摘要:

About half of the 67 adults admitted to a burn treatment unit during the course of a year were found to have pre-existing physical and/or psychiatric conditions that increased their susceptibility to injury. In addition, the majority of victims were unmarried, unemployed, and came from low social class, circumstances that tended to increase their vulnerability. A significant increase in stressful life events was reported by these patients during the year preceding burn injury. This life change was negatively correlated with age, income, and number of friends, and positively correlated with social class and psychiatric illness. Two subgroups of persons vulnerable to burns were identified, the first, older women with physical illness, and the second, persons of low social class with psychiatric disorders. The findings have implications for burn prevention and rehabilitation of burn victims.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Using polytomographic techniques, gas myelography was performed in 162 patients with post-traumatic neurologic deficit. The type, extent, and location of lesions were easily demonstrated, allowing adequate preoperative surgical planning. In cases in which expected neurologic improvement did not follow surgery, postoperative myelography provided information so that remedial measures could be taken. No neurologic deterioration was noted in any of the patients and furthermore, arachnoiditis, which may accompany positive contrast myelography, has not been detected in any of the patients in the series reported.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Experience gained in treating patients with hand burns admitted to an active Regional Burn Center has resulted in the development of a biphasic approach which separates early healing and later reconstructive surgical procedures. This schedule permits late definitive surgery on healed functioning hands and is accomplished in a single operation in most cases.This biphasic approach has led to better results at our institution in terms of hand function and appearance, and to a decrease in total numbers of surgical procedures. Reports of others using alternative methods and schedules, also with satisfactory results, are discussed.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Myocardial contusion secondary to nonpenetrating chest trauma can occur in the absence of any identifiable large vessel coronary artery occlusion or injury. It has also been reported in association with coronary artery atheromata, thrombosis, rupture, and fistula formation. After reviewing the clinical and experimental research literature, we conclude that myocardial contusion necrosis results from changes in perfusion of small vessels and the coronary microvasculature. Coronary arteriography and emergency coronary artery bypass surgery do not appear promising as therapeutic modalities to reduce myocardial necrosis in this condition.More appropriate therapeutic emphasis may result from research efforts to develop pharmacologic interventions to preserve contused myocardium similar to those currently being evaluated in the management of patients with ischemic myocardium secondary to coronary artery disease.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The increasing prevalence of terrorist attacks and natural disasters has mandated that more emphasis be placed on emergency disaster planning. This report focuses on the 1976 Courthouse bombing in Boston, which generated 20 casualties. Ambulance response by Boston's Emergency Medical Service system was made in 2.5 minutes and all victims were transported from the scene within 20 minutes. Successful management of this incident employed several important principles of disaster planning. These include the initial medical response, staging at the scene, and hospital notification. Additionally, the concept of triage as an integral part of disaster planning is explained with examples of the on-site medical stabilization and treatment of casualties. The importance of these concepts in practice and the necessity of close coordination of ambulance response and the responses of other emergency agencies, i.e., Police and Fire, were clearly demonstrated in the disaster which resulted from the Courthouse bombing.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

One hundred nine head-injured patients with epidural and acute and chronic subdural hematomas were evaluated by computed tomography (CT). Eighty-two patients had subsequent CT examinations in order to evaluate postoperative changes and responses to therapy. Results seen on CT studies were compared to patients' neurologic status at the time of scanning. The rapid return of the appearance of the brain and the patients' neurologic status to normal soon after evacuation of an uncomplicated epidural hematoma reflect the lack of parenchymal damage. In contrast, acute subdurals are usually produced by associated contusions or cortical lacerations. The mass effect of these parenchymal lesions is responsible for a degree of ventricular shift out of proportion to the usual small size of the acute subdural. Small acute subdurals managed medically and residual collections found after evacuation resolved spontaneously. No acute subdurals progressed to a chronic subdural. The latter are infrequently associated with cerebral parencymal injury and their symptoms are due to the size of the collections. Deformity of the underlying brain by the chronic process and slow re-expansion of the brain account for the common finding of a slowly resorbing, residual fluid collection following surgical evacuation.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The hemodynamic response to missile injury was studied in the hind legs of dogs. Spherical projectiles were used and velocity and mass were varied.The regional arterial blood flow to the injured thigh was recorded and the energy transfer to the tissues determined. In addition the pressure within the aortic arch was recorded immediately after the impact of the missile. Missile penetration caused a marked peak of flow followed by a less pronounced elevation of the flow level for at least 30 minutes. The magnitude of the peak was related to the amount of energy transferred to the tissues. The origin of the circulatory changes is discussed. Shock waves of considerable magnitude were recorded within the aortic arch in connection with the bullet penetration.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

The techniques of fibular bypass grafting for massive tibial bone loss have been well described over the past 50 years. These techniques have generally been used as salvage procedures in post-traumatic civilian patients with chronic sepsis, or for congenital pseudoarthrosis. We present the experience of the Orthopaedic Department of the Hadassah University Hospital in successfully treating massive tibial bone loss by early fibular bypass grafting in four war injuries, where such definitive procedures would have been avoided in the past.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Fracture of the humerus, radius, and ulna is a rare combined injury. In our review of 21 cases, it was found that this injury was usually a result of rather severe trauma. There are frequently associated injuries to other organ systems. The most common associated injury was residual nerve damage, which occurred in over 50% of cases. Of all the different treatment modalities no one was found to be better than the others.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID

摘要:

Six unreduced posterior dislocations of the elbow are reported and the clinical details, operative procedures, and results obtained are presented. The literature is reviewed and the necessity of triceps V-Y plasty at operation discussed.

ISSN:0022-5282    

出版商:OVID    

年代:1979

数据来源: OVID