300,258 research outputs found

    C-clamp and pelvic packing for control of hemorrhage in patients with pelvic ring disruption

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    BACKGROUND: Exsanguinating hemorrhage is the major cause of death in patients with pelvic ring disruption. AIMS: The aim of this study was to document outcomes after the stabilization of pelvic ring injuries by a C-clamp and control of hemorrhage by pelvic packing. Physiological parameters were tested as prognostic factors. SETTING AND DESIGN: This was a retrospective study at a level I trauma center. The study period was from January 1996 to December 2007. MATERIALS AND METHODS: Fifty patients with pelvic ring disruption and hemorrhagic shock were analyzed. The pelvic rings were fixed by a C-clamp, and patients with ongoing hemorrhage underwent laparotomy and extra- and/or intra-peritoneal pelvic packing. Clinical parameters (heart rate, mean arterial pressure) and physiological parameters (lactate levels, hemoglobin, hematocrit) were documented at admission and at different time points during the initial treatment (1, 2, 3, 4, 6, 8, and 12h after admission). RESULTS: Within 12 h of admission, 16 patients died (nonsurvivors) due to hemorrhagic shock (n=13) or head injuries (n=3). In this group, 12 patients underwent laparotomy with pelvic packing. Thirty-four patients survived the first 12 h (early survivors) after fixation by a C-clamp and additional packing in 23 patients. Four of these patients died 12.3±7.1 days later due to multiple organ failure (n=3) or severe head injury (n=1). The blood lactate level at admission was significantly higher in the group of nonsurvivors (7.2±0.8 mmol/L) compared to the early survivors (4.3±0.5 mmol/L, P<0.05). While hemoglobin values improved within the first 2 h in nonsurvivors, lactate levels continued to increase. CONCLUSION: Pelvic packing in addition to the C-clamp fixation effectively controls severe hemorrhage in patients with pelvic ring disruption. Early sequential measurements of blood lactate levels can be used to estimate the severity of shock and the response to the shock treatment

    Looking at the Wood, Seeing the Trees and More: Australia-New Zealand Tree-Ring Science Conference, January 2025

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    The Australia-New Zealand Tree-Ring Conference was held January 21–23, 2025, at Waipapa Taumata Rau/University of Auckland, in Aotearoa/New Zealand. It was intended to provide an opportunity for the Australian and New Zealand dendrochronological researchers to meet, present current research, and discuss the challenges and opportunities in working with Southern Hemisphere tree species, but it was open to others outside of Australasia, including some keynote speakers. The meeting brought together many researchers from within and outside academia for the first time since the pandemic, and in addition to providing a look at current interesting and ongoing dendrochronology projects, it promoted camaraderie for this regional tree-ring community

    Millennium-Long Tree-Ring Chronology Reveals Megadroughts on the Southeastern Tibetan Plateau

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    Millennium-aged trees are rare in natural forests. Herewe present an 1184-year-long tree-ring width chronology from living juniper trees in the Biru area on the southeastern Tibetan Plateau. Growthclimate response analysis shows that the Biru chronology is significantly and positively correlated with late-spring (May-June) Standardized Precipitation Evaporation Index (SPEI) (r = 0.67, n = 53, p < 0.01). The tree-ring chronology explains 44.5% of the total variance of SPEI during the period AD 1957-2010. Reconstruction of May-June SPEI shows that there was a two-century-long megadrought during the late 13th to late 15th Centuries, and a seven-decade-long megadrought during AD 1630s to 1690s. Comparisons with other moisture records in the region suggest that the two-century megadrought identified in our reconstruction might be a widespread phenomenon most likely reflecting a stage of reduced Southwest Asian Summer Monsoon. Our results provide new evidence on the megadrought events on the Tibetan Plateau for the last millennium
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