Advanced Emergency Medicine (E-Journal)
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Comparison of splint and conventional cast for treating wrist torus fractures in children (systematic review)
Get PDFWrist torus fractures in children are common. Although it might be simple and straightforward, the management of these injuries remains controversial and depends on the personal experience and preference of the treating physician. The consensus agreement, however, is that these fractures are inherently stable. Some authors argue that splints should replace the traditional method of cast immobilisation. The splints are viewed as easier to use, more convenient and do not require follow up clinics for removal. It has also been argued that splints are more cost-effective than casts. The aim of this systematic review is to examine the effectiveness and cost-effectiveness of removable splints versus casts in the treatment of torus wrist fractures of children in the current literature. This review followed the Systematic reviews and Meta-Analyses (PRISMA) statement for reporting. Comprehensive electronic database search and handsearch were conducted. Studies were considered for review if they were randomised or quasi-randomised controlled trial and compared removable splints and casts for treating torus fractures of distal radius and/or ulna in children. Four papers identified by two reviewers as potentially eligible for inclusion were appraised and two identified for inclusion were further assessed for any risk of bias. Data were narratively presented and discussed as meta-analysis would not have been possible for the identified studies. The limited available data favours the use of splint as a clinically effective and more cost-effective method of immobilisation. However, the findings of the systematic review are limited by the quality of the identified studies. It has been viewed that explanation to patients and parents and involving them in the decision, plus implementation of safety protocol to avoid under-treatment of misdiagnosed fractures and allow easy access of patients to the clinic, is an alternative way to provide safe, convenient and cost-effective treatment
Framing the preoperative assessment of the oncogreriatric patient. The surgeon’s point of view
Get PDFElderly cancer patients represent a steadily rising population constituting a daily problem for any physician, who is confronted not only with medical questions but also with ethical and social dilemmas. In addition oncogeriatric patients are underrepresented or excluded from trials especially in surgery which results in a gap in practical and evidence based knowledge regarding their preoperative evaluation and treatment. Therefore the authors outline the framework a decision making process for a meaning – and success- full treatment plan has to rely on
Closed Reduction and Internal Fixation with Hollow Needle for High-Risk Aged Trochanter Fracture
Get PDFObjective: To discuss the therapeutic efficacy of closed reduction and internal fixation with hollow needle for high-risk aged trochanter fracture. Methods: 60 patients with high-risk aged trochanter fracture, who received treatment in our hospital from February 2010 to August 2012, were selected, 40 cases underwent closed reduction and internal fixation with hollow needle, as the treatment group. 20 cases received DHS internal fixation, as the control group. follow-up was made for six months to two years to observe the therapeutic efficacy. Results: 59 cases were cured successfully, 1 case had infection and bone exposure, which was cured through changing medicine, there was no cases of death, hip varus deformity, fixation loosening and other complications. Conclusion: The closed reduction and internal fixation with hollow needle for high-risk aged trochanter fracture has the advantages of being relatively easy to use, reliable to fix, minimal trauma, less bleeding, less complication, high cure rate, etc. worthy of extensive promotion and application in clinical
Clinical Analysis of the Treatment of Exudative Tuberculous Pleurisy with Central Venous Catheter Drainage
Get PDFObjective: To evaluate the clinical effect of the treatment of exudative tuberculous pleurisy with central venous catheter drainage. Methods: 60 cases of exudative tuberculous pleurisy were divided into two groups. The treatment group was treatedwith central venous catheter drainage, while the control group was treated with multipleconventional thoracentesis. Results: The clinical effect of the treatment group was significantlyhigher in comparison to the control group (p < 0.01). The adverse reaction of the treatment group was significantly lower in contrast to the control group (p < 0.01). Conclusion: Application of central venous catheter drainage in the treatment of exudativetuberculous pleurisy revealed a positive effect, by showing less adverse reaction.Therefore, the treatment is worth to be promoted for clinical application
Analysis of Misdiagnosis Cases for Acute Abdomen Cardiovascular Disease
Get PDFWith the continuous improvement of the grassroots medical reform, the basic medical care for human being arose in order to avoid problems. Complicated cases faced by the grassroots doctors in treating patients was largely due several factors namely, the hospital equipment, coupled with most doctors have not yet been fully trained as general practitioner, knowledge limitations, less clinical experiences especially in terms of emergency patients’ cases, treatment was not given in time, not having accurate diagnosis, and mistreatment. Facing with the current medical condition, therefore it is the main purpose of this study to deal with the phenomenon of the patients that were unable to be treated in time. The study involved the cases of cardiovascular diseases which had been misdiagnosed as acute abdomen to exemplify China’s grassroots misdiagnosis phenomenon, by providing summary from the analysis and expounding on how to avoid misdiagnosis phenomenon at the grass-roots level
Study on the Diagnosis and Treatment of Retinal Vein Occlusion
Get PDFObjective: Study on the diagnosis and treatment of retinal vein occlusion. Method: 96 patients with retinal vein occlusion in our hospital from April 2014 to February 2015 were retrospectively analyzed. A total of 48 patients (p > 0.05) were randomly divided into observation group and control group. The control group was treated with traditional medicine, while the observation group was treated by surgery. The two groups were treated with predictive nursing. Results: The result from control group of 48 patients and the observation group of 48 patients were changed after a period of treatment but the control group was not significantly improved compared with the observation group. Conclusion: The clinical effect of observation group operation treatment of retinal vein occlusion is remarkable, so the study of its significance is far-reaching, and it is worth to be popularized and applied in clinic
Clinical Study of Lumbar and Leg Pain Injury Caused by Subarachnoid Hemorrhage
Get PDFObjective: To study the application of lumbar puncture cerebrospinal fluid (CSF) aspiration in the treatment of subarachnoid hemorrhage (SAH) induced by lumbosacral nerve neuralgia. Methods: CSF from 313 patients after craniotomy, brain contusion and laceration, and lumbosacral nerve pain were withdrawn via lumbar puncture. 10−20 mL hemorrhagic CSF was withdrawn 1−3 times except when contraindicated, to promote spinal nerve stimulation while relieving the effects of lumbosacral nerve pain symptoms. Results: Lumbar puncture CSF treatment application of hemorrhagic traumatic SAH induced by lumbosacral nerve pain was a success except in 3 patients with low intracranial pressure symptoms. Conclusion: Lumbar puncture to remove CSF was successfully applied to treat hemorrhagic traumatic SAH induced by lumbosacral nerve pain effect
The Comparative Study of Open and Laparoscopic Partial Hepatectomy in 64 Cases of Patients
Get PDFObjective: A comparative study between two methods of open and laparoscopic partial hepatectomy. Method: 64 cases of patients with partial hepatectomy were choosing from our hospital from January 2014 to December 2014. Two groups were assigned according to the principle of random allocation of the open group and laparoscopic group, respectively and were observed its operation index, post-operative recovery indicators and other indicators. Results: Abdominal incision length, intra-operative bleeding volume, post-operative advanced liquid time, and hospitalization time were significantly better in Laparoscopic than laparotomy group (p < 0.05). There was no significant difference in the operation time and complications between the open and laparoscopic group (p > 0.05). Conclusion: Laparoscopic partial hepatectomy is obviously superior to open liver resection where it is worth promoting in clinical practice
Statistical Analysis of Blood Cell Parameters in Premature Infants
Get PDFObjective: Analysis and discussion of the clinical statistics of the blood cell parameters in premature infants. Method: From May 2008 to January 2015, 85 cases of premature infants were selected to analyze the relationship between blood cell parameters and birth weight, gestational age and the changes of blood cell parameters in premature infants with intracranial hemorrhage. Results: Blood cell parameters PDW and PLT were decreased with the decrease of birth weight and gestational age. MPV increased with the decrease of birth weight and gestational age, the difference was statistically significant (p < 0.05). Compared with the non-bleeding group, the intracranial hemorrhage in premature infants with PLT was significantly decreased, the difference was statistically significant (p < 0.05), MPV and PDW were not statistically significant (p > 0.05). Conclusion: The blood cell parameters were correlated with the birth weight and gestational age, and the parameters of blood cells were closely related to the complications of premature infants and premature infants with intracranial hemorrhage
Cellular and Molecular Mechanisms of Hepatic Fibrosis
Get PDFThe occurrence of hepatic fibrosis is a multi-factor involved process. The key is the activation of hepatic stellate cells (HSC). Synthesis of extracellular matrix in the liver cells increases while degradation decreases. This paper reviews the tissue factors and the mechanism closely related to the forming of hepatic fibrosis