Articles: trauma.
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Thoracic Surgery PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: Advances in video-assisted thoracic surgery (VATS) techniques and associated technology have allowed the rapid development of uniportal VATS (UniVATS) lung resection in recent years. UniVATS may be associated with less access trauma and pain, quicker recovery and improved cosmesis. We review our experience and early outcomes for patients following UniVATS wedge resections (W), lobectomies (L) and pneumonectomy (P). ⋯ The following authors have nothing to disclose: Rainbow Lau, Calvin Ng, Micky Kwok, Randolph Wong, Eugene Yeung, Innes Wan, Song Wan, Malcolm UnderwoodNo Product/Research Disclosure Information.
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Critical Care Posters ISESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMINTRODUCTION: Cardiac arrest patients are often admitted to CCU/MICU depending on academic setting. We aimed to compare outcomes of cardiac arrest patients based on demographics of the patients admitted to CCU Vs MICU. We also tried to identify role of hypothermia in different type underlying arrest rhythms ⋯ Patients admitted to CCU had better survival rate, home returning rate, less LOS and Ventilator dependent day. The majority of the patients admitted to CCU had Vfib as underlying rhythm compared to PEA/Asystole in MICU patients. Greatest benefit of therapeutic hypothermia was seen in patients with Vfib than PEA/Asystole, with inverse survival relationship noticed if presenting rhythm was asystole.Reference #1: Circulation. 2003; 108: 118-121DISCLOSURE: The following authors have nothing to disclose: Parth Rali, Win NaingNo Product/Research Disclosure Information.
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The role of total hip arthroplasty (THA) for fracture in octogenarians remains unclear. Over a two-year period, 354 patients aged > 80 years were admitted with a displaced intracapsular hip fracture. Using defined clinical guidelines, 38 patients underwent THA with a median age of 84 years, mean follow-up of 20 months. ⋯ There were no dislocations or periprosthetic fractures and patient survival was 97% at 30 days and 87% at one year. There was one revision for deep infection. This study demonstrates that THA for selected octogenarians can be performed safely, allows the majority of patients to return to independent living and has a low complication rate.
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Trauma is one of the major causes of morbidity and mortality. Thoracic injuries are associated with inflammatory complications such as ARDS. The pathogenesis of this complication after pulmonary injury is incompletely understood, but neutrophils are thought to play a pivotal role. The aim of this project was to gain more insight in the role of thoracic injuries in the pathophysiological processes that link systemic neutrophil activation with inflammatory complications after trauma. ⋯ Penetrating thoracic trauma leads to a distinct primed activation status of circulating neutrophils within hours. In addition to activation of cells, both young and reverse migrated neutrophils are released into the circulation. This degree of systemic inflammation does not exceed a threshold of inflammation that is needed for the development of inflammatory complications like ARDS.
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Evaluating the cervical spine in the obtunded trauma patient is a subject fraught with controversy. Some authors assert that a negative computed tomography (CT) scan is sufficient. Others argue that CT alone misses occult unstable injuries, and magnetic resonance imaging (MRI) will alter treatment. This study examines the data in an urban, county trauma center to determine if a negative cervical spine CT scan is sufficient to clear the obtunded trauma patient. ⋯ In the obtunded trauma patient with a negative cervical spine CT, obtaining an MRI does not appear to significantly alter management, and no unstable injuries were missed on CT scan. This should be taken into consideration given the current efforts at cost-containment in the health care system. It is one of the larger studies published to date.