Eur J Trauma Emerg S
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We present a case of traumatic fibular bowing associated with ankle fracture in a 14-year-old girl. Acute traumatic bowing deformities of the fibula have always been reported as associated with mid-shaft tibial fractures, but involvement of the distal fibula associated with an ankle fracture has not been reported. The clinical picture is described and the mechanism of injury discussed.
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Eur J Trauma Emerg S · Apr 2008
The Prognostic Significance of Pulmonary Contusions on Initial Chest Radiographs in Blunt Trauma Patients.
The importance of immediate versus delayed pulmonary contusions among severely injured blunt trauma patients is unknown. We hypothesized that patients with pulmonary contusions apparent on initial chest radiographs have higher rates of mortality and acute respiratory distress syndrome than patients who have delayed radiographic changes of pulmonary contusions. ⋯ Amongst intubated blunt trauma patients with confirmed pulmonary contusions diagnosis, an initial chest radiograph that reveals immediate pulmonary contusion is associated with higher mortality and ARDS compared with the absence of such findings. This suggests that the initial chest radiographs have prognostic significance in relation to pulmonary contusions due to blunt trauma.
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Eur J Trauma Emerg S · Apr 2008
Cytokine Responses to Glucocorticoids and Surgery : A Randomized Controlled Trial.
This prospective randomized study was designed to evaluate the implication of high preoperative doses of glucocorticoids on the cytokine responses after surgical correction in patients with ankylosing spondylitis. ⋯ This study shows that surgery adds a complexity to cytokine productions in patients with ankylosing spondylitis, and that the balance of these cytokines is significantly influenced by glucocorticoids.
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Eur J Trauma Emerg S · Apr 2008
Effective Hemostasis in Severe Mesenteric Vein Laceration with Tachosil(®), using a Low- or Non-thrombogenic Patch to Prevent Tachosil(®)-induced Thrombosis.
Fibrinogen- and thrombin-coated collagen fleece (FTCC) facilitates surgical hemostasis, and is of particular value during resection of parenchymatous organs. Since thrombosis may ensue if the preparation is unintentionally applied intravascularly, it has not been recommended for treating lacerations of large veins, and no previous reports describe its use in vein repair. Our observations in two patients suggest, however, that FTCC might be indicated for hemostasis in vein injury where vascular suture is difficult or not possible, provided a low- or non-thrombogenic patch is interposed to prevent FTCC-induced vein thrombosis. ⋯ In our second patient we therefore put a small patch of parietal peritoneum on the section of the Tachosil(®) targeted to cover the vein tear to avoid direct contact between Tachosil(®) and the vein lumen. Ultrasound examination 3 days postoperatively, and autopsy 11.5 months later showed that the vein was widely patent with no stenosis or thrombus. Our observations in these two patients were that an FTCC-omentum pack alone secured rapid hemostasis in severe SMV laceration, and when a peritoneal patch was interposed between FTCC and a lacerated SMV, FTCC-induced vein thrombosis did not occur.