J Trauma
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When operated carelessly, snowblowers can produce serious trauma to the hand. During a 3-year period, 13 cases were identified. The injuries occurred when the operators attempted to dislodge impacted snow from the snowblower chute. ⋯ Injuries were treated with debridement and primary repair. Operator carelessness is usually responsible for the injury. If the public is made aware of snowblower hazards at the time of heavy snowfall, injuries may be avoided.
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The blood supply to a Meckel's diverticulum exists either within the small bowel mesentery, or within a separate mesodiverticular band. The latter is associated with bowel obstruction. It is a rare source of hemorrhage. The case report describes hemoperitoneum resulting from blunt trauma-induced disruption of a mesodiverticular band.
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Although adequate volume resuscitation has decreased mortality from hemorrhagic shock, recovery in many patients is complicated by sepsis. To determine whether a subject debilitated by hemorrhagic shock would exhibit greater cardiocirculatory dysfunction when challenged with sepsis, ten dogs (Group I) were hemorrhaged to a mean arterial blood pressure of 30 mm Hg. After 2 hours of hypotension, shed blood and lactated Ringer's solution (50 ml/kg) were given, and the dogs were observed for 3 to 6 days. ⋯ Blood glucose and insulin levels were significantly elevated in the resuscitated shocked dogs, likely due to increased circulating catecholamine concentrations and enhanced glycogenolysis. Endotoxin shock caused significant hypotension, acidosis, and impaired regional perfusion in all dogs. In addition, cardiac output, stroke volume, dP/dT, and left ventricular end-diastolic pressure fell and hyperglycemia and hyperinsulinemia occurred in all dogs after endotoxin injection.(ABSTRACT TRUNCATED AT 250 WORDS)
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Case Reports
Mitral and tricuspid valve rupture from blunt trauma sustained during a motor vehicle collision.
The incidence of mitral valve injury resulting from blunt trauma is low. This report presents the case of a 36-year-old male who survived the rupture of both his mitral and tricuspid valves after striking the steering wheel during a motor vehicle accident. Echocardiograms were used to make the diagnosis.
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Twenty-five patients with aseptic nonunion of the humeral shaft, treated by a combined therapeutic procedure, are reported. The initial treatment of these 21 closed and four open fractures had been nonoperative in 21 patients and surgical in four. Seven further open procedures had been performed in four of these patients, also undergoing failure. ⋯ A uniform therapeutic protocol, consisting of decortication, internal fixation with a broad, straight DCP ASIF plate and autologous cancellous bone grafting, was performed in all cases, supplemented with the use of surgical cement in one. Radiologic healing was achieved primarily in 24 patients in periods averaging 6 months and after renewal of the protocol in one patient. Followup averaged 35 months (range, 8-69 months): results were good in 21 patients.