Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Mar 2023
Utility of Ranson score, computed tomography severity index, and CRP criteria in risk stratification on the day of hospital admission in patients with acute pancreatitis: A cross-sectional analysis.
The early identification of severe acute pancreatitis (AP) remains a great challenge in clinical practice and novel predictors are needed to complement available scoring systems. This study aimed to investigate utility of Ranson score, and computed tomography severity index (CTSI) and C-reactive protein (CRP) criteria in determination of risk prognostic status in AP. ⋯ Our findings suggest a stronger individual prognostic value of CTSI alone, rather than CRP or Ranson score alone, in risk stratification of AP patients for severity of disease and related mortality risk on the day of admission, whereas emphasize the likelihood of using CRP or Ranson score complementary to CTSI to enable further identification of poor prognostic status.
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Ulus Travma Acil Cer · Mar 2023
Evaluation of factors predicting appendiceal tumoral lesions in patients undergoing appendectomy for acute appendicitis.
Tumoral lesions are a relatively rare cause of acute appendicitis. Accurate pre-operative diagnosis is essential to provide appropriate treatment. The aim of this study was to evaluate factors that may increase diagnostic rate of appendiceal tumoral lesions in patients undergoing appendectomy. ⋯ Predicting an appendiceal tumoral lesion preoperatively is critical to ensure a favorable post-operative outcome. Higher age and low WBC counts appear to be independent risk factors for an appendiceal tumoral lesion. In case of doubt and in the presence of these factors, wider resection should be favored over appendectomy only to provide a clear surgical margin.
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Ulus Travma Acil Cer · Feb 2023
Case ReportsOut-of-hospital cardiac arrest due to cervical spine injury by uncertain trauma: A study of two cases.
Cervical spinal cord injury is a well-known cause of cardiac arrest in trauma victims. Unless trauma is definitively suspected, emergency medical services teams perform resuscitation in the pre-hospital stage without cervical spine immobilization. During advanced cardiovascular life support (ACLS), intubation with cervical spinal immobilization causes difficulty in accessing the airway, thus, immobilization tends to not be performed, unless the patient is a clear case of trauma. ⋯ Emergency medical physicians tend to neglect cervical spine injury when the likelihood of trauma is unclear in a patient presenting with OHCA. These cases urge physicians to consider the possibility of cervical spinal injuries, even in cases of minor trauma. If there is a possibility of cervical spinal injury, imaging should not be delayed and should be followed by appropriate treatment.
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Ulus Travma Acil Cer · Feb 2023
Evaluation and clinical significance of predictors for strangulation and intestinal resection in emergency anterior abdominal wall hernia surgery.
Emergency anterior abdominal wall hernia surgery plays a pivotal role in emergency general surgery practice. In this study, the predictive value of laboratory and imaging findings as well as demographic information and comorbidities of the patients for the recognition of strangulation and intestinal resection was investigated. ⋯ Indices of systemic inflammation such as lactate dehydrogenase to white blood cell ratio, neutrophil to platelet ratio, and particularly neutrophil to albumin ratio may be potentially beneficial to prevent complications and improve clinical outcomes in emergency hernia surgery.
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Sacral fractures are uncommon and understanding three-dimensional morphology is needed to obtain proper treatment. The purpose of this study was to identify the repeatable fracture patterns and comminution zones for traumatic sacral fractures and create fracture maps. ⋯ Sacral fractures showed specific repeatable patterns for each zone. These findings may be helpful for pre-operative planning, placement of fixation material, design of new implants, and modification of current fracture-classification systems.