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101.
Ruth Dailey Grainger Clifford Levin Lois Allen-Byrd Ronald M. Doctor Howard Lee 《Journal of traumatic stress》1997,10(4):665-671
Controlled studies of treatments effective with victims of natural disasters are almost nonexistent. This is a small study conducted under difficult conditions to test the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) in treating trauma related reactions following Hurricane Andrew. The results were positive in that EMDR produced significant improvement over wail list controls in perceived posttraumatic avoidance behaviors and thoughts as measured by changes in the Impact of Event Scale and significant improvement in subjective aversive reactions to representative experiences of the hurricane. These results suggest and support other studies that EMDR can be an effective therapeutic intervention for trauma reactions. 相似文献
102.
目的 研究巢湖水有机提取物致突变性。方法 单细胞凝胶电泳技术测定鱼红细胞DNA损伤效应。结果 巢湖源水引起慧星细胞的百分率最高 (5 7.2 5 % ) ,滤前水最低 (2 7.6 3% ) ,出厂水经过二次加氯后慧星细胞的百分率有所上升 (4 4 .0 0 % )。结论 巢湖源水具有潜在致突变性 ,经混凝、活性炭吸附及沉淀处理后其DNA损伤作用有所下降 ,但氯化消毒可增加水中有机提取物的DNA损伤作用。 相似文献
103.
James P. Bartek MD Anthony Grasch PA-C Stephen R. Hazelrigg MD 《The Annals of thoracic surgery》1997,63(6):1783-1785
Video-assisted thoracic surgery or thoracoscopy has proved to be valuable in many settings in thoracic surgery. The use of video-assisted thoracic surgery in trauma has been limited, especially with respect to penetrating trauma. We report the use of thoracoscopy to remove intrathoracic fragments of glass and avert the need for a thoracotomy. 相似文献
104.
The experience of Advanced Trauma Life Support training received by three anaesthetists is discussed with particular reference to the teaching of airway management, the grade of staff who should attend the present courses and the relevance to the British hospital system. We conclude that these courses are useful but limited by their inflexibility and failure to recognise the difference in skill mix in the British setting. 相似文献
105.
U. Lehmann G. Regel B. Ellendorf E. Rickels M. Lorenz H. Becker H. Tscherne 《Der Unfallchirurg》1997,100(9):705-710
Summary
A total of 208 multiple trauma patients with head injury (HI) were investigated who had been treated in the period from 1990
to 1995. The average age was 35.2 ± 17.7 years; the injury severity according to ISS was 30.2 ± 8.6 points; 20.5 % died as
a result of the HI; the mortality of all patients was 26.5 %. The Glasgow Coma Scale (GCS) was determined at an average of
22 min after trauma (8.0 ± 4.3 points) at the scene of accident. The patients were classified according to GCS into minor
HI (group 1: 14–15 points), moderate HI (group 2: 9–13 points) and severe HI (group 3: 3–8 points). Patient outcome was assessed
by the Glasgow Outcome Scale (GOS) and was classified as good (GOS 4 and 5) and poor (GOS 1, 2 and 3) outcome. At the latest,
2 h after trauma, a CT scan of the head (CCT) was done. The HI groups are compared regarding frequency of types of injury.
In all HI groups the fractures of the bony face occurred at the same frequency (36.0–38.9 %). The frequency of calotte fractures
(Kal-Fx) increased from group 1 (8.0 %) to 2 (19.2 %) and 3 (25.6 %); fractures of the skull base significantly differed between
group 1 (16.0 %), 2 (7.8 %) and 3 (33.4 %). Epidural hemorrhage (EDB) appeared only in group 2 (7.8 %) and 3 (6.7); subdural
hemorrhage was found in group 1 (2.7 %), 2 (7.8 %) and 3 (10.0 %). Subarachnoid hemorrhage (SAB) was significantly more frequently
seen, dependent on HI severity, in group 3 (26.7 %) compared to group 2 (11.7 %) and 1 (8.0 %). Intracerebral contusion (ICK)
significantly increased from group 1 (12.0 %) to 2 (27.3) and 3 (45.6 %). Brain swelling (BS) also significantly increased
from group 1 (8.0 %) to 2 (19.5 %) and 3 (49.0 %) and lesions of ventricles (VL) from group 1 (2.7 %) to 2 (11.7 %) and 3
(20.0 %). Midline shift (13.4 %) and signs of herniation (4.5 %) only occurred in group 3. The analysis of correlation/regression
and receiver operating characteristics was able to predict 79 % of patients' outcome accurately using GCS (r 0.54; P < 0.0001) alone, using CCT (r 0.65; P < 0.0001) 87 % were correctly predicted with significant variables Cal-Fx, EDB, SAB and BS. CCT with GCS (r 0.74; P < 0.0001) were able to predict 88 % accurately with significant variables Cal-Fx, EDB, BS and GCS. The combination of CCT
with GCS, age and ISS (r 0.78; P < 0.0001) was able to predict only 87 % correctly, although the r value was the highest; significant variables were Kal-Fx, EDB, BS, VL, GCS, age and ISS.
相似文献
106.
W. N. HABRE E. F. VAN GESSEL CH. MAMIE R. CANTIENI P. M. SUTER 《Acta anaesthesiologica Scandinavica》1994,38(6):612-614
Severe aortic regurgitation was discovered in a young man 21 days after blunt chest trauma and after a prolonged febrile state with positive blood cultures. Using transoesophageal echocardiography (TEE), it was possible to make the differential diagnosis between traumatic rupture and endocarditis as the cause of valvular insufficiency. The use of TEE in the initial evaluation of severe thoracic trauma with an unclear clinical picture is recommended. This method is easy to use at the bedside and gives precise information on the aortic valve and the ascending aorta. 相似文献
107.
Lutz Claes Nikola Maurer-Klein Thomas Henke Heinz Gerngross Mark Melnyk Peter Augat 《Journal of orthopaedic research》2006,24(6):1178-1185
The aim of this study was to investigate the effect of a moderate soft tissue trauma to the course of fracture healing in a standardized animal model. Thirty-eight Wistar rats were randomly divided into a fracture group (F, n = 19) and a group with a fracture and a soft tissue trauma (F + STT, n = 19). The fracture and the soft tissue trauma were created using an impact device with a standardized energy. All fractures were stabilized by two Kirschner wires. Three rats were measured for blood flow and sacrificed at days 1, 3, 7, and 14, and seven rats at day 28, from both groups. A three-point bending test was performed on the healed tibia after 28 days. During the first 24 h there was a reduction in blood flow, which was more pronounced in the F + STT group than in the F group. From histological sections, the shape of the callus formation, as well as the tissue distribution of newly formed bone, fibrous cartilage and fibrous connective tissue were determined. Distinctly more periosteal new bone formed and a larger callus formed at days 3 and 7 in group F compared to group F + STT. However, by days 14 and 28, the ossification and overall callus size no longer showed differences between the two groups. A fast recovery of blood flow and callus formation took place in the F + STT group, which led to similar histological and biomechanical results in fracture healing observed after 28 days between the two groups. 相似文献
108.
The impact of trauma is a major public health challenge which is likely to escalate in the early 21st century. A systematic approach to this problem is required. This review explains the conceptual framework that defines a trauma system, gives a brief historical perspective and describes some of the essential elements of the system which should make a difference to patient outcome. Emergency physicians are well placed to play a leading role in the development and implementation of trauma systems. 相似文献
109.
目的 探讨影响胸部钝伤住院患者治疗方式的因素,对胸部X线片判读的差异进行分析,作为改进处置胸部钝伤患者的依据及参考。方法 采用回顾性研究方法,收集2004—2006年因胸部钝伤或其外伤合并胸部钝伤,经急诊评估损伤严重指数(ISS)≤15,且对胸部钝伤暂采保守疗法的住院患者共96例(男76例,女20例)。对患者年龄、既往史、ISS、胸部X线片判渎等对治疗方式的影响与关系分为因病情需要改采用手术治疗组和继续采用保守治疗组来比较分析。结果两组在平均年龄、性别、ISS的统计上无差别。影响患者住院期间采用手术治疗的因素有年龄〉65岁(OR,3.14;95%CI,1.21~8.12;P〈0.05);过去有心肺疾病病史(OR,2.85,95%CI,1.24~6.52,P〈0.05);第一次的胸部X线片判读有血胸(OR,3.97;95%CI,1.43~10.98;P=0.015)。结论 年龄〉65岁,有心肺病史、第一次的胸部X线片判读有血胸是胸部钝伤患者在住院后改采用手术治疗的危险因子。有必要住院后追踪胸部X线片。 相似文献
110.
An evaluation of the residual activity of quick-drying agents (alcoholic solutions) used for hygienic hand disinfection is described. We looked for residual efficacy following hand disinfection with soap and water alone or followed by one of two alcoholic handrub lotions supplied from an automatic hand washing machine. The bacterial counts on the hands obtained before and within 2 successive hours after disinfection showed that alcoholic chlorhexidine was the most effective for 10 minutes after contamination of the hands. WELPAS® (alcoholic chlorbenzarconium) followed this in its immediate effect and was better than soap and water alone. There were no significant differences after 30‘ or 120‘ between the three disinfecting methods. 相似文献