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Pelvic fractures in blunt trauma patients:A comparative study

World Journal of Orthopedics 2024年第5期15卷 418-434页

作者： Alexander A Fokin Joanna Wycech Knight Madison E Tharp Kyler C Brinton Phoebe K Gallagher Justin Fengyuan Xie Russell D Weisz Ivan Puente Trauma and Critical Care Services Delray Medical CenterDelray BeachFL 33484United States Charles E Schmidt College of Medicine Department of SurgeryFlorida Atlantic UniversityBoca RatonFL 33431United States Trauma and Critical Care Services Broward Health Medical CenterFort LauderdaleFL 33316United States Charles E Schmidt College of Medicine Florida Atlantic UniversityBoca RatonFL 33431United States Herbert Wertheim College of Medicine Department of SurgeryFlorida International UniversityMiamiFL 33199United States

BACKGROUND Pelvic fractures(PF)with concomitant injuries are on the rise due to an increase of high-energy *** of the elderly population with age related comorbidities further complicates the *** organ injuries are kindred with PF due to the proximity to pelvic *** of contrast blush(CB)on computed tomography in patients with PF is considered a sign of active bleeding,however,its clinical significance and association with outcomes is *** To analyze polytrauma patients with PF with a focus on the geriatric population,co-injuries and the value of contrast *** This retrospective cohort study included 558 patients with PF admitted to level 1 trauma center(01/2017-01/2023).Analyzed variables included:Age,sex,mechanism of injury(MOI),injury severity score(ISS),Glasgow coma scale(GCS),abbreviated injury scale(AIS),co-injuries,transfusion requirements,pelvic angiography,embolization,laparotomy,orthopedic pelvic surgery,intensive care unit and hospital lengths of stay,discharge disposition and *** study compared geriatric and non-geriatric patients,patients with and without CB and abdominal *** score matching was implemented in comparison *** PF comprised 4%of all trauma admissions.89 patients had CB.286(52%)patients had concomitant injuries including 93(17%)patients with abdominal *** patients compared to non-geriatric had more falls as MOI,lower ISS and AIS pelvis,higher GCS,less abdominal co-injuries,similar CB and angio-embolization rates,less orthopedic pelvic surgeries,shorter lengths of stay and higher *** propensity matching,orthopedic pelvic surgery rates remained lower(8%vs 19%,P<0.001),hospital length of stay shorter,and mortality higher(13%vs 4%,P<0.001)in geriatric *** of 89 patients with CB,45(51%)were *** propensity matching,patients with CB compared to without CB had more pelvic angiography(71%vs 12%,P<0.001),hi

关键词： Pelvic fractures Geriatric trauma patients Abdominal co-injuries Contrast blush Contrast extravasation Angioembolization Polytrauma patients surgical interventions Blunt trauma External and internal fixation for pelvic stabilization

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Clear cell sarcoma metastasizing to the pancreas

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World Journal of Clinical Cases 2024年第17期12卷 2928-2931页

作者： Meer M Chisthi Department of General Surgery Government Medical College PathanamthittaKonni 689691KeralaIndia

In this editorial based on a case report,we delve into a seldom-seen occurrence of clear cell sarcoma featuring pancreatic metastasis in a 47-year-old male *** for its typical tendency to metastasize to the lungs,bones,and brain,clear cell sarcoma rarely extends its reach to the *** the initial absence of discernible abnormalities during the patient's physical examination,the manifestation of abdominal pain prompted further *** abdominal computed tomography brought to light the presence of a pancreatic tumor,culminating in the definitive diagnosis of clear cell sarcoma with pancreatic *** successful management of this atypical presentation involved a series of surgical interventions,including distal pancreatectomy and *** report not only sheds light on the infrequent manifestation of clear cell sarcoma within the pancreas but also underscores the pivotal role of vigilant postoperative follow-up in addressing this rare *** emphasis on postoperative care serves as a crucial aspect of the broader narrative,acknowledging the need for ongoing monitoring and management to ensure a comprehensive and successful treatment trajectory for patients with this unique presentation of clear cell sarcoma.

关键词： Clear cell sarcoma Pancreatic metastasis Soft tissue sarcoma surgical interventions Postoperative follow-up

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Management strategies in malignant glaucoma secondary to antiglaucoma surgery

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International Journal of Ophthalmology(English edition) 2016年第1期9卷 63-68页

作者： Zuo-Hong Wu Yu-Hong Wang Ying Liu Aier Eye Hospital of Wuhan Wuhan 430063 Hubei Province China Aier Eye Hospital of Changsha Changsha 410015 Hunan Province China Wilmer Eye Institute Johns Hopkins University Baltimore 21231 MD USA

AIM：To assess the outcomes of various interventions for malignant glaucoma（MG）.·M ETHODS：A retrospective,comparative analysis of case series were performed on 38 eyes of 35 MG patients treated in Aier Eye Hospital of Wuhan between Jan.2009and *** treatments were administered including medical therapy,neodymium：yttriumaluminium-garnet（Nd：YAG）laser posterior capsulotomy and hyaloidotomy as well as 3 surgical *** characteristic,treatment option and outcome of MG in every individual patient were reviewed and analyzed among all patients who were followed up for an average of 27.1±9.1mo.·RESULTS：Four eyes of 3 patients achieved complete resolution with medical ***：YAG laser posterior capsulotomy and hyaloidotomy were performed on 2 eyes,both of which achieved resolution after initial ***-two eyes were given surgical treatments with anterior vitrectomy-reformation of anterior chamber in13 eyes,phacoemulsification-intraocular lens implantation in 10 eyes and phacoemulsification-intraocular lens implantation-anterior vitrectomy in 9 *** of MG was seen in almost all *** mean intraocular pressure decreased from 41.87±9.44 mm Hg at presentation to 15.84±3.73 mm Hg at the last *** mean anterior chamber depth improved from 0.28±0.27 mm to 2.28±0.19 *** eyes with preoperative visual acuity better than counting figure/50 cm had various visual *** occurred in 3 eyes of 3 patients including bleeding at the entry site of vitrectomy into vitreous cavity,corneal endothelial decompensation and allergic to atropine respectively.·CONCLUSION：MG occurs as a result of multiple mechanisms involved simultaneously or *** therapy is advocated as the initial treatment,laser therapy is beneficial in pseudophakic eyes,and different surgical regimen is recommended based on different pathogenesis of MG when non-response occurs to nonsurgical *** can be managed successfully by

关键词： malignant glaucoma pathogenesis medicaltherapy laser therapy surgical interventions

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Childhood constipation:Current status,challenges,and future perspectives

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World Journal of Clinical Pediatrics 2022年第5期11卷 385-404页

作者： Shaman Rajindrajith Niranga Manjuri Devanarayana Marc A Benninga Department of Paediatrics Faculty of MedicineUniversity of ColomboColombo 00800Sri Lanka University Paediatric Unit Lady Ridgeway Hospital for ChildrenColombo 00800Sri Lanka Department of Physiology Faculty of MedicineUniversity of KelaniyaRagama 11010Sri Lanka Department of Pediatric Gastroenterology and Nutrition Emma Children HospitalAmsterdam University Medical CenterAmsterdam 1105AZThe Netherlands

Constipation in children is a major health issue around the world,with a global prevalence of 9.5%.They present to clinicians with a myriad of clinical *** Rome IV symptom-based criteria are used to diagnose functional *** constipation is also a huge financial burden for healthcare system and has a detrimental impact on health-related quality of life of *** are various risk factors identified globally,including centrally connected factors such as child abuse,emotional and behavioral issues,and psychological *** is also precipitated by a low-fiber diet,physical inactivity,and an altered intestinal *** main pathophysiological mechanism is stool withholding,while altered rectal function,anal sphincter,pelvic floor,and colonic dysfunction also play important *** evaluation is critical in making a diagnosis,and most investigations are only required in refractory *** the treatment of childhood constipation,both nonpharmacological(education and demystification,dietary changes,toilet training,behavioral interventions,biofeedback,and pelvic floor physiotherapy),and pharmacological(osmotic and stimulant laxatives and novel drugs like prucalopride and lubiprostone)interventions are *** children with refractory constipation,transanal irrigation,botulinum toxin,neuromodulation,and surgical treatments are *** frequent use of probiotics is still in the experimental stage,healthy dietary habits,living a healthy lifestyle and limiting exposure to stressful events,are all beneficial preventive measures.

关键词： Constipation Children Functional gastrointestinal disorders Psychological stress Treatment surgical interventions

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Pierre Robin sequence from orthodontic and surgical perspective

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World Journal of Stomatology 2014年第4期3卷 30-37页

作者： Songül C?mert K?l?? Nihat K?l?? Hüsamettin Oktay Ali Kiki Department of Oral and Maxillofacial Surgery Atatürk University25240 ErzurumTurkey Department of Orthodontics Faculty of DentistryAtatürk University25240 ErzurumTurkey Department of Orthodontics Faculty of DentistryIstanbul Medipol University34083 IstanbulTurkey

Pierre Robin sequence(PRS)is a triad of micrognathia,glossoptosis,and cleft palate that results in an obstruction of the airway on inspiration and impeding *** tongue of infants with PRS fall back toward the posterior pharyngeal wall(glossoptosis)due to receding chin produced by mandibular micrognathia(small jaw)or *** causes a serious condition with potentially severe,life-threatening airway *** untreated,this problem can lead to exhaustion,cardiac failure,and ultimately death,especially during the early months of ***,in the majority of PRS infants,these symptoms can be managed by placing the infant in the prone position until adequate growth of the jaw *** this type of treatment fails,the infant then should be considered for other conservative therapies or surgical *** paper reviews surgical interventions such as tongue-lip adhesion,mandibular traction,mandibular distraction,tracheotomy and conservative orthodontic approaches,and presents a baby treated successfully with an orthodontic appliance.

关键词： Pierre Robin sequence Micrognathia Glossoptosis surgical interventions Orthodontic approaches

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