UltraSonography (US) represents the method of choice for patients referred following blunt abdominal trauma, whereas multislice computed tomography (MSCT) remains a second-line method of investigation, although it provides a fully comprehensive assessment of their injuries and allows for their categorization according to the severity of traumatic injuries...
September 2006: European Journal of Radiology
Gregorio Tugnoli, Sergio Ribaldi, Marco Casali, Stefano M Calderale, Massimo Coletti, Marco Alifano, Sergio N Forti Parri, Silvia Villani, Andrea Biscardi, M Chiara Giordano, Franco Baldoni
BACKGROUND: The consequence of the low rate of penetrating injuries in Europe and the increase in non-operative management of blunt trauma is a decrease in surgeons' confidence in managing traumatic injuries has led to the need for new didactic tools. The aim of this retrospective study was to present the Corso di Chirurgia del Politrauma (Trauma Surgery Course), developed as a model for teaching operative trauma techniques, and assess its efficacy. METHOD: the two-day course consisted of theoretical lectures and practical experience on large-sized swine...
2006: World Journal of Emergency Surgery: WJES
A V Ciurea, T Coman, L Roşu, J Ciurea, S Băiaşu
Authors present a seven years retrospective study on 85 cases of severe brain injuries (SBI) in children (GCS </= 8) treated in the Pediatric and ICU Departments of the Clinic Hospital "Bagdasar-Arseni" Bucharest, Romania. The relationship between ICP, GCS on admission, the CT-scan/MRI alteration and the outcome evaluated by the Glasgow Outcome Scale (GOS) were studied in order to highlight the most important factors to improve prognosis. An overall mortality of 25.9% was found in this series. Authors concluded that the ICP values at admission >/= 20 mmHg, the Diffuse Axonal Injury (DAI) on MRI and the GCS on admission are factors of prognosis in SBI in children...
2005: Acta Neurochirurgica. Supplement
S Abramovici, R L Souza
OBJECTIVES: To present objectively the therapeutic aspects for the management of child victim of trauma.METHODS: The most relevant articles about the management of acute trauma were selected.RESULTS: Children possess great potential for recovery after a trauma, however, inappropriate resuscitation is the major cause of death preventable.Care in the opening and maintenance of the airways, adequate input of fluid to the child victim of politrauma or burns as well as prompt diagnosis and effective management to internal bleeding has improved prognosis and can reduce mortality considerably...
November 1999: Jornal de Pediatria
A Orlandi, S Fratoni, I Hermann, L G Spagnoli
A 41 year old man with a history of politrauma presented with a nodular mass of the left false vocal cord, associated with progressive dysphonia, dyspnoea, and dysphagia. A computed tomography scan of the neck region showed a rounded and circumscribed mass without infiltration of the surrounding tissues. Histological investigation of the nodule revealed the presence of fibroelastic cartilaginous tissue, surrounded by a thin rim of fibrous tissue, with rare hypercellular areas, occasional binucleated cells, slight hyperchromasia, and an irregular nuclear profile...
December 2003: Journal of Clinical Pathology
Rafał Pankowski, Anita Wilmanowska, Tomasz Gos, Andrzej Smoczyński
We reviewed the autopsy records of 1872 cases of death because of politrauma, gunshot wounds and suicidal hanging. The analysis included causes and frequency of cervical spine fractures, their most common localisation, architecture of bone destruction and their influence on cervical cord. The most common cause of cervical spine injury was motor vehicle accidents. We examined 82 specimens with traumatic fractures of cervical spine obtained from accident victims. About half of the injuries occurred in upper cervical spine...
2003: Chirurgia Narzadów Ruchu i Ortopedia Polska
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