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Epidemiological profile of pediatric ocular trauma in a tertiary hospital of northern India

Chinese journal of traumatology 2018年第2期21卷 100-103页

作者： Shazia Qayum Rashid Anjum Shagufta Rather Department of Ophthalmology MMIMSR Mullana Ambala India orthopedic & trauma surgeon j&k health services Jammu India Department of Ophthalmology GMC Jammu India

Purpose： Ocular trauma is one of the most common causes of acquired blindness in children. It measures about 8%-14% of total childhood injuries. This study aims to determine the epidemiological profile of ocular trauma in the pediatric age group attending a tertiary hospital in northern India. Methods： A retrospective study was conducted in our hospital between june 2014 to july 2015 and all the children aged 0-16 years presenting with ocular trauma in eye outpatient department and emergency were enrolled in the study. Various epidemiological parameters like age, sex distribution, duration of presentation, mode of injury, type of injury and final visual outcome were analyzed. Results： Of total 357 patients, 271 （76%） were below the age of 12 years： 41.1% of children with ocular trauma belonged to age group 2-6 years. The male to female ratio was 2.9：1. Out of total patients, 242 （67.8%） presented with closed globe injury. Among the closed globe injury, the history of fall was present in about 35% of children, followed by trauma while playing with bat/ball （15.7%） and finger nail trauma （13.2%）. Among open globe injury, trauma with needle, knife, glass and pen were common causes. Home was the most common place of injury （47.8%）, followed by streets （17.9%） and playground （14.9%）. Conclusion： Children are vulnerable to ocular trauma and need more supervision. Sharp objects like needles, knives, household chemicals like acids should be out of reach of children.

关键词： Ocular trauma Open globe injuries Closed globe injuries Birmingham eye trauma terminology system Adnexal injuries Pediatric ocular trauma

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Restoration of the joint geometry and outcome after stemless TESS shoulder arthroplasty

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World journal of orthopedics 2017年第10期8卷 790-797页

作者： Lars V von Engelhardt Michael Manzke Andreas Breil-Wirth Timm j Filler joerg jerosch Faculty of health University of Witten/Herdecke Department of orthopedics Trauma Surgery and Sports MedicineJohanna Etienne Hospital Department of Anatomy Heinrich-Heine University of Duesseldorf

AIM To evaluate the joint geometry and the clinical outcome of stemless, anatomical shoulder arthroplasty with the TESS *** Twenty-one shoulders with a mean follow-up 18 of months were included. On scaled digital radiographs the premorbid center of rotation(CoR) was assessed and compared to the CoR of the prosthesis by using the MediC AD~? software. Additionally, the pre-and post-operative geometry of the CoR was assessed in relation to the glenoid, the acromion as well as to the proximal humerus. Radiological changes, such as radiolucencies, were also assessed. Clinical outcome was assessed with the Constant and DASH score. RESULTS Both, the Constant and DASH scores improved signifi-cantly from 11% to 75% and from 70 to 30 points, P ked glenoids, etc.(P > 0.05). The pre-and postoperative humeral offset, the lateral glenohumeral offset, the height of the CoR, the acromiohumeral distance as well as neckshaft angle showed no significant changes(P > 0.05). The mean deviation of the CoR of the prosthesis from the anatomic center was 1.0 ± 2.8 mm. Three cases showed a medial deviation of more than 3 mm. These deviations of 5.1, 5.7 and 7.6 mm and were caused by an inaccurate humeral neck cut. These 3 patients showed a relatively poor outcome *** TESS arthroplasty allows an anatomical joint reconstruction with a very good outcome. Outliers described in this study sensitize the surgeon for an accurate humeral neck cut.

关键词： Anatomical shoulder arthroplasty Stemless Omarthrosis Total shoulder replacement joint geometry

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Digital templating in total hip arthroplasty:Additional anteroposterior hip view increases the accuracy

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World journal of orthopedics 2017年第1期8卷 30-35页

作者： Sophia k Stigler Franz j Müller Sebastian Pfaud Michael Zellner Bernd Füchtmeier Clinic for trauma Orthopaedic and Sports MedicineHospital Barmherzige Brüder

AIM To analyze planning total hip arthroplasty(THA) with an additional anteroposterior hip view may increases the accuracy of preoperative planning in *** We conducted prospective digital planning in 100 consecutive patients: 50 of these procedures were planned using pelvic overview only(first group), and the other 50 procedures were planned using pelvic overview plus antero-posterior(a.p.) hip view(second group). The planning and the procedure of each patient were performed exclusively by the senior surgeon. Fifty procedures with retrospective analogues planning were used as the control group(group zero). After the procedure, the planning was compared with the eventually implanted components(cup and stem). For statistic analysis the x^2 test was used for nominal variables and the t test was used for a comparison of continuous *** Preoperative planning with an additional a.p. hip view(second group) significantly increased the exact component correlation when compared to pelvic overview only(first group) for both the acetabular cup and the femoral stem(76% cup and 66% stem vs 54% cup and 32% stem). When considering planning ± 1 size, the accuracy in the second group was 96%(48 of 50 patients) for the cup and 94% for the stem(47 of 50patients). In the analogue control group(group zero), an exact correlation was observed in only 1/3 of the *** Digital THA planning performed by the operating surgeon and based on additional a.p. hip view significantly increases the correlation between preoperative planning and eventual implant sizes.

关键词： Digital Templating Preoperative planning Hip view Total hip arthroplasty

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Rhubarb-based Chinese herbal formulae for hepatic encephalopa-thy:a systematic review and Meta-analysis

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journal of Traditional Chinese Medicine 2017年第6期37卷 721-734页

作者： Zhang Ning Zhou Shuangnan Xiao Xiaohe Wanq Zhen Bai Yunfeng He Tingting Zhou Chao Wang Yao kun Zhou Wang Zhongxia Liu Bing Larry j.Prokop Matthew C.Hernandez Li jun Gong Man Center of Integrative Medicine 302 Military Hospital of ChinaBeijing 100039China Liver Transplantation Center 302 Mili-tary Hospital of ChinaBeijing 100039China Evidence-based Practice Center Mayo ClinicRochester 55905USA Library Public services Mayo ClinicRoch-ester 55905USA Division of trauma Critical CareDepartment of SurgeryMayo ClinicRochester 55905USA

OBjECTIVE: To evaluate the effectiveness and safety of rhubarb-based Chinese herbal formulae(RCHF), which are widely used to treat hepatic encephalopathy(HE) in ***: Nine online databases were searched from inception to November 22, 2016. Eligible studies were randomized controlled trials of Traditional Chinese Medicine(TCM) treatment for adult patients(≥ 18 years old) with HE. Outcomes such as mortality rate, clinical response rate, blood ammonia level, and alanine aminotransferase were evaluated between TCM group and control ***: Thirty studies involving 2661 HE patients were analyzed. Most studies used RCHF *** with conventional treatment as usual,lactulose, and vinegar, RCHF were associated with significant improvement in clinical response rate[risk ratio(RR) = 1.33, 95% confidence interval(CI) =1.25, 1.43, I2= 0%; RR = 1.26, 95% CI = 1.14, 1.38, I2=22%; and RR = 1.19, 95% CI = 1.06, 1.33, I2= 0%, respectively] and significant reductions in levels of blood ammonia and alanine aminotransferase. Only minor RCHF-associated adverse events, such as abdominal pain(0.3%), anal tenesmus(0.3%), and diarrhea(2.3%), were reported, and there were no significant differences in these events between the treatment group and the three types of control ***: The findings suggest that RCHF may be an alternative treatment option for HE patients. More rigorous multicenter studies with larger samples and longer observational periods are needed to confirm these findings.

关键词： Drugs, Chinese herbal Rheum Hepaticencephalopathy Meta-analysis Review

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Donor preoperative oxygen delivery and post-extubation hypoxia impact donation after circulatory death hypoxic cholangiopathy

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World journal of Gastroenterology 2016年第12期22卷 3392-3403页

作者： Thomas j Chirichella C Michael Dunham Michael A Zimmerman Elise M Phelan M Susan Mandell kendra D Conzen Stephen E kelley Trevor L Nydam Thomas E Bak Igal kam Michael E Wachs Department of Surgery Division of Transplant Surgery University of Colorado Aurora CO 80045 United States trauma/Critical Care services St. Elizabeth Health Center Youngstown OH 44501 United States Department of Transplant Surgery Medical College of Wisconsin Milwaukee WI 53226 United States Department of Anesthesiology University of Colorado Aurora CO 80045 United States Donor Alliance Organ Procurement Organization Denver CO 80045 United States Department of Transplant Surgery Children's Hospital Colorado Aurora CO 80045 United States

AIM: To evaluate donation after circulatory death (DCD) orthotopic liver transplant outcomes [hypoxic cholangiopathy (HC) and patient/graft survival] and donor ***: From 2003-2013, 45 DCD donor transplants were performed. Predonation physiologic data from UNOS DonorNet included preoperative systolic and diastolic blood pressure, heart rate, pH, SpO2, PaO2, FiO2, and hemoglobin. Mean arterial blood pressure was computed from the systolic and diastolic blood pressures. Donor preoperative arterial O2 content was computed as [hemoglobin (gm/dL) × 1.37 (mL O2/gm) × SpO2%) + (0.003 × PaO2)]. The amount of preoperative donor red blood cell transfusions given and vasopressor use during the intensive care unit stay were documented. Donors who were transfused ≥ 1 unit of red-cells or received ≥ 2 vasopressors in the preoperative period were categorized as the red-cell/multi-pressor group. Following withdrawal of life support, donor ischemia time was computed as the number-of-minutes from onset of diastolic blood pressure 2/100 mL blood vs 16.8 ± 3.3 m

关键词： Orthotopic liver transplantation Ischemic cholangiopathy Hypoxic cholangiopathy Donation after circulatory death Biliary complications Reperfusion injury

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世界腹腔间隙学会腹内高压和腹腔间隙综合征2013版专家共识与诊疗指南

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中华外科杂志 2015年第3期53卷 173-175页

作者： Andrew W.kirkpatrick Derek j.Roberts jan De Waele Roman jaeschke Manu L.N.G.Malbrain Bart De keulenaer juan Duchesne Martin Bjorc Ari Leppaniemi Departments of Surgery and Critical Care Medicine and Regional trauma services Foothills Medical Centre Calgary Alberta T2N 2T9 Canada

随着人们对腹内压（intra-abdominal pressure,IAP）的重视,大量研究开始关注腹内高压（intraabdominal hypertension,IAH）和腹腔间隙综合征（abdominal compartment syndrome,ACS）.世界腹腔间隙学会（The abdominal compartment society,WSACS）先后在2006年提出了IAH和ACS的专家共识,2007年发表了诊疗指南,2009年明确了疾病相关研究的推荐方向.2013年WSACS发布了新的IAH和ACS专家共识与诊疗指南.该指南由多学科专家共同参与制定,大部分是外科专家和重症监护专家.专家们首先明确24个临床医师关心的IAH和ACS问题,随后进行了系统有序的文献整理.

关键词：腹腔间隙综合征外科专家诊疗指南腹内高压 hypertension 学会世界 2009年

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Decline in stroke alerts and hospitalisations during the COVID-19 pandemic

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Stroke & Vascular Neurology 2020年第4期5卷 403-405页

作者： Malveeka Sharma Vasileios-Arsenios Lioutas Tracy Madsen judith Clark jillian O'Sullivan Mitchell S.VElkind joshua Z.Willey Randolph S.Marshall Magdy H.Selim David Greer David L.Tirschwell Tina Burton Amelia Boehme Hugo j.Aparicio Department of Neurology University of Washington School of MedicineSeattleWashingtonUSA Department of Neurology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMassachusettsUSA Deparment of Emergency Medicine Brown UniversityProvidenceRhode IslandUSA Department of Neurology Boston University School of MedicineBostonMassachusettsUSA Department of Neurology Vagelos College of Physicians and SurgeonColumbia UniversityNew YorkNew YorkUSA Department of Epidemiology Mailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA Department of Neurology Brown UniversityProvidenceRhode IslandUSA

Introduction Patients with stroke-like symptoms may be underutilising emergency medical services and avoiding hospitalisation during the COVID-19 *** investigated a decline in admissions for stroke and transient ischaemic attack(TIA)and emergency department(ED)stroke alert *** We retrospectively compiled total weekly hospital admissions for stroke and TIA between 31 December 2018 and 21 April 2019 versus 30 December 2019 and 19 April 2020 at five US tertiary academic comprehensive stroke centres in cities with early COVID-19 outbreaks in Boston,New York City,Providence and *** collected available data on ED stroke alerts,stroke severity using the National Institutes of health Stroke Scale(NIHSS)and time from symptom onset to hospital *** Compared with 31 December 2018 to 21 April 2019,a decline in stroke/TIA admissions and ED stroke alerts occurred during 30 December 2019 to 19 April 2020(p trendks in *** of the five centres with 2019 and 2020 stroke alert data had a 46%decline in ED stroke alerts in late March and April 2020,compared with *** baseline NIHSS during these 4 weeks was 10 in 2020 and 7 in *** was no difference in time from symptom onset to hospital *** At these five large academic US hospitals,admissions for stroke and TIA declined during the COVID-19 *** was a trend for fewer ED stroke alerts at three of the five centres with available 2019 and 2020 *** stroke therapies are time-sensitive,so decreased healthcare access or utilisation may lead to more disabling or fatal strokes,or more severe non-neurological complications related to *** findings underscore the indirect effects of this *** health offici

关键词： alert centre hospital

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Peno-scrotal soft tissue loss:a need for multidisciplinary and multimodal integration

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Plastic and Aesthetic Research 2016年第1期3卷 273-278页

作者： Pradeoth korambayil Mukundan Prashanth Varkey Ambookan Ragu Angappan Vinoth kumar Dilliraj Department of Plastic Surgery and Burns Bahrain Defence Force Royal Medical ServicesEast Riffa 38285Bahrain

Aim:Scrotal soft tissue loss is a part of the challenging conditions for plastic *** non-availability of adequate nearby healthy soft tissue and its probability of frequent contamination by excretory substances make the issue of reconstruction *** authors present their experience with penoscrotal soft tissue loss with hyperbaric oxygen therapy as an ***:This retrospective study was undertaken in the department of plastic surgery,over a period of 2 *** patients with scrotal or penile injury and infection were enrolled in the *** of the patients ranged 20-60 *** patients had traumatic loss of scrotal skin and 4 resulted following necrotizing soft tissue *** patients underwent hyperbaric oxygen therapy before and following ***:Healing was complete in all patients with minor complications as partial skin graft loss in 2 *** patients(55.5%)had sustained the soft tissue loss due to *** cause of necrotizing fasciitis was found in 4 patients(44.4%).The mean length of hospital stay was 42.5 ***:Management of soft tissue loss of penoscrotal region requires an organized approach and the utilization of newer modalities for early recovery of these injuries is of primary *** surgeons should know the various reconstructive pathways and use of adjunct measures like hyperbaric therapy for early recovery.

关键词： Scrotal soft tissue loss necrotizing fasciitis soft tissue reconstruction hyperbaric oxygen therapy

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Current trauma care system and trauma care training in China

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Chinese journal of traumatology 2018年第2期21卷 73-76页

作者： Lian-Yang Zhang Xiu-Zhu Zhang xiang-jun Bai Mao Zhang Xiao-Gang Zhao Yong-An Xu Hao Tan Yang Li trauma Center. State key Laboratory of trauma Burns and Combined Injury Research Institute of Surgery Doping Hospital Amry Medical University Chongqing 400042 China Department of traumatic Surgery TonEi Hospital Tongji Medical College Huazhong University of Sdence and Technology Wuhon 430030 China Department of Emergency Medidne The Second Affiliated Hospital of Medical College Zhefiang University Zhejiang 310009 China

trauma is a life-threatening ＂modern disease＂. The outcomes could only be optimized by cost-efficient and prompt trauma care, which embarks on the improvement of essential capacities and conceptual revolution in addition to the disruptive innovation of the trauma care system. According to experiences from the developed countries, systematic trauma care training is the cornerstone of the generalization and the improvement on the trauma care, such as the Advance trauma Life Support （ATLS）. Currently, the pre-hospital emergency medical services （EMS） has been one of the essential elements of infrastructure of health services in China, which is also fundamental to the trauma care system. Hereby, the China trauma Care Training （CTCT） with independent intellectual property rights has been initiated and launched by the Chinese trauma surgeon Association to extend the up-to-date concepts and techniques in the field of trauma care as well to reinforce the generally well-accepted standardized protocols in the practices. This article reviews the current status of the trauma care system as well as the trauma care training.

关键词： trauma care system trauma care training China

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Relationship between perioperative anaemia and outcomes in older people with hip fractures: A systematic review and meta-analysis protocol

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World journal of Meta-Analysis 2019年第6期7卷 290-296页

作者： kareeann SF khow Michelle Wk kee Pazhvoor N Shibu Solomon CY Yu Mellick j Chehade Renuka Visvanathan Aged and Extended Care services the Queen Elizabeth HospitalWoodville SouthSA 5011Australia Centre of Research Excellence Frailty Trans-disciplinary Research to Achieve Healthy AgeingUniversity of AdelaideAdelaideSA 5005Australia Discipline of Orthopaedics and trauma Faculty of Medical and Health SciencesUniversity of AdelaideAdelaideSA 5005Australia

BACkGROUND Hip fractures are common with increasing age and is associated with decline in mobility. Both the fracture and the surgery can lead to blood loss, resulting in anaemia. However, it is uncertain at which time point haemoglobin is most strongly associated with different clinical outcomes after hip fracture. Our hypothesis is perioperative anaemia (admission, postoperative and discharge) during hip fracture surgery is associated with poor clinical outcomes. AIM To determine the effects of perioperative anaemia during hip fracture surgery on mortality, functional status and other clinical outcomes. METHODS Electronic databases will be searched to identify studies evaluating perioperative anaemia and outcomes of hip fracture surgery. Reference lists of included studies will also be searched to identify additional published studies. Eligibility criteria are as follows: Population: People who underwent hip fracture surgery;Exposure: Perioperative anaemia;Comparison: No anaemia before or after hip fracture surgery;Outcome: Mortality, hospital length of stay, postoperative complications, hospital readmission, change of discharge destination, quality of life and functional status. Risk of bias assessment will be assessed using the Cochrane Collaboration’s tool for randomized controlled trials and the modified version of the Epidemiological Appraisal Instrument for observational studies. Data will be pooled for meta-analysis if deemed appropriate. CONCLUSION This review seeks to clarify outcomes associated with perioperative anaemia at various time-points around hip fracture surgery. These findings will potentially inform evidence-based clinical practice on interventions in those with anaemia.

关键词： Anaemia Haemoglobin Hip fracture Length of stay Mortality Outcomes Perioperative Readmission

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