Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Aug 2007
The Evaluation of Protective Effects of FK-506 on Neural Ischemic-Reperfusion Injury: an Experimental Study.
In this study, we aimed to delineate the mode of neuroprotective action of FK-506, and demonstrated that FK-506 could decrease oxidative stress and apoptotic cell death in an in vivo rat model of neural ischemia-reperfusion after hemorrhagic shock. ⋯ The results suggest that the prophylactic use of FK-506 in an in situ ischemic neural tissue may prevent reperfusion injury.
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Eur J Trauma Emerg S · Aug 2007
Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures.
Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age. ⋯ The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality, biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature.
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Replacement of an almost completely absent medial meniscus with a collagen implant (CMI), reconstruction of form and function of the medial meniscus, delay of the development of arthrosis deformans. ⋯ 60 patients (19-68 years, average 41.6 years) with subtotal loss of the medial meniscus and varus morphotype were treated from January 2001 to May 2004 as part of a prospective, randomized, arthroscopically controlled study. The sample consisted of 30 patients with high tibial valgus osteotomy combined with implantation of a CMI, and 30 patients with valgization correction osteotomy only. The CMI had to be removed from one patient because of a dislocation. Evaluation on the Lysholm Score, IKDC (International Knee Documentation Committee), and subjective pain data revealed only slight, nonsignificant differences for 39 patients after 24 months (CMI and correction n = 23; correction only n = 16). The chondroprotective effect of the CMI in the long term remains to be seen.
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Eur J Trauma Emerg S · Aug 2007
Postoperative Management after Pneumonectomy for Blunt Thoracic Trauma.
Pneumonectomy for blunt thoracic injury carries a high mortality rate. We present a case of severe bilateral blunt thoracic injury in which left pneumonectomy was done. The immediate postoperative measures were directed to maintain right heart performance by minimizing hypoxia, avoiding fluid overload and limiting pulmonary hypertension. We believe that this approach contributed to the favorable outcome of this patient.
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Eur J Trauma Emerg S · Aug 2007
A Retrospective Study of Five Clinical Criteria and One Age Criterion for Selective Prehospital Spinal Immobilization.
Full spinal immobilization of blunt trauma victims is a widely accepted prehospital measure, applied in order to prevent (further) damage to the spinal cord. However, looking at the marginal evidence that exists for the effectiveness of spinal immobilization, and the growing evidence for the negative effects following immobilization, a more selective protocol might be able to reduce possible morbidity and mortality as good as the present prehospital immobilization protocol. In a retrospective study, the sensitivity of a selective prehospital immobilization protocol that adds an age criterion to five clinical spine clearance criteria is examined. ⋯ In this retrospective study, a selective protocol based on clinical criteria instead of trauma mechanism showed 99.2% sensitivity for spinal fractures with or without spinal cord damage. Based on this study and the current controversy surrounding spinal immobilization, a prospective study should be considered to evaluate the five clinical criteria and one age criterion in the prehospital setting.