ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Nasal reconstruction is one of the most important elements in rehabilitation of the patient suffering from the devastating deformities of full‐thickness facial burns. When possible we use a single pedicle for complete nasal reconstruction. The forehead furnishes the best donor area. More distant donor sites are used if the forehead is not available. In lesser deformities, resurfacing with composite grafts or full‐thickness skin grafts gives satisfactory results.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;The technical aspects of Ender's method in the treatment of trochanteric fractures are described. Problems and complications encountered with this method and their prevention and treatment are discussed. Intraoperative and postoperative problems are subdivided into those in the hip area and around the knee joint, such as: varus deformity, protrusion of the rod medially or laterally or into the hip joint, cracking the distal femur, incorrectly placing the window on the anteromedial side of the femoral condyle, backing out of the rods, and supracondylar fractures.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A routine, carefully planned meeting with families of patients in a trauma unit or critical care setting can improve coping and enhance patient care. Even though staffs in intensive care units realize that families may profoundly influence a patient's psychologic state, or may themselves be severely stressed, few units systematically address the needs of families in crisis. Common needs of families of acutely injured patients are the need to be with the patient, to learn about his condition, to feel useful, to express feeling about the situation, and to obtain emotional support. Besides addressing these needs, a family meeting can reduce family turmoil, help dispel family‐staff conflict, and provide a format for educating staff about psychologic responses to life‐threatening illness. The experience with eight patients in an ICU is described, and guidelines given for family meetings. Factors assuring a successful family meeting include careful attention to leadership, timing, communication, and clear priorities.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;The effects of supplemental albumin infusion on serum protein homeostasis were studied in 94 seriously injured patients who received an average of 14.4 transfusions, 9.2 L electrolyte solution, and 829 ml fresh frozen plasma before and during operation. Based on randomization, 46 patients received an average of 31 gm albumin during operation followed by 150 gm/day for 5 days; 48 patients received no albumin. Supplemental albumin caused a significant (p=<0.05) increase in total serum protein and albumin concentrations. In contrast, supplemental albumin caused a significant decrease in &agr;1globulin, &agr;2globulin, &bgr; globulin, &ggr; globulin, and fibrinogen levels. The prothrombin time used as index of prothrombin concentration was significantly prolonged in albumin patients. These changes, not previously documented, need further evaluation to determine clinical significance.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A new method of measuring intracellular Na and K using Li substitution analysis was applied to a study of red cell Na changes in hemorrhagic shock. Using a rat hemorrhagic shock model, significant changes in red cell Na were found after 2 hours. Red cell Na in shocked animals was significantly higher than in control animals (p< 0.025). A small decrease in red cell K occurred. There was no intracellular shift of Li. In addition, a fall in plasma Na and a rise in plasma K occurred with progressive shock. In a 2‐hour period following retransfusion there was no significant change in cell Na or K, but the plasma Na and K returned toward preshock levels. These results confirm a prolonged and significant impairment of red cell membrane function in shock and suggest that impaired Na‐K pump function may be responsible for the changes.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Loss of sensory, motor, and reflex function during spinal shock obscures the usual signs of significant blunt abdominal trauma. In a retrospective study of ten acutely quadriplegic patients, initial physical findings, vital signs, and hematocrit determinations were not found to be helpful in detecting intra‐abdominal injury. Diagnostic peritoneal lavage was an accurate indicator of the presence or absence of significant intraperitoneal hemorrhage in all ten cases in this series.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;Cardiac mitochondria showed significant uncoupling of oxidative phosphorylation after rats were given intraperitoneal alcohol. The rate of oxygen utilization in the absence of ADP was increased while there was no significant change in oxygen utilization in the presence of ADP. These in vivo results were confirmed with in vitro experiments. Also, intraperitoneal alcohol increased the mortality of blunt cardiac trauma. The alterations in cardiac energy metabolism demonstrated may explain the increased mortality in alcohol‐pretreated animals subjected to cardiac contusion.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID

摘要:

&NA;A study to document the utilization by house officers of the Diagnostic Radiologic Examination (DRE) in trauma patients was carried out over 2 years at Stanford University Medical Center. Physicians recorded the likelihood of a fracture being present for patients requiring DRE's to evaluate traumatic injuries. The physician's opinion and the radiologist's final interpretation of the DRE were compared for 24 anatomic regions. Preliminary findings reveal: for almost half the DRE's the house officer indicated that the reason for the DRE was medicolegal; 7% of the medicolegal cases had fractures present; less than 4% of these fractures was important enough to change the medical treatment. The levels of house officer experience are suggested as possible causes of excessive DRE utilization, as well as the influence of defensive medicine. Using Green and Swets' Theory of Signal Detection, it is possible to mathematically describe an accuracy index, and a “fear” index for each physician. We plan to use this model in analysis of the study data.

ISSN:0022-5282    

出版商:OVID    

年代:1980

数据来源: OVID