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1.
Cir. Esp. (Ed. impr.) ; 83(6): 320-324, jun. 2008. tab
Artigo em Es | IBECS | ID: ibc-66223

RESUMO

Objetivos. Definir el perfil epidemiológico y lesional de los pacientes graves atendidos por accidente de quad en la UCI de traumatología de un hospital terciario de referencia. Métodos. Estudio observacional descriptivo que incluye a todos los pacientes ingresados por accidente de quad en los últimos 3 años, recogidos prospectivamente en la base de datos de nuestra UCI de traumatología. Se registraron variables relativas a datos demográficos, situación al ingreso, evolución, lesiones por regiones corporales, índices de gravedad y probabilidad de supervivencia por TRISS. Resultados. Entre 2004 y 2006 se recibió a 12 pacientes accidentados por quad, todos varones, con una mediana de edad de 28,5 (18-37,75) años. La mediana del ISS fue de 25 (17-27) puntos. En cuanto a las lesiones, el 75% de los pacientes presentaron lesiones craneales y encefálicas (región AIS 1); el 41,6%, faciales (AIS 2); el 33%, en las extremidades superiores (AIS 7); el 25%, torácicas (AIS 4); el 16,7%, raquimedulares (AIS 6) y en extremidades inferiores (AIS 8), y ninguno cervicales y abdominales (AIS 3 y 5). La mortalidad en UCI y a los 28 días alcanzó el 16,7%, y la mortalidad hospitalaria fue del 25%. La mediana de la estancia en UCI fue 8 (1,75-17) días y la estancia hospitalaria fue de 21,5 (8,25-27) días. La estancia en UCI fue menor en los pacientes sin traumatismo craneoencefálico (TCE) que en los pacientes con TCE (1 [1-1,5] frente a 12 [5-23]; p < 0,05). Conclusiones. El uso de quad es una fuente de accidentes con alta morbimortalidad y está en aumento. Se describen los patrones lesionales relaciona-dos con estos accidentes. El TCE es frecuente y empeora el pronóstico. Se necesitan nuevos estudios epidemiológicos y clínicos para definir mejor el problema The increased use of biomaterials for the repair of abdominal wall hernias has achieved a significant reduction in recurrences and consequently improved the quality of life of patients. However, the appearance of complications such as infection may require the implanted prosthetic material to be removed in a considerable number of patients. A possible treatment option in areas compromised by infection is the implant a biocompatible prosthetic material to generate, or induce the formation of a support tissue so that, in a second stage, the definitive repair of the parietal defect may be undertaken. This is the main goal of bioprostheses. These implants are composed of collagen of animal (usually porcine) or human origin. They should be acellular and fully biocompatible so that they induce a minimal foreign body reaction and immune response (AU)


Objective. To define the epidemiological and injury profile of patients severely injured due to all-terrain vehicle accidents admitted to the Trauma ICU of a tertiary hospital. Methods. Descriptive observational study including all patients admitted to our ICU who suffered an all-terrain vehicle accident in the last three years, included prospectively in our data base. We recorded demographic variables, clinical condition at admission, outcome, injury pattern, severity scores and survival probability by TRISS. Results. Between 2004 and 2006 twelve patients who suffered an all-terrain vehicle accident were admitted. All of them were male and had a median age of 28.5 years (18-37.75). The median ISS was 25 points (17-27). Cranium and brain (AIS region 1) were present in 75% of the patients, face (AIS 2) in 41.6%, upper limbs (AIS 7) in 33%, thorax (AIS 4) in 25%, spine (AIS 6) and lower limbs (AIS 8) in 16.7% and there were no injures in AIS region 3 (neck) and 5 (abdomen-pelvis). Mortality at ICU and at day 28 was 16.7% and hospital mortality was 25%. Median ICU stay was 8 days (1.75-17) and median hospital stay was 21.5 days (8.25-27). ICU stay was shorter in patients without traumatic brain injury (1 [1-1.5] vs 12 [5-23]; p < 0.05). Conclusions. All-terrain vehicle use is a growing source of high morbidity and mortality accidents. Injury patterns associated to these accidents are described. Traumatic brain injuries are common and have a poorer prognosis. New epidemiological and clinical studies are needed for a better knowledge of the problem The increased use of biomaterials for the repair of abdominal wall hernias has achieved a significant reduction in recurrences and consequently improved the quality of life of patients. However, the appearance of complications such as infection may require the implanted prosthetic material to be removed in a considerable number of patients. A possible treatment option in areas compromised by infection is the implant a biocompatible prosthetic material to generate, or induce the formation of a support tissue so that, in a second stage, the definitive repair of the parietal defect may be undertaken. This is the main goal of bioprostheses. These implants are composed of collagen of animal (usually porcine) or human origin. They should be acellular and fully biocompatible so that they induce a minimal foreign body reaction and immune response (AU)


Assuntos
Humanos , Masculino , Adulto , Idoso , Veículos Off-Road , Ferimentos e Lesões/epidemiologia , Perfil de Saúde , Escala de Gravidade do Ferimento , Sobrevivência , Escala de Coma de Glasgow , Hospitais Universitários , Espanha
2.
Emergencias (St. Vicenç dels Horts) ; 19(4): 229-231, jul.-ago. 2007. ilus
Artigo em Es | IBECS | ID: ibc-055188

RESUMO

El neumopericardio se define por la presencia de aire en la cavidad pericárdica. Puede provocar taponamiento cardíaco. Presentamos el caso de un varón de 21 años, que tras sufrir un accidente de moto, ingresa consciente, inquieto, con trabajo respiratorio marcado, taquipneico y saturación periférica de oxígeno del 88%. Presenta un gran enfisema subcutáneo torácico, especialmente en hemitórax derecho que se extiende al flanco abdominal. La auscultación respiratoria muestra una disminución marcada del murmullo vesicular en hemitórax derecho. Se procede a la intubación orotraqueal inmediata y canalización de una vía central y administración de cristaloides. Se realiza ecografía abdominal y toracocentesis. Se realiza una radiografía de tórax portátil que muestran hemotórax y contusión pulmonar multilobular, así como una imagen de Neumopericardio. El paciente fallece a los 15 minutos del ingreso. La necropsia demostró la presencia de rotura de aorta torácica, y se mantuvo una duda razonable respecto a la causa inmediata de la muerte, taponamiento cardíaco secundario al neumopericardio o shock hipovolémico hemorrágico (AU)


Pneumopericardium is defined as the presence of air within the pericardial sac; it may be the cause of cardiac tamponnade. We here report the case of a 21-year-old male who, after suffering a motorcycle accident, was admitted to hospital conscious but anxious, with marked dyspnoea and tachypnoea and with a peripheral oxygen saturation level of 88%. The clinical examination disclosed marked thoracic subcutaneous emphysema mainly on the right haemithorax and extending to the side of the abdomen. On auscultation there was a marked diminution of the vesicular murmur in the right haemithorax. Orotracheal intubation was performed immediately and a central venous access catheter was inserted with crystalloid administration. An abdominal ultrasound scan and thoracocentesis were performed. The plain chest film (portable apparatus) disclosed haemothorax and multilobar lung contusion and an image highly suggestive of pneumopericardium. The patient died 15 minutes after admission. The Forensic Pathology examination (the report was received later) demonstrated rupture of the thoracic aorta and posed reasonable doubts as to the immediate cause of death: cardiac tamponnade secondary to the pneumopericardium or haemorrhagic hypovolaemic shock (AU)


Assuntos
Masculino , Adulto , Humanos , Pneumopericárdio/etiologia , Ruptura Aórtica/etiologia , Acidentes de Trânsito , Tamponamento Cardíaco/etiologia , Choque/etiologia , Veículos Off-Road , Evolução Fatal
3.
Sanid. mil ; 63(2): 146-149, abr.-jun. 2007. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-86981

RESUMO

El vehículo transporte oruga de montaña, TOM, ha sido puesto a prueba como vehículo de transporte sanitario. Esta adaptación de vehículo de transporte de personal a vehículo de transporte sanitario viene precedida por los diferentes problemas encontrados por el Servicio de Sanidad destacado en Qala-eh-Naw, Afganistán, durante el planeamiento de posibles evacuaciones1, a lo largo de diciembre y enero de 2005 y 2006 respectivamente. Aún sin alterar la estructura original del vehículo fueron necesarios algunos cambios esenciales para su utilización sanitaria, siempre con objeto de asegurar las evacuaciones durante la época invernal (AU)


The mountain tracked vehicle (TOM) has been tested as a MEDEVAC vehicle. This adaptation from a personnel transportation mean to a MEDEVAC vehicle has been preceded by the different problems met by the medical support deployed in Qalaeh- Naw (Afghanistan) during the planning of possible evacuations, in December 2005 and January 2006. Even without altering the original structure of the vehicle some changes were necessary to make it suitable for medical utilization, keeping always in mind the need to ensure the evacuations during wintertime (AU)


Assuntos
Humanos , Transporte de Pacientes/métodos , Veículos Off-Road/normas , Ferido de Guerra , Evacuação Estratégica
4.
Acta pediatr. esp ; 64(8): 383-385, sept. 2006. tab
Artigo em Es | IBECS | ID: ibc-049990

RESUMO

Objetivo: Conocer la magnitud del problema de los accidentes causados por vehículos todo terreno tipo quad. Diseño: Estudio observaciona con alerta programada en el buscador Google Noticias entre el 27 de diciembre de 2005 y el 19 de abril de 2006. Emplazamiento: Servicio de Pediatría del Hospital General de Elda. Participantes: No procede. Principales variables evaluadas: Número de lesionados. Resultados: Se observaron 21 accidentes con 29 lesionados, un 20,68% de ellos menores de edad. Conclusiones: Las lesiones causadas por los accidentes de quad son frecuentes y graves. Deben emprenderse acciones legales e informativas para lograr su disminución, especialmente en lo que se refiere a los menores de edad


Objective: To determine the magnitude of the problem associated with accidents caused by quad-like off-road vehicles. Design: An observational study based on alerts received from the Google News search engine between December 27 2005 and April 19 2006. Setting: The Pediatric Service of Hospital General de Elda in Alicante, Spain. Participants: Not applicable. Main outcome measures: Number of individuals injured, age, and sites and types of lesions. Results: There were 21 accidents with 29 injured, 20.68% of whom were minors. Conclusions: Quad accidents frequently result in injuries, which can be of consideration. Legal and informative measure should be undertaken to reduce their incidencee, specially in minor


Assuntos
Humanos , Acidentes de Trânsito/estatística & dados numéricos , Veículos Off-Road/estatística & dados numéricos , Traumatismo Múltiplo/epidemiologia
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