RESUMO
Fat embolism syndrome is a clinical diagnosis, and diagnostic procedures are not specific. In every trauma patient, Fat embolism syndrome has to be considered as a possibility and supportive treatment should begin as soon as possible. The authors reported a rare case of Fat embolism syndrome whose only neurological symptom was motor aphasia. A young man sustained comminuted femoral shaft fracture following an accident presented dyspnea, motor aphasia and petechial rash. The Po2 and O2 Saturation were 53 and 91.1%. The body temperature was 38.5 °C. The hemoglobin decreased from 12.9 to 8.7 and platelet from 121000 to 84000 mg/dl. The pulse rate was 120 bpm. The CT scan and MRI were normal. Fat embolism syndrome was diagnosed according to both Gurd and Schonfeld criteria ruling out other possible causes. Patient recovered completely. Although rare, focal neurological symptoms and motor aphasia should be kept in mind as a part of diagnostic criteria.
RESUMO
BACKGROUND: Hip fracture Management in supine position on a fracture table with biplane fluoroscopic views has some difficulties which leads to prolongation of surgery and increasing x- rays' dosage. The purpose of this study was to report the results and complications of hip fracture management in lateral position on a conventional operating table with just anteroposterior fluoroscopic view. METHODS: 40 hip fractures (31 trochanteric and 9 femoral neck fractures) were operated in lateral position between Feb 2006 and Oct 2012. Age, gender, fracture classification, operation time, intra-operation blood loss, reduction quality, and complications were extracted from patients' medical records. The mean follow-up time was 30.78±22.73 months (range 4-83). RESULTS: The mean operation time was 76.50 ± 16.88 min (range 50 - 120 min).The mean intra-operative blood loss was 628.75 ± 275.00 ml (range 250-1300ml). Anatomic and acceptable reduction was observed in 95%of cases. The most important complications were malunion (one case in trochanteric group), avascular necrosis of femoral head and nonunion (each one case in femoral neck group). CONCLUSIONS: It sounds that reduction and fixation of hip fractures in lateral position with fluoroscopy in just anteroposterior view for small rural hospitals may be executable and probably safe.
RESUMO
Tablets of microcrystalline cellulose were formed at different compaction pressures and physical properties, such as pore size distribution, surface area, and pore surface fractality, were extracted from N2 adsorption isotherms. These properties were compared to previously published data on the water-induced ionic conductivity of the tablets. The conduction process was shown to follow a percolation model with a percolation exponent of 2 and a porosity percolation threshold of approximately 0.1. The critical pore diameter for facilitated charge transport was shown to be in the 5-20 nm range. When the network of pores with a diameter in this interval is reduced to the point where it no longer forms a continuous passageway throughout the compact, the conduction process is dominated by charge transport on the surfaces of individual microfibrils mainly situated in the bulk of fibril aggregates. A fractal analysis of nitrogen adsorption isotherms showed that the dominant interface forces during adsorption is attributed to surface tensions between the gas and the adsorbed liquid phase. The extracted fractal dimension of the analyzed pore surfaces remained unaffected by the densification process at low compaction pressures (< approximately 200 MPa). At increased densification, however, pore-surface structures smaller than approximately 100 nm become smoother as the fractal dimension decreases from approximately 2.5 at high porosities to approximately 2.3 for the densest tablets under study.