Energy Technology Data Exchange (ETDEWEB)

The number of multislice CT (MSCT) scans performed in polytraumatized children has increased rapidly. There is growing concern regarding the radiation dose in MSCT and its long-term consequences, especially in children. To determine the effective dose to polytraumatized children who undergo whole-body MSCT. A total of 51 traumatized children aged 0-16 years underwent a polytrauma protocol CT scan between November 2004 and August 2006 at our institution. The effective dose was calculated retrospectively by a computer program (CT-Expo 1.5, Hannover, Germany). The mean effective dose was 20.8 mSv (range 8.6-48.9 mSv, SD{+-}7.9 mSv). There was no statistically significant difference in the effective dose between male and female patients. Whole-body MSCT is a superior diagnostic tool in polytraumatized children with 20.8 mSv per patient being a justified mean effective dose. In a potentially life-threatening situation whole-body MSCT provides the clinicians with relevant information to ...

UK PubMed Central (United Kingdom)

BackgroundTraumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundTo evaluate the performance of three different advanced treatment techniques on a group of complex paediatric cancer cases.MethodsCT...Full Text Available

Science.gov (United States)

PMID:19813524

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective was to define and characterize the costs associated with trauma care at a level I trauma center. Once the costs were identified, attending physician-led teams were designed...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundSymptomatic heterotopic ossification (HO) in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the...Full Text Available

UK PubMed Central (United Kingdom)

Three patients are described with foveal lesions resembling minute holes following trauma. The similarity of the lesions to foveomacular retinitis and solar retinopathy suggests that all these conditions...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

This book provides an analysis of pathophysiologic concepts of trauma and reviews the effectiveness of the available imaging modalities in acute trauma of various organ system. Topics covered are chest injuries; abdominal trauma; fractures of long bones; the foot and ankle; the knee; hand and wrist; the elbow; the shoulder; the pelvis hips; the spine; the skull and facial trauma and the clinical assessment of multiple injuries patients. Comparative evaluation of diagnostic techniques of radiography is discussed. Normal anatomy and bone fractures along with soft-tissue injuries are described.

UK PubMed Central (United Kingdom)

Fetal growth restriction (FGR) is an adverse pregnancy outcome associated with significant perinatal and paediatric morbidity and mortality, and an increased risk of chronic disease later in adult life....Full Text Available

UK PubMed Central (United Kingdom)

Hepatic damage occurs in males and ovariectomized (OVX), not in proestrus (PE), females following trauma-hemorrhage (T-H). The mechanism responsible for hepatoprotection remains unknown. We hypothesized...Full Text Available

UK PubMed Central (United Kingdom)

Blunt chest-wall trauma is common; however, resultant tricuspid valve rupture is rare and can be subtle in its presentation. Transthoracic echocardiography plays a key role in diagnosis.Herein,...Full Text Available

Science.gov (United States)

Preliminary psychometric properties of a new instrument, Angie/Andy Cartoon Trauma Scales (ACTS), are presented. Angie/Andy features a cartoon-based methodology, measuring trauma-related sequelae of prolonged, repeated abuse. A sample of 208 children comprised intrafamilial trauma, extrafamilial trauma, combined trauma, and nontrauma groups. Angie/Andy demonstrated high internal consistency, with coefficient alphas from 0.70 to 0.95. The three trauma groups scored significantly higher than the nontrauma group on all scales (p's < 0.0001). Generally, the most severely traumatized group scored significantly higher than the less severely traumatized groups. The number of types of violence exposures correlated with Angie/Andy scores from 0.55 to 0.74. The frequency and severity of trauma exposure correlated with Angie/Andy scores from 0.44 to ...

Energy Technology Data Exchange (ETDEWEB)

Epiphyseal plates of growing bones are sensitive to ionizing radiation and this poses problems for the paediatric radiotherapist. In this case report we describe a child in whom electron beam therapy to the groin delivered only low dose radiation to the proximal hip epiphyses - 130 cGy fractionated over 5 weeks - but who suffered late maldevelopment. We explore the success of various radiotherapy techniques in minimizing the dose to the hip epiphyses in four other children. The appropriate positioning of the limb, the choice of treatment modality and, where possible, individual shielding blocks are considered and their effect on the dose to the hip estimated. Absorbed doses of radiation delivered to the midpoint of the proximal femoral epiphyses have been retrospectively determined. (author).

UK PubMed Central (United Kingdom)

Background/Objectives:Imaging technology is an important part of the diagnosis and management of spinal trauma. Indications and findings in post-traumatic imaging of the vertebral...Full Text Available

International Nuclear Information System (INIS)

The objectives of this paper are to discuss the following aspects of physiopathology of iodine nutrition related to thyroid irradiation by nuclear accidents: (1) The cycle of iodine in nature, the dietary sources of iodine and the recommended dietary allowances for iodine. (2) The anomalies of thyroid metabolism induced by iodine deficiency. The caricatural situation as seen in endemic goitre will be used as mode. (3) The specific paediatric aspects of adaptation to iodine deficiency. (4) The present status of iodine nutrition in Europe. (author).

UK PubMed Central (United Kingdom)

Simultaneous bilateral femoral neck fractures are extremely rare and associated with various conditions. Up to now Most cases had correlations with major trauma, repetitive minor trauma, seizure, parathyroid...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

Angiography plays a vital role in the investigation of the patient suffering from multiple trauma. The commonest injuries have been rupture of the thoracic aorta, renal lacerations, arterial bleeding associated with fractures and soft-tissue injuries to the pelvis, and occlusions of the arteries supplying the limbs. Transcatheter arterial embolization may be the definitive therapeutic procedure in pelvic bleeding.

Science.gov (United States)

All Streptococcus pneumoniae strains isolated from paediatric clinical samples at Heraklion University General Hospital in the 10-year period 2000-2009 were tested for serotype and susceptibility to antimicrobials. Among a total of 258 strains, 159 were isolated in the 5-year period 2000-2004, before the introduction of the heptavalent pneumococcal conjugate vaccine (PCV7), and 99 in the post-PCV7 5-year period 2005-2009. The prevalence of PCV7-included serotypes decreased in the post-PCV7 period (p?=?0.0002), but an increase was observed for serotypes 7F (p?=?0.002) and 19A (p?=?0.004). Pan-susceptibility rates and susceptibility to cotrimoxazole increased in the post-PCV7 period (p?=?0.01 and p?=?0.008, respectively), but serotype 19A emerged as a contributor to multi-resistance (p?=?0.007). PCV7 was followed by decreased S. pneumoniae resistance and prevalence of vaccine-related serotypes but increased prevalence of serotypes 7F and 19A. Continuing surveillance ...

Science.gov (United States)

Purpose. To report a comparative prospective long-term functional analysis after Riboflavin UV A corneal cross-linking (CXL) in three different age groups of patients affected by progressive keratoconus (KC). Methods. Functional analysis comprised paediatric patients (?18 years) included 152 eyes (29.5%); intermediate group (19-26 years) 286 eyes (55.4%), and adults (?27 years) 78 eyes (15.1%). CXL was performed according to the Siena protocol by using the Vega CBM (Caporossi-Baiocchi-Mazzotta) X linker (CSO, Florence, Italy) at Siena University by the same authors. Pre- and post-op examinations included UCVA, BSCVA, corneal topography, and surface aberrometry (CSO Eye Top, Florence, Italy), at 48 months followup. Results. At 48 months followup paediatrics, intermediate, and adult patients showed a mean gain in UCVA of +0.2, +0.14 and +0.12 Snellen lines. BSCVA gained by a mean of +0.21, +0.2, and +0.1 Snellen lines. K(max) was reduced by a ...

Energy Technology Data Exchange (ETDEWEB)

Tridimensional localization of bone and soft tissue injuries in complex facial trauma is fundamental for treatment. The face can be conceptualized as 3 groups of interconnected osseous struts that are oriented in the horizontal, sagittal and coronal planes. Each group of struts is closely related to specific soft tissue structures that are susceptible to injury. Any single CT section in the coronal plane or in the axial plane contains parts of one or more these struts. Facial CT in biplane were performed in 32 patients of facial trauma. The most common site of facial fractures is found in middle part of horizontal struts, geometrically in anteromedial portion of the inferior orbital fissure of the face. The most common soft tissue injury combined with facial fracture is hematoma and/or herniated orbital contents into the maxillary sinus. The serious combined soft tissue injuries were ocular rupture, retroorbital hematoma and optic nerve injury ...

UK PubMed Central (United Kingdom)

BackgroundExperimental psychology has only recently provided supporting evidence for Freud's and Janet's description of unconscious phenomena. Here, we aimed to assess whether specific...Full Text Available

UK PubMed Central (United Kingdom)

Current military conflicts in Iraq and Afghanistan have produced a significant number of complex injury patterns. Multiple extremity trauma and wide zones of injury mandate a flexible approach to these...Full Text Available

UK PubMed Central (United Kingdom)

OBJECTIVE: The management and outcome of 138 abdominal shotgun wounds were examined over a 5-year period. SUMMARY BACKGROUND DATA: It has been proposed that exploratory laparotomy may be unnecessary...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundTracheal rupture is a rare but life-threatening complication that most commonly occurrs after blunt trauma to the chest, but which may also complicate tracheal intubation....Full Text Available

UK PubMed Central (United Kingdom)

This study explored posttraumatic growth (PTG), positive change resulting from struggling with trauma, among 7- to 10-year-olds impacted by Hurricane Katrina. Analyses focused on child self-system...Full Text Available

UK PubMed Central (United Kingdom)

BackgroundComplex situations that follow war and natural disasters have a psychosocial impact on not only the individual but also on the family, community and society. Just as the...Full Text Available

Energy Technology Data Exchange (ETDEWEB)

This case report makes evident that in a 75 years old patient with a (cured) femoral neck fracture 15 years ago a refracture at the same site following a new trauma could not be detected by conventional X-ray. The follow-up of a radionuclide bone study, however, enabled the dignosis of a refracture. From these findings, it is further evident that the decreased bone metabolism in older patients has to be considered. Thus, although the initial bone scan following the trauma is negative, a follow-up scan should be performed within a 4 day-period.

International Nuclear Information System (INIS)

A 3"1/_2-year-old child developed unilateral diaphragmatic paralysis after chest drain insertion. Plain chest X-ray demonstrated paravertebral positioning of the chest-tube tip, and magnetic resonance imaging revealed hematomas in the region of the chest-tube tip and the phrenic nerve fibers. The trauma to the phrenic nerve was apparently secondary to malposition of the chest tube. This is a rare complication and has been reported mainly in neonates. Radiologists should notify the treating physicians that the correct position of a chest drain tip is at least 2 cm distant from the vertebrae. (orig.)

International Nuclear Information System (INIS)

AIM: To assess the impact of the introduction of a computed tomography (CT) imaging protocol for multi-trauma patients on the workload, overall diagnostic yield, and effect on detection of cervical spine injury and pneumothorax. METHOD: Between February 1997 and April 2004, all patients presenting acutely to the Emergency Department (ED) with haemodynamically stable trauma (Abbreviated Injury Scale 3 or more) involving more than two body systems were imaged with a comprehensive pre-set helical CT protocol (including non-contrast head, cervical spine: cranio-cervical and cervico-thoracic junctions; and oral and intravenous contrast-enhanced thoracic, abdomen and pelvis) after initial triage and a standard trauma series of radiographs (chest, lateral C-spine and pelvis). Diagnosis of cervical spine fracture and pneumothorax was noted before and after the CT protocol was carried out and findings from all studies were recorded ...

British Library Electronic Table of Contents (United Kingdom)

Background The Norwood procedure consists of three palliative operations, performed in neonates with hypoplastic left heart syndrome. Especially the first stage (Norwood I) is associated with the highest mortality rates in paediatric cardiac surgery (up to 25%). During surgery, the aorta is reconstructed and a systemic-to-pulmonary shunt is applied. Originally the modified Blalock-Taussig shunt was used, but recently the right-ventricle-to-pulmonary-artery shunt is increasingly being employed. We reviewed the results of our operative strategy, where an individualised choice of shunt is made. Furthermore, attempts to reduce interstage mortality (between Norwood I and II) were assessed. Methods All neonates who underwent Norwood stage I palliation from August 2004 until November 2010 were in...

Science.gov (United States)

Following the February 2011 earthquake in Christchurch, New Zealand (NZ), the authors participated in counselling local residents, and debriefing and supervising support teams. Indications were that risk for mental health disorders, including Post-Traumatic Stress Disorder (PTSD), may be elevated in residents, and that this risk may continue for some time. Patients may be de-prioritising their mental health issues when these become normalised throughout the city's population. The authors recommend that primary care patients are assessed using a brief, comprehensive tool (for example, the Case-finding and Help Assessment Tool) that targets many health and behavioural issues identified as increasing in the city following the earthquake. Anxiety and mood disorder symptoms may indicate assessment is appropriate to reduce harm arising from increased risk for PTSD. Concern also is raised for primary health care providers who may have experienced the trauma and ...

Science.gov (United States)

The most common causes of omental sac collections (OSC) are necrotic pancreatitis (90%) and pancreatic trauma (10%). Acute OSC is a form of local peritonitis in acute pancreatitis, subacute OSC are caused by internal pancreatic fistulas. The clinical and radiological signs, enzymatic activity of the exudate, morphological features of peritonitis were investigated. Treatment of acute OSC included conservative measures, of subacute OSC-surgical procedures. PMID:9163152

Science.gov (United States)

Two patients, treated for blunt thoracoabdominal trauma with ruptured diaphragm and concomitant avulsion of the pericardial sac in its entirety from the central tendon of the diaphragm, are presented. We do not think this entity has been reported before. We explain this type of lesion on the basis of embryological development of the pericardium at the level of the central tendon of the diaphragm. PMID:15302069

Science.gov (United States)

AbstractOBJECTIVETo provide an overview of the 2009 edition of the Rourke Baby Record (RBR), which incorporates recent research in the literature relating to preventive health care for children aged 0 to 5 years.QUALITY OF EVIDENCERecommendations are identified as supported by good, fair, or consensus evidence, according to the classification of the Canadian Task Force on Preventive Health Care.MAIN MESSAGENew information and recommendations are given for growth monitoring, nutrition, developmental surveillance, physical examination maneuvers, immunization schedules, and advice for parents. Anticipatory guidance updates relate to injury prevention, infant swaddling, literacy facilitation, nonparental child care, parenting skills programs, serum lead levels, over-the-counter cough and cold medications, pacifiers, antipyretics, insect repellents, and dental care and oral health. The 2009 RBR is available in English and French in both National and Ontario versions and is endorsed by the ...

International Nuclear Information System (INIS)

CT scans were performed on 25 patients suspected of sustaining ranal trauma. The utility of CT in both detecting renal damage and appraising the gravity of injuries was assessed. Nowadays, in fact, nephrectomy or reserved for lesions devastanting the kidney parenchyma or rupturing the renal pedicle; so it is very important to identyfy both the purposes of a better planned therapeutic approach. CT does both, being more accurate than urography in the detection of renal fractures, intra or extraparenchymal hematomas and contrast media extravasation. Urography very often shows aspecific lesion patterns and sometimes it is also falsely negative. In the present series CT was more reliable than angiography itself, particulary in the diagnosis of extra-renal hematic collections, contrast media extravasation and injuries to the other abdominal organs. Although CT may arouse the suspicion of and sometimes correctly diagnose vascular lesions, such as renal infarction, ...

Energy Technology Data Exchange (ETDEWEB)

Purpose of this work is to evaluate the effectiveness and role of CT in blunt diaphragmatic injuries by reviewing our 8-year experience. It is reviewed the preoperative CT findings of 35 patients with surgically confirmed diaphragmatic rupture. Surgical repair was performed in the acute setting (within 12 hours of trauma) in 22 cases, and late (8 months-5 years) in 13 cases. Twenty-eight patients (80%) were examined with conventional CT and 7 (20%) with Helical CT. Of the 13 patients examined long after trauma, the left hemi diaphragm was ruptured in 12 cases (with visceral herniation in 4), and the right hemi diaphragm in 1, with no herniation. The diaphragmatic rent was found in the dome (15 cases, 43%), muscolotendinous junction (11 cases, 31%), muscular portion (8 cases, 23%), and at the muscular attachments on the ribs (1 case, 3%). As for the site of diaphragmatic injury, CT never depicted the diaphragmatic rent in the dome and at the ...

British Library Electronic Table of Contents (United Kingdom)

The discussion focuses on the ways in which the 3 panelists in their lives and work embody fourth wave feminism, which combines politics, psychology, and spirituality in an overarching vision of change. Jane Fonda's emphasis on the importance of making narratives of gender a central organizer for personal and societal transformation, Hedda Bolgar's insistence that psychoanalysts recognize the complex dialectic between unconscious dynamics and sociocultural realities in order not to conflate conflicts rooted in social inequalities with individual issues, and Sue Shapiro's understanding of the ambiguous role of individual therapy in situations of historical and social trauma such as the tsunami in Indonesia are all examples of fourth wave feminism in practice. The unfinished business of the ...

Energy Technology Data Exchange (ETDEWEB)

The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.

International Nuclear Information System (INIS)

Cross-sectional imaging has revolutionised the radiological diagnosis of pleural collections. Not only can the precise location and volume of a pleural effusion be established, but also features specific for the aetiology of the effusion can be demonstrated. Increasingly, radiologists are called upon to perform image-guided biopsies, aspirations and small bore chest drain placement, all of which have been shown to be safe and efficacious. Pneumothoraces occurring due to acute trauma and in an intensive care setting can also benefit from radiological input, both in terms of diagnosis and image-guided treatment. (orig.)

International Nuclear Information System (INIS)

A 37-year-old military mechanic presented to our institution with a chronic history of a slowly enlarging left elbow antecubital fossa mass. There was no history of other chronic illness or trauma. Magnetic resonance imaging (MRI) and excisional biopsy revealed fatty villi and synovial inflammation within the left bicipitoradial bursa, consistent with lipoma arborescens. Four years later the patient presented with a 6-month history of swelling at the antecubital fossa of the opposite elbow. Diagnostic computed tomography and MRI examinations were performed. The surgical and pathologic findings confirmed the imaging diagnosis of lipoma arborescens at the right bicipitoradial bursa. (orig.)

International Nuclear Information System (INIS)

Objective: To evaluate the feasibility and clinical application of two stents insertion via single tract for treatment of hepatic hilar cholangiocarcinoma. Methods: Eighteen patients with hepatic hilar cholangiocarcinoma who had left and right bile duct obstruction were treated with stents insertion via right bile duct puncturing routeway. These two stents were implanted between right and left bile duct, and between right bile duct and common bile duct. Results: Eighteen patients obtained successful two stents placement by right bile duct puncturing tract and succeeded with internal drainage for all biliary tree jaundice subsided distinctly. Conclusions: The technique of two stents insertion via single tract could predigest interventional drainage procedure of high bile duct obstruction, reduce operation trauma, shorten handling time and possess promising application value

British Library Electronic Table of Contents (United Kingdom)

Spastic equinovarus foot deformity commonly occurs after stroke or head trauma. Management by split anterior tibial tendon transfer to the lateral border of the foot was chosen by the authors. The purpose of that work was to assess the reliability of this method to improve patient's functional autonomy and investigate the relationship between the initial clinical examination findings and the quality of the functional results. 84 feet, operated in 82 patients out of 130, of mean age 46 years, were reviewed at a mean follow-up of 65 months. Very few complications were observed. Toe deformities remain a commonly associated problem. 80 patients were able to walk barefoot, 74 reported an increase in their walking distance, and 73 could regularly wear normal shoes. There is a strong relationship...

British Library Electronic Table of Contents (United Kingdom)

Background: Ecchymosis, oedema, haematoma and pain after SMAS-based facelift surgery are all the direct result of the physical trauma of surgery and subsequent inflammatory response. Hilotherapy is a novel form of cryotherapy that purports to minimise these events through single-use face masks circulating cooled, sterile water. This study was performed to assess the validity of Hilotherapy in this population of patients. Methods: Over 14 weeks fifty consecutive patients were randomised to post-operative facial cooling with Hilotherapy or management with standard dressings alone, while fifteen subsequent, consecutive patients were randomised to cooling of one side of the face but not the other. Assessment of ecchymosis, oedema, haematoma and pain was performed independently by clinical staf...

Energy Technology Data Exchange (ETDEWEB)

A noninvasive method is described for estimating local cerebral blood flow (LCBF) and local partition coefficients by means of computed tomographic scanning during inhalation of 30% stable xenon gas in oxygen. Time-dependent xenon concentrations in arterial blood and brain tissue during the wash-in and washout phases are used to calculate partition coefficients and LCBF values by means of a least-squares curve-fitting analysis. Control values for partition coefficient and LCBF obtained from control subjects with minor head trauma in the chronic stage were compatible with those in several past reports, and reproducibility was satisfactory. The theoretic grounds underlying this new method of curve-fitting analysis are discussed.

Energy Technology Data Exchange (ETDEWEB)

The radiographs and initial clinical findings of 73 patients who had sustained trauma to the cervical spine without bony injury in vehicle collisions were reviewed. The patients were also re-examined clinically two years after the injury. Forty eight (65.8%) had abnormal radiographs at presentation - prevertebral soft tissue swelling in 15 (20.6%), degenerative changes in 15 (20.6%), and an angular deformity between two adjacent vertebral bodies in 27 (37.0%). The exact mode of inury is not associated with any specific radiographic appearance except that ''roll overs'' and side collisions are more likely to cause angulation in the cervical spine. (orig./GDG).

British Library Electronic Table of Contents (United Kingdom)

Delayed endolymphatic hydrops (DEH) is a unique disorder characterized by fluctuating otologic symptoms in the setting of preexisting unilateral deafness. The symptoms include aural fullness, fluctuating hearing, and/or episodes of vertigo similar to those observed in Meniere disease and may occur ipsilateral or contralateral to the previously deafened ear. In most reported cases, the unilateral deafness has been a profound sensorineural hearing loss with a sudden onset that has been variously attributed to bacterial or viral labyrinthitis, acoustic or cranial trauma, otosclerosis, and congenital CMV infection. Familial occurrence of the syndrome has not previously been reported in the literature. In this report, we describe two possible familial instances of delayed DEH. These patients ra...

British Library Electronic Table of Contents (United Kingdom)

This three-part article describes the early years of one of the mother-baby-children groups of the Project for Mothers, Infants, and Young Children of September 11, 2001. The goal of the group was to help prevent the effects of trauma and loss from disrupting the relationships among the mothers, their infants, and growing children. View I by Anni Bergman describes the mothers' states of minds as the group began, when they felt that their worlds had collapsed under them. View II by Sally Moskowitz focuses on the clinical experience of working in the group, transference and countertransference themes, helping the mothers and children with their mourning process, and helping the mothers' relationships to each other, their babies, older children, family, and friends. The evolution of a casual,...

Energy Technology Data Exchange (ETDEWEB)

In a retrospective study of 21 patients, in whom the acetabular fractures were suspected on initial radiographs, we compared and analysed the computed tomographic findings and plain radiographic findings. The results were as follow: 1. In patients with multiple trauma, no further change in position was required during CT examinations. 2. CT showed intraarticular loose bodies, which were invisible on plain radiographs. 3. CT was useful in detecting the fractures of acetabular rims, medial wall of acetabulum, and femoral head. 4. CT permitted better evaluation of shape, extent, and degree of separation of fracture fragments. 5. CT was helpful in detecting the associated fractures and soft tissue injuries. 6. CT also demonstrated the adequacy of reduction, the position of metallic fixation devices, and the presence or absence of remaining intraarticular osseous fragments after surgery.

British Library Electronic Table of Contents (United Kingdom)

The aim of this study was the evaluation of contralateral hip fractures after a previous hip fracture. For this retrospective analysis patients were selected from the database of the LUMC, a teaching hospital in the south-west of the Netherlands. We analyzed all patients with a second fracture of a hip between 1992 and 2007. The exclusion criteria were high impact trauma and patients with diseases or medication known to have a negative effect on bone metabolism. A total of 1,604 hip fractures were identified. The possible predictive factors for the second fracture and descriptive statistics related to surgery (Hb and HT before and after the operation, total amount of intra- and postoperative blood loss, type of osteosynthesis, complications, time of death after the last fracture, time betw...

Science.gov (United States)

BACKGROUND: Denys-Drash Syndrome (DDS) is an uncommon disorder that appears sporadically and in rare cases may be inherited as an autosomal dominant trait It manifests either at birth or within the first year of life and typically consists of the triad of congenital nephropathy, Wilms tumour and intersex disorder. CASE REPORT: A 10 year-old Caucasian girl was referred to the Dental Department, at Glasgow Royal Hospital for Sick Children by her Paediatric Nephrologist Consultant. The patient was being teased by her peers over her markedly discoloured teeth. The dental history revealed that the patient was a regular dental attendee from an early age. She was dentally anxious having only experienced dental treatment under general anaesthesia (GA) when she was 4 years old. Apparently her primary dentition also showed a generalised discolouration. TREATMENT: This consisted of multiple visits for diet analysis and tooth brushing instruction with the use of disclosing ...

Energy Technology Data Exchange (ETDEWEB)

Acute thoracic aortic injuries account for up to 10-20% of fatalities in high-speed deceleration road accidents and have an estimated immediate fatality rate of 80-90%. Untreated survivors to acute trauma (10-20%) have a dismal prognosis: 30% of them die within 6 hours, 40-50% die within 24 hours, and 90% within 4 months. It was investigated the diagnostic accuracy of Helical Computed Tomography (Helical CT) in acute traumatic injuries of the thoracic aorta, and the role of this technique in the diagnostic management of trauma patients with a strong suspicion of aortic rupture. It was compared retrospectively the chest Helical CT findings of 256 trauma patients examined June 1995 through August 1999. Chest Helical CT examinations were performed according to trauma score, to associated traumatic lesions and to plain chest radiographic findings. All the examinations were performed with no intravenous ...

Science.gov (United States)

The family of natriuretic peptides consists of the atria natriuretic peptide (ANP), the cerebral natriuretic peptide (BNP), the type C natriuretic peptide (CNP) and the peptide isolated from the dendroaspis snakes' poison (DNP), whose presence in humans has not been confirmed. The physiological function of ANP is in the control of arterial blood pressure by regulation of systemic vascular resistance of blood vessels. BNP is produced as one of the factors in the acute response to inflammatory tissue damage, mainly in coronary vessels. Increased serum concentrations of natriuretic peptides have been found in stress situations, such as trauma or major surgery, systemic hypotension, and in intrinsic myocardial dysfunction. High concentrations of natriuretic peptides were observed in severe sepsis, septic shock and in multiple organ failure, probably due to increased secretion by mediators of the inflammatory process.The highest concentrations of ANP and BNP were found ...

Science.gov (United States)

The knowledge of wound ballistics and of wounding mechanisms is mandatory for the radiologist to interpret the CT findings of gunshot wounds. The severity of a bullet wound depends on the characteristics of the tissue it goes through, i.e., tissue elasticity, density, thickness of the wounded body part, the type of tissue, its specific gravity, internal cohesiveness and anatomical relationships, as well as on missile characteristics, i.e., mass, shape, fragmentation and deformation. Bullet velocity is certainly a major factor in wounding, but it is only one factor. Two major wounding mechanisms exist the crushing of the bullet-struck tissue (forming the permanent cavity) and radial stretching (forming a temporary cavity). Bullet "yaw" is defined as the angle between the long axis of the bullet and its flight path. The yaw is directly proportional to tissue crushing and stretching: the wider the yaw, the most severe tissue crushing and stretching and, therefore, the more severe tissue ...

Science.gov (United States)

I review the past and present of wound ballistics research in China and look toward the future of this subject. The main points area as follows: (1) Before the 1970s, China did not conduct any experimental study on wound ballistics. (2) After the 1970s, experts in ordnance and medicine closely cooperated to conduct a series of experiments or tests on wound ballistics, such as wounding effects and the mechanism of various high-speed projectiles, the treatment of the protection from firearm wounds, high quality of ammunition design, lethality criterion, blast injuries, etc. Between 1981 and 1993, four national symposia on wound ballistics were held in China. In 1988, China sponsored the Sixth International Symposium on wound Ballistics. China has made great contributions to this subject. (3) As for the future of Chinese research on wound ballistics, I suggest strengthening the following areas: the relationship with weapons traumatology; the basic science research on ...

Energy Technology Data Exchange (ETDEWEB)

Changes in radiostrontium clearance (SrC) and bone formation (tetracycline labeling) were observed in the femurs of skeletally mature dogs following the various operative steps involved in bone screw fixation. Drilling, but not periosteal stripping, produced a small but statistically significant increase in SrC and endosteal bone formation in the distal third of the bone. Strontium clearance values equivalent to those produced by drilling alone were recorded after screw fixation at low or high torque (5 versus 20 inch pounds), as well as by the insertion of loosely fitting stainless steel implants. Bone formation (equals the percentage tetracycline-labeled trabecular bone surfaces) was increased by 30% when SrC values exceeded 3.5 ml/100 g bone/min, and the relationship was linear when SrC values ranged between 1.0 and 7.0 ml/100 g bone/min. The changes in SrC and bone formation one-week after bone screw application are primarily those associated with a response to local ...

Scientific Electronic Library Online (English)

Abstract in english INTRODUCTION: Treatment of the cryptorchid testicle is justified due to the increased risk of infertility and malignancy as well as the risk of testicular trauma and psychological stigma on patients and their parents. Approximately 20% of cryptorchid testicles are nonpalpable. In these cases, the videolaparoscopic technique is a useful alternative method for diagnosis and treatment. MATERIALS AND METHODS: We present data concerning 90 patients submitted to diagnostic lapa (more) roscopy for impalpable testicles. Forty-six patients (51.1%) had intra-abdominal gonads. In 25 testicles of 19 patients, we performed a two stage laparoscopic Fowler-Stephens orchiopexy. The other 27 patients underwent primary laparoscopic orchiopexy, in a total of 29 testicles. RESULTS: We obtained an overall 88% success rate with the 2 stage Fowler-Stephens approach and only 33% rate success using one stage Fowler-Stephens surgery with primary vascular ligature. There ...

International Nuclear Information System (INIS)

AIM: To define the value of digital radiography with a clinical flat panel detector system for evaluation of wrist fractures in comparison with state of the art storage phosphor radiography. MATERIAL AND METHODS: Hard copy images of 26 fractured wrist specimens were acquired with the same exposure dose on a state of the art storage phosphor radiography system and a clinical flat panel detector. Image features like cortical bone surface, trabecular bone, soft tissues and fracture delineation were independently analysed by 4 observers using a standardised protocol. Image quality ratings were evaluated with an analysis of variance (ANOVA). RESULTS: Flat panel detector radiographs were rated superior with respect to cortical and trabecular bone representation as well as fracture evaluation, while storage phosphor radiographs produced better soft tissue detail. CONCLUSION: In some of the observed image quality aspects, the performance of caesium iodide/amorphous silicon flat panel detector ...

International Nuclear Information System (INIS)

Initial CT grading of renal injury was correlated with the frequency of complications and the time course of healing in 35 children. All renal contusions (grade 1, 8) and small parenchymal lacerations (grade 2, 8) healed without complications. All lacerations extending to the collecting system (grade 3, 9) resulted in mild to severe loss of renal function with progressive healing over 4 months. One of four segmental infarcts (grade 4 A), and five of six vascular pedicle injuries (grade 4 B) resulted in severe loss of renal function. Complications, including urinoma (2), sepsis (1), hydronephrosis (1), and persistent hypertension (2), were limited to grade 3 and 4 injuries. Our results suggest that mild renal injuries do not require follow-up imaging. Major renal lacerations and vascular pedicle injuries, however, often result in loss of renal function and should be followed up closely due to the risk of delayed complications. Follow-up examinations should continue for 3-4 months until ...

Energy Technology Data Exchange (ETDEWEB)

The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. Approximately 10% of the HO is massive and causes severe restriction in joint motion or ankylosis. The most common sign and symptom are decreased range of motion and pain. The locations are the proximal limbs and joints. Sites of HO about a joint may vary according to the etiology of the HO. Roentgenographic evolution of HO occurs during a six-month period in the majority of patients. Treatment modalities include diphosphonates, indomethacin, radiation, range of motion exercises, and surgical excision. Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 years. A small number ...

Energy Technology Data Exchange (ETDEWEB)

Penetrating liver wounds are related to many causes and rank second after blunt abdominal and liver trauma. In this report are examined the clinical and radiological findings of personal series of patients with penetrating trauma, especially by firearms and stab and cut wounds. It will also tried to define the diagnostic workup of these traumas, which is especially based on CT signs of liver damage and associated changes and which is of basic importance for following treatment, both surgical or conservative. In the last seven years it was retrospectively reviewed 31 cases of penetrating liver trauma. The patients were 19 men and 12 women, ranging in age 18 to 73 (mean 42), with penetrating liver injuries from firearms (16 patients) and stab (9 cases) wounds; 6 patients had injuries from different cases. Abdominal CT was carried out in emergency with the CT Angiography (CTA) technique in all patients. In ...

International Nuclear Information System (INIS)

In 65 adult rabbits of both sexes (2.5 to 6 kg) the following salvaging procedures were performed after simulated trauma: (1) Continuous suture line; (2) closure with fibrin sealant after temporary clamping; (3) hemisplenectomy with omental wrap; (4) suture fixation of fragments and slices of spleen tissue to the peritoneum; (5) suture fixation of spleen fragments to the omentum; (6) extraperitoneal subcutaneous transposition of spleen cubes. In addition, the likelihood of spontaneous splenosis was examined in a preliminary study involving 5 animals by introducing unattached spleen meal and fragments. Scanning was repeated 4 to 12 weeks postoperatively. The functional competence of minor parenchymal islands was also investigated with well counter measurements of organ and muscle tissue homogenates. Spontaneous splenosis after abdominal injuries was not found to be the rule. Salvaging procedures at the natural vascular hilus by sutures, fibrin sealant and ...

Energy Technology Data Exchange (ETDEWEB)

(1) To determine the accuracy of computed tomography (CT) in the evaluation of ligament tear and avulsion in patients with tibial plateau fracture. (2) To evaluate whether the presence or severity of fracture gap and articular depression can predict meniscal injury. A fellowship-trained musculoskeletal radiologist retrospectively reviewed knee CT and MRI examinations of 41 consecutive patients presenting to a level 1 trauma center with tibial plateau fractures. Fracture gap, articular depression, ligament tear and footprint avulsions were assessed on CT examinations. The MRI studies were examined for osseous and soft tissue injuries, including meniscal tear, meniscal displacement, ligament tear, and ligament avulsion. CT demonstrated torn ligaments with 80% sensitivity and 98% specificity. Only 2% of ligaments deemed intact on careful CT evaluation had partial or complete tears on MRI. Although the degree of fracture gap and articular depression was significantly ...

International Nuclear Information System (INIS)

Purpose: To assess the role of CT in the evaluation of traumatic and spontaneous oesophageal perforation. Materials and methods: From March 2001 to May 2003, we studied 12 patients (7 males and 5 females; age range: 25-66 years, mean age: 43.5 years) with suspected oesophageal perforation due to motor-vehicle accidents (4 cases), stab wound (one case), post-intubation (2 cases), foreign body ingestion (2 cases) and spontaneous (3 cases). Five patients underwent standard chest and cervical radiography; two patients with suspected foreign body ingestion also underwent a gastrografin swallow study; all of the 12 patients underwent CT of the neck, chest and abdomen before and after intravenous, and in four cases oral, administration of contrast material. Results: In 5 patients with cervical, thoracic and abdominal trauma, the CT examination showed the presence of pleuroparenchymal injury (pneumothorax, pleural effusion and subcutaneous emphysema) as well as findings ...

International Nuclear Information System (INIS)

Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were treated in this study with a total of 11 ...

Energy Technology Data Exchange (ETDEWEB)

Aim: Today, MRI is an integral part of the presurgical evaluation of patients suffering from partial epilepsy. These patients frequently show focal morphological abnormalities with potential epileptogenic character and surgical resection of these lesions is associated with superior postsurgical outcome as to seizure frequency. Apart from easily detectable defects, such as post-traumatic lesions or cerebral infarction, as wide variety of mainly small abnormalities can be detected using MRI. Methods: In this study, 484 patients suffering from partial epilepsy of temporal or frontal onset were evaluated for the incidence of different lesions in this population. Results: All lesions found were included without evaluating their potential epileptogenicity, which remains to be proven using other procedures (EEG, SPECT, PET, etc.). Involvement of the hippocampal formation was a major finding in temporal lobe epilepsy, which could be detected as sclerosis (T2w-images), atrophy (T2w-TSE or ...