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81.
82.
Study Design
Case series.Introduction
A salvaged limb is one that has undergone a major traumatic injury, followed by repeated surgical attempts in order to avoid amputation. Psychological recovery for individuals with lower extremity limb salvage has been examined in a number of studies. However, psychosocial reactions for individuals with upper extremity (UE) limb salvage are understudied in the literature.Purpose of the Study
The purpose of this study was to explore the process of psychosocial adaptation for 3 trauma cases after UE limb salvage.Methods
The Reactions to Impairment and Disability Inventory was used to assess psychosocial adaptation. Physical function outcomes (pain, range of motion, edema, sensation, and dexterity) are presented. The Disabilities of the Arm, Shoulder, and Hand measure was used to assess perceived disability. Medical and rehabilitation history are discussed for each case, in order to provide in-depth understanding of the impact of these injuries.Results
Reactions to injury varied across the cases; however, outcomes suggest that psychosocial adaptation may be influenced by the experience of pain, the ability to participate in valued roles and activities, and having a supportive social network.Discussion
For this population, therapists may consider emphasizing pain management, focusing on client-centered goals and interventions, and facilitating peer support. Providers should closely monitor patients for signs of poor adaptation, such as hand-hiding behaviors.Conclusions
This study is among the first to examine psychological outcomes for the UE limb salvage population. Future research would be beneficial to provide deeper understanding of the psychosocial challenges for these individuals. 相似文献83.
Nina MC Mathijssen Pieter LC Petit Peter Pilot B Wim Schreurs Pieter Buma Rolf M Bloem 《BMC musculoskeletal disorders》2010,11(1):96
Background
Allograft bone used in joint replacement surgery can additionally serve as a carrier for antibiotics and serve as a prophylaxis against infections. However, in vitro dose-response curves for bone chips impregnated with different kinds of antibiotics are not available. In addition, while it would be desirable to add the antibiotics to allograft bone chips before these are stored in a bone bank, the effects of different storage temperatures on antibiotics are unknown. 相似文献84.
Fungal wound infection (not colonization) is independently associated with mortality in burn patients 总被引:1,自引:0,他引:1 下载免费PDF全文
Horvath EE Murray CK Vaughan GM Chung KK Hospenthal DR Wade CE Holcomb JB Wolf SE Mason AD Cancio LC 《Annals of surgery》2007,245(6):978-985
OBJECTIVE: To analyze the occurrence of fungal wound infection (FWI) after thermal injury and its relationship to mortality. BACKGROUND: FWI is an uncommon but potentially lethal complication of severe thermal injury. METHODS: The records of patients with thermal burns admitted to a single burn center (1991-2002) were reviewed. Analyses accounted for total burn size (TBS, percentage body surface area), full-thickness burn size (FTBS, percentage body surface area), age, inhalation injury, sex, and fungal-status category. Fungal colonization and infection were determined histopathologically. RESULTS: Criteria for inclusion were met by 2651 patients. Each patient's fungal-status category was defined according to the deepest level of fungal involvement observed during the hospital course: no fungus (2476 patients), fungal wound colonization (FWC, 121 patients), or fungal wound infection (FWI, 54 patients). Median TBS (9%, 47%, 64%, respectively) and mortality (5%, 27%, 76%, respectively) varied significantly among fungal-status groups. Logistic regression was used to detect significant independent associations. FWI was associated with higher TBS. Mortality was associated with TBS, FTBS, inhalation injury, FWI, and age. Unlike FWI, FWC was not independently related to mortality, the greater observed mortality in FWC being explained by other variables such as TBS. The odds ratio for FWI (8.16) suggested about the same mortality impact as augmenting TBS by 33%. A midrange TBS of 30% to 60% was required for most of the detectable association of FWI with mortality. CONCLUSIONS: FWI accompanies larger burns and is associated with mortality in burn patients, particularly in those with TBS 30% to 60%. This association is independent of burn size, inhalation injury, and age. 相似文献
85.
R Morley BA Baker LC Greene MBE Livingstone PSEG Harland A Lucas 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(12):1230-1234
Serum lipid and lipoprotein cholesterol levels track from childhood and are associated with risk of coronary heart disease. There is some evidence that these are influenced by dietary intake and exercise. Serum lipid and lipoprotein cholesterols were measured in a cohort of 119 British children aged 12–15 y who completed a dietary assessment and exercise questionnaire. The ratio of total- to high-density lipoprotein cholesterol fell with increasing fibre intake, but after adjustment for age, body mass index, sex and other dietary factors, this was not statistically significant. Children exercising at least once a day had significantly lower serum total cholesterol and low density lipoprotein cholesterol levels than those exercising less frequently, even after adjustment for the above factors and dietary fibre intake. No dietary factor was significantly associated with any lipid measure after adjustment for the above factors. The challenge is how to optimize exercise level in adolescent children. 相似文献
86.
Colchicine for recurrent pericarditis in children 总被引:4,自引:0,他引:4
The incidence of recurrence of acute pericarditis in children varies from 15% to 30% and is accompanied by a high morbidity. Various treatment modalities have been used with variable success rates and side effects. La Serna et al. (Lancet 1987; 26: 1517) were the first to treat adults with recurrent pericarditis with colchicine, and were followed by other authors. To our knowledge no studies in children have been reported. In this paper, we present three children who suffered from viral or idiopathic recurrent pericarditis, despite multiple courses of non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids. They responded remarkably well to colchicine, which was administered for 6 months with no adverse reactions. They continue to do well 18, 11 and 12 months after cessation of treatment, respectively. 相似文献
87.
Induced drug resistance inhibits selection of initiated cells and cancer development 总被引:1,自引:1,他引:0
Compounds exerting a mitoinhibitory effect on normal hepatocytes are potent
promoters in the resistant hepatocyte model of chemical carcinogenesis in
combination with stimulation of regenerative growth by partial hepatectomy
or treatment with carbon tetrachloride. 2- Acetylaminofluorene (2-AAF)
almost completely inhibits liver cell regeneration after partial
hepatectomy, allowing only resistant cells to participate in regenerative
growth. After initiation by diethylnitrosamine and promotion with 2-AAF and
partial hepatectomy (PH), focal growth of initiated cells generates liver
lesions which occupy 40% of the hepatic volume three weeks after PH. In
this work the mechanism for the anti promoting effects of phenobarbital and
3- methylcholantrene were investigated as well as their effects on the
development of malignant hepatocellular carcinoma in the resistant
hepatocyte model. Treatment with phenobarbital or, especially, 3-
methylcholanthrene rendered normal rat hepatocytes resistant to the
mitoinhibitory effect of 2-AAF. In combination with 2-AAF/PH, 3-
methylcholanthrene shortened the regenerative growth period to less than
one week. In the Solt-Farber protocol for experimental
hepatocarcinogenesis, treatment with phenobarbital or 3- methylcholanthrene
during promotion with 2-AAF/PH permitted hepatocytes surrounding the focal
lesions to respond with regenerative growth. The foci and surrounding liver
grew until the liver/body mass index reached the control value. With
phenobarbital treatment the total focal volume was 20% of the liver volume
three weeks after PH, whereas the corresponding value in the case of
3-methylcholanthrene was only 1%. Labelling index data supported the
conclusion that growth of the liver lesions in the resistant hepatocyte
model was dependent on differential inhibition of normal hepatocyte growth
by the promoter and that the size of the foci obtained was related to the
length of time after PH required to complete liver regeneration.
3-methylcholanthrene induced 2- AAF resistance prevented the development of
large persistent nodules and hepatocellular carcinoma while phenobarbital
delayed cancer development with several month. The data thus supports the
idea that the degree of clonal expansion during promotion determines the
size of the population at risk for malignant transformation, as well as the
final frequency of carcinomas.
相似文献
88.
89.
0 引言 东方人接受皮肤磨削术治疗后色素沉着的发生率明显高于西方人.尽管采用了目前被认为是最适宜亚洲人的铒激光治疗,色素沉着仍可发生.因此,在实施该手术治疗前应严格掌握适应证,制定严密的预防治疗措施,使得色素沉着的发生率降至最低,从而最大限度的防止医疗纠纷的发生.1 对象和方法1.1 对象 21例患者,男2例,女19例,平均年龄29.2(08~48)岁.皱纹祛除8例,浅表疤痕7例,浅咖啡斑、黑子5例,不良纹眉1例.铒激光其它适应证:①老年斑;②细小皱纹;③“白皮肤”雀斑;④痤疮后疤痕⑤色素减退… 相似文献
90.