Ulusal travma dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Randomized Controlled Trial Clinical Trial
[The effect of pentaglobin therapy on prognosis in patients with severe sepsis].
This study was designed to assess the effects of polyclonal immunoglobulin administration on septic shock incidence and prognosis in patients with severe sepsis. Patients with severe sepsis were randomly allocated into two groups. One group (n = 21) received 5 ml/kg/day IgM enriched immunoglobulin preparation (Pentaglobin) for 3 days. ⋯ However, a significant decrease in procalcitonin levels were detected only in patients who received pentaglobin (p = 0.001). Mortality rate was 5/21 (23.8%) in pentaglobin group and 5/18 (27.7%) in the control group. Although pentaglobin therapy could not achieve a statistically significant improvement in septic shock occurrence and mortality, the constant reduction in procalcitonin levels indicated the beneficial effects of immunotherapy on the severity of inflammatory response to infection in severe sepsis.
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We retrospectively evaluated 572 patients with thoracic trauma from total of 2163 trauma patients who admitted to 2nd General Surgery Emergency Service of Kartal Education and Research Hospital from January 1997 to February 2000. 501 of the patients (87.5%) were male and 71 (12.5%) were female. The range of ages 2-84 and mean age was 32.2. 337 (59%) patients had blunt and 235 (41%) had penetrating thoracic trauma. ⋯ The rates of mortality were 6.8% and of morbidity 3.3%. Early diagnosis and immediate appropriate treatment in thoracic trauma increases the survival.
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To evaluate the diagnostic accordance between scintigraphy and radiography in the early period following blunt thoracic trauma. ⋯ Scintigraphy gave better results in the evaluation of sternal fractures during the early period of thorax trauma. Conventional plain radiography is thought to be the initial imaging modality, because it saves time and shows hemothorax or pneumothorax besides the osseous abnormality.
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The medical reports of 164 patients who were operated for abdominal gunshot wounds at Sirnak Military hospital were reviewed retrospectively. One hundred and twenty-nine patients had isolated abdominal injury whereas, 28 had associated thoracic injuries. Seven of these laparotomies revealed no intraperitoneal injury and were considered as non-therapeutic laparotomy. ⋯ The most commonly injured organs were the small bowel in 67, the colon in 63 and the liver in 49 patients. Postoperative complications occurred in 34 patients (20.7%) and mortality rate was 6% (10 patients). In spite of the developing technology and operative techniques, gunshot wounds are still very important with high morbidity and mortality rates.
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184 patients were admitted with splenic injuries, between 1992 and 1998. 131 (71%) patients were male and 53 (29%) patients were female. The average age of patients were 20.4 years. There were 176 (95%) blunt and 8 (5%) penetrating injuries. ⋯ The lenght of hospital stay of splenectomies; partial splenectomy and splenorraphy were 7.9, 7 and 6 days respectively. The complication rate of splenectomy, partial splenectomies; and splenorraphy after the operation were 3 (2%), 1 (0.5%) and 0. No deaths occurred as a result of splenic injury and operation.