摘要:

A survey was made of car crashes in Japan of injuries to seat belt users compared to nonusers. The purpose of the study was to clarify the relationship between the types of injuries and the way the belts were used at the time of the crash. Eight hundred individuals were involved in the study. The data indicate that those using seat belts sustained less severe injury than nonusers. Of the belted occupants who were seriously injured or killed, it appears that their injuries were due to improper placement of the seat belts on the anatomy. In some situations the precrash position of the occupant allowed him to submarine beneath the belt system, allowing the belt to ride up on the soft belly wall.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The background to the passage of the seat belt usage law in Britain is described. Voluntary belt use rates in the 1970's were approximately 30%, with educational campaigns having a minimal effect. The political process and the factors influencing the seat belt legislation are described, particularly the role of the media. The provisions and the consequences of the law are outlined with belt use in the general traffic stream rising to 90%. Deaths and serious injury to front seat car occupant casualties declined by 25% in comparing the year after with the year before the introduction of the law. Changes in other categories of casualties were within normal statistical limits and were uninfluenced by the seat belt legislation.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Twenty-eight consecutive patients with chronic refractory osteomyelitis uncomplicated by persistent fracture nonunion, septic arthritis, total joint arthroplasty, or major systemic disease (immune deficiency, malignancy, malnutrition, renal or hepatic failure) were treated from January 1980 through December 1985 to evaluate the potential benefits of hyperbaric oxygen (HBO) therapy. Patients were classified by a staging system taking into account: the bone involved; subchondral, periarticular bone involvement; extent of bone involvement; quality of soft-tissue envelope and vascular supply; and general health status of the patient. Using this staging system patients were assigned to either hyperbaric oxygen therapy or control status after their initial debridement. Hyperbaric oxygen therapy on a 100% oxygen, 2 atmospheres pressure, 2-hour duration, one dive per day, six dives per week regimen was utilized in 14 of the 28 patients. Hyperbaric oxygen had no effect on length of hospitalization, rapidity of wound repair, initial clinical outcome, or recurrence of infection noted to date.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The activities of a trauma service in a university hospital were analyzed to test the hypothesis that operative caseload alone does not adequately measure the trauma experience of a surgical resident. Over a 2-year period, 378 victims of major trauma (blunt in 79%) were admitted to the service. Only 41% of them required a major operation by the Trauma Service. The patients spent an average of 2.8 days in the intensive care unit and often presented complex challenges in surgical critical care, including ventilator support and hemodynamic monitoring. A trauma service in a university center manages significant numbers of patients with multisystem injuries who never undergo a general surgical procedure. This experience constitutes such an important component of surgical education in trauma that it should be recognized by agencies accrediting residents and training programs. Completion of surgical residency should also imply competence in critical care of surgical patients.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Surgical wound infections following traumatic injury remain a source of morbidity and mortality. A simple system for estimating the risk of infectious complications was evaluated in 949 trauma patients requiring operative therapy. The majority of cases were caused by penetrating trauma (784). Truncal, neck, and extremity procedures were included.The overall wound infection rate was 7%. Infection rates were related to amount of bacterial contamination and mechanism of injury. Age, type of antibiotics, and delay time from injury to operation were not risk factors for any injury type. Wound classification, shock, blood loss, number of organs injured, and operative time were significant risk factors, but had different effects on infection rate related to injury type. Multivariate analysis revealed no significant infectious risk factors for stabwounds. Significant factors were wound class (p = 0.02) and shock (p = 0.001) for gunshot wounds, wound class (p = 0.03) and number of organs injured (p = 0.01) for blunt trauma, and blood loss (p = 0.01) for shotgun wounds.This classification system can be used to review outcome and compare trauma patient populations for infectious morbidity in a more uniform fashion.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

The aim of the present study was to investigate pressure changes and possible damage to the central and peripheral nervous system induced by a high-energy missile striking a peripheral extremity.Anesthetized pigs were shot with a high-velocity missile (1,500 ms−1) in their left thigh. Transducers placed in the abdomen and brain recorded short-lasting bursts (1.0 to 1.5 ms) of oscillating pressure waves of high frequency. The amplitude of the pressure waves within the brain was about 125 KPa, and in the abdomen about 270 KPa, with a mean value of transferred energy from the missile of about 700 joules. Concomitantly, there were one or two apneic periods with a duration of a few seconds during the first minute after the shot. No significant changes in the heart rate, blood pressure, or other circulatory parameters were detected. Minor blood-brain and blood-nerve barrier damage occurred. It is concluded that the pressure waves caused by hits of peripheral parts of the body by high-energy missiles may be of such a large magnitude that distant damage to nervous tissue may result.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Increased alanine and aspartate aminotransferase (ALT and AST) serum levels are usually considered expressions of cellular necrosis, especially in hepatocytes. They represent cellular damage due to burn which, according to many authors, becomes normal before discharge of patients.We studied 43 consecutive burned patients, both during and after recovery, from a minimum of 120 to a maximum of 640 days, and an average of 18.62 blood samples were taken from each patient. Hepatitis A and B markers were tested.Results showed a 67.44% increase in aminotransferases in patients during recovery and a 25.58% increase after discharge. No neopositivity was observed for hepatitis A and B markers.We therefore conclude that the increase of enzymes during recovery expresses a toxic-infective phase and this increase, contrary to what was believed, does not always drop to normal values at time of discharge. Instead, after discharge, higher values can be a manifestation of a Non-A Non-B hepatitis.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

We have recently treated two patients with closed pronation-external rotation bimalleolar ankle fractures. During the surgical explorations, an avulsion type rupture of the posterior tibial tendon was observed. Open reduction and internal fixation of the fracture in conjunction with primary tendon repair has produced excellent clinical results. We wish to report these two cases of this uncommon injury. More important, we wish to point out the association of the tendon rupture in conjunction with a particular type of fracture pattern.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Mediastinal widening on a chest X-ray associated with chest trauma is a sign of possible traumatic aortic rupture. This paper presents a case of left-sided vena cava which mimicked an aortic rupture on chest roentgenogram. Contrast CT scan demonstrated the anomaly as the cause of the abnormal plain film.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID

摘要:

Two patients sustained massive hepatic injuries from blunt trauma in motor vehicle accidents. At the time of operation, nonreconstructable injuries to the porta hepatis were found in addition to destruction of the right lobe. Life-threatening hemorrhage was controlled, but both patients were left with nonfunctional or inadequate hepatic remnants. Liver transplantation was performed. Both patients recovered after liver replacement. One died 7 weeks later of cytomegalovirus infection. The other recipient is well 16 months later. Liver transplantation is a reasonable option in patients with lethal hepatic injuries or unreconstructable injuries to the porta hepatis.

ISSN:0022-5282    

出版商:OVID    

年代:1987

数据来源: OVID