Computer-based cognitive retraining: a controlled study

Microcomputers have gained popularity as treatment tools after severe head injury but there have been no controlled studies to show it the programmes used can modify behaviour or cognitive improvement. This paper describes a controlled study of such a training programme using three groups of subjects of ten each, one head-injured group using the computer, one head-injured group not using the computer, and a non-head-injured group. The study lasted 4 weeks. The only differences found were in the behavioural aspects of attention. Psychomotor and vigilance were not improved. The reasons for this are discussed.     

Prognostic factors in traumatic atlanto-occipital dislocation

Traumatic atlanto-occipital dislocation (AOD) is an ominous injury with high mortality and morbidity in trauma patients. Improved survival has been observed with advancements in pre-hospital and hospital care. Furthermore, high quality imaging studies are accessible at most trauma centers; these are crucial for prompt diagnosis of AOD. The objective of this study is to perform a comprehensive literature review of traumatic AOD, with specific emphasis on identifying prognostic factors for survival. A review of the literature was performed using the Medline database for all traumatic atlanto-occipital articles published between March 1959 and June 2015; 141 patients from 60 total studies met eligibility criteria for study inclusion. A binary logistic regression model was utilized to identify prognostic factors. The analysis assessed age, sex, spinal cord injury (SCI), traumatic brain injury (TBI), polytrauma injury (PI), and Traynelis AOD Classification. Only TBI was statistically significantly associated with death (OR 8.05 p < 0.05); SCI did not reach statistical significance for predicting mortality in AOD patients (OR 1.25 p > 0.05). Age, sex, PI, and Traynelis AOD Classification did not meet significance to predict mortality in AOD patients. We found that patients with TBI are eight times more likely to die than patients without TBI. A high degree of suspicion for AOD during pre-hospital care, as well as, prompt diagnosis and management in the trauma center play a key role in the treatment of this devastating injury. The relationship between survival and factors such as TBI and SCI should be further explored.     

Rückenprotektoren im Wintersport

The general incidence of skiing and snowboarding injuries is decreasing in the last years. But there is some evidence that rare severe injuries like traumatic brain injury and spinal cord injury are increasing. Higher speed, extreme acrobatic forms of sport practice and increased risk taking behavior are discussed as possible reasons. Information about the risk and the sequelae of spine injuries should be placed in the first place. The spine protectors available on the market deliver only protection in specific situations.     

严重胸腹联合伤急救与护理

目的探讨胸腹联合伤的急救与护理措施及效果,总结护理经验。方法采用非同期队列比较法,收集我科2000年1月至2010年1月接诊抢救的胸腹联合损伤患者50例,其中2005年1月之前的20例患者为对照组,按原有急救护理程序进行救治;2005年以后的30例患者作观察组,采用科学综合的护理干预方式进行护理,比较二者的病死率及护理效果。结果观察组护理效果明显好于对照组,差异有统计学意义(P<0.05)。结论胸腹联合损伤患者的急救及护理有其特殊性,及时有效的救护措施是降低死亡率和并发症的关键。