ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundRisk behaviors and psychological problems may limit recovery after trauma, may be related to injury recidivism, and may limit the effectiveness of alcohol interventions in trauma patients. The aim of the current study was to evaluate the prevalence of behaviors associated with injury and their relationship with alcohol use in adult trauma patients.MethodsA prospective cohort of 301 adult patients admitted to a single Level I trauma center were interviewed regarding risk behaviors and alcohol use.ResultsThere was evidence of acute and/or chronic alcohol use in 48.2% of cases. Over three fourths of patients (77%) engaged in one or more high-risk driving practices, 40% engaged in one or more violence-related behaviors, and 19% reported suicidal ideation in the last year. These risk behaviors were more common in patients who evidenced acute and/or chronic alcohol use.ConclusionBehaviors that place an individual at greater risk for traumatic injury are common among seriously injured adult patients admitted to an urban Level I trauma center and frequently coexist with alcohol use. Their importance to injury, injury recidivism, and recovery after trauma requires further investigation.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundHealth profile of trauma victims might affect accident involvement. Information linking medical data to accident epidemiology is lacking. This study aims to identify health factors that increase risk of accident involvement.MethodsThe Israeli Defense Forces maintains two databases: records of periodical health examination of military personnel and a trauma registry including emergency department referrals of personnel resulting from injury. We identified 5,578 subjects who were examined in the Periodical Health Examination Center and were victims of trauma. We analyzed relation between injuries and various health parameters.ResultsResults shows cigarette smoking is more frequent among the population involved in trauma (40% in motor vehicle crash, 37% in fall injury, and 31% in blunt contusion compared with 28% in Periodical Health Examination Center population not involved in trauma,p< 0.05). Odds ratio of smokers involvement in motor vehicle crash is 1.82 (95% confidence interval, 1.25–2.67,p< 0.005). Younger age is relatively more frequent among trauma victims.ConclusionWe conclude that cigarette smokers and younger subjects might be at greater risk of being involved in accidental injuries.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundThis study examined crash severity and injury patterns between helmeted and unhelmeted adolescent motorcycle riders.MethodsAmong an initial population of 4,721 junior college students, 1,284 students were involved in 1,889 motorcycle crashes during a 20-month follow-up period. Crash severity was measured by both the type of collision object and the repair cost of motorcycle damage.ResultsThe incidence rates of crash, injury, hospitalization, and deaths per 1,000 person-years in the cohort were 358, 104, 14, and 1.3, respectively. Compared with helmeted riders, unhelmeted riders had more noncollisions and fewer collisions with a moving car but there was no significant difference in repair cost of motorcycle damage between these groups. More injuries to the external skin, face, and head and more severe injuries occurred in unhelmeted than in helmeted riders. Among crashes resulting in hospitalization/death, more injuries to the face and head occurred in unhelmeted riders than in helmeted riders.ConclusionCrashes involving unhelmeted riders were not more severe but more frequently involved face and head injuries than crashes involving helmeted riders.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundSkeletal muscle atrophy induced by denervation is associated with apoptosis. This study was undertaken to determine the role of apoptosis and the expression of apoptosis-associated genes in rat skeletal muscle made atrophic by brachial plexus injury, and to study the apoptotic signal transduction pathway.MethodsAn animal model of skeletal muscle atrophy was established in rats by severing the brachial plexus of one forelimb. Apoptosis of muscle cells was investigated with terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate end labeling, flow cytometry, deoxyribonucleic acid (DNA) electrophoresis, and electron microscopy. The apoptosis-associated genes Fas, FADD, Caspase 8, c-myc, p53, and Bcl-2 were detected by immunohistochemistry and Northern blot.ResultsBy terminal deoxynucleotidyl transferase–mediated deoxyuridine triphosphate end labeling and flow cytometry we found that the percentage of apoptotic muscle cells was higher in atrophic than in healthy skeletal muscle (p< 0.05). DNA laddering could be seen in gel electrophoresis of DNA from atrophic muscle. By electron microscopy, we observed morphologic change of early apoptosis, such as aggregation of chromosomes, expansion of nucleic cistern, and contraction of the nucleus. Using immunohistochemistry, we determined that in atrophic muscle Fas, FADD, and Caspase-8 genes were highly expressed, whereas Bcl-2 was poorly expressed (p< 0.01). However, we did not detect a change in the expression of p53 or c-myc genes. Northern blots indicated that Fas messenger ribonucleic acid was higher and Bcl-2 messenger ribonucleic acid was lower in atrophic than in healthy muscle (p< 0.01).ConclusionThere are many more apoptotic cells in muscle atrophied as a result of brachial plexus injury than in healthy muscle, and apoptosis plays an important role in the pathogenesis of atrophy. The apoptotic signal may be transmitted from Fas to FADD to Caspase-8, with a decrease in Bcl-2 expression aggravating the process.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundWe sought to consolidate evaluation and management of traumatic urethral disruption using cystourethroscopic evaluation without retrograde urethrogram or suprapubic cystostomy placement.MethodsWe review our experience with initial flexible cystourethroscopic evaluation of suspected urethral injury from blunt trauma with placement of a Council urethral catheter to provide primary endoscopic realignment of the urethra.ResultsAccess into the bladder was achieved in 8 of 10 patients. After a mean follow-up of 18 months (range, 9–27 months) in the six living patients, only three have required treatment for urethral stricture—direct vision internal urethrotomy in two, and open perineal urethroplasty in one. Urinary continence has been achieved in five of six patients.ConclusionPrimary flexible cystourethroscopy with placement of a urethral catheter streamlines evaluation and management of traumatic posterior urethral injury. In the presence of partial disruption it provided stricture-free outcomes in three of three surviving patients.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundThe association between facial and cervical spine injuries has been documented. However, only severe spinal injuries were included in previous analyses. It was the purpose of this study to evaluate the incidence of and risk factors for these injury combinations including the complete injury spectrum.MethodsBetween 1995 and 1997, 4,907 patients with cervical spine injuries were treated at our hospital. One hundred five (2.14%) of these patients had suffered a concomitant facial injury. This group was compared with the group of patients with cervical spine injury but without facial trauma.ResultsThe majority of cases (98%) consisted of minor lesions to both regions. With increasing severity of cervical spine trauma, the risk for facial injury increased. Age and male gender represent significant (p< 0.05) risk factors for combined injuries.ConclusionPatients sustaining cervical spine trauma have a small but real chance of injuring their face as well. The cervical spine must be examined carefully, whenever facial injuries are present.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundA long-term review of metal prosthetic radial head replacement in patients with radial head fractures associated with gross instability of the elbow has been performed.MethodTwenty patients were reviewed using a modified Mayo Clinic functional rating index system. The mean follow-up was 12.1 years, with a range from 6 to 29 years.ResultsResults were excellent in 12 patients, good in 4 patients, fair in 2 patients, and poor in 2 patients. A metal radial head replacement restored elbow stability when fracture of the radial head occurred in combination with dislocation of the elbow, rupture of the medial collateral ligament, fracture of the proximal ulna, and/or fracture of the coronoid process.ConclusionWe conclude that a metal radial head prosthesis has select indications. We advocate its use when the radial head cannot be reconstructed in the setting of a clinically unstable elbow. Results suggest that it functions well on a long-term basis.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

BackgroundThe distally based superficial sural artery flap, first described as a distally based neuroskin flap by Masquelet et al., is a skin island flap supplied by the vascular axis of the sural nerve. In the difficult area of defects in the lower leg and the ankle and heel region, it has a wide variety of indications, even in the vascularly compromised patients. It has the largest arc of rotation of all flaps that have been described in this region. The most important advantage is that it does not compromise a major artery. It is simple to dissect and has a low donor morbidity.MethodsWe reported our experience with this new flap in 15 cases and also described a new indication for the patients with neglected ruptures of the Achilles tendon.ResultsIn 13 patients, the flap was successfully transferred. In two cases, partial necrosis of the flap ensued, which healed with secondary intention.ConclusionThis flap deserves a high degree of interest in the reconstructive armamentarium of the trauma surgeon.

ISSN:0022-5282    

出版商:OVID    

年代:2001

数据来源: OVID