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1.
Estima (Online) ; 19(1): e0421, jan.-dez. 2021.
Artigo em Português | BDENF - Enfermagem | ID: biblio-1178058

RESUMO

Objetivos:identificar na literatura científica o conhecimento produzido sobre lesões por fricção em idosos. Métodos: trata-se de uma revisão integrativa de literatura (2014-2019), realizada a partir de busca nas bases de dados/plataformas National Library of Medicine, Biomedical Answers e Biblioteca Virtual em Saúde, com descritores e os operadores booleanos "and" e "or". Resultados: a partir da busca bibliográfica, seleção e análise, oito artigos compuseram a amostra. Para lesão por fricção em idosos emergiram quatro pilares do cuidado: manutenção da homeostase orgânica e tissular com foco na nutrição e hidratação apropriada; evitar traumas na pele senil, proporcionando um ambiente seguro com dispositivos adequados; e a sistematização da assistência e educação em saúde do cuidado com a pele do idoso. Conclusão: como mecanismos de prevenção, encontram-se a realização da prevenção primária por meio de um plano de cuidados singular e as atividades de educação em saúde, focadas nos fatores de risco e nas vulnerabilidades, minimizando danos e complicações


Assuntos
Ferimentos e Lesões , Idoso , Fricção , Enfermagem Geriátrica
2.
Artigo em Inglês | MEDLINE | ID: mdl-34071610

RESUMO

BACKGROUND: This study examined the effect of the COVID-19 pandemic and the resulting decrease in the incidence of various categories of injuries, with the main focus on fractures and mild traumatic brain injuries in a paediatric population. METHODS: This retrospective cohort study evaluated all children from 0 to 18 years of age presenting with an injury at the level 1 trauma centre of the University Clinic of Orthopaedics and Trauma Surgery in Vienna during the lockdown from 16 March to 29 May 2020 compared to records over the same timeframe from 2015 to 2019. RESULTS: In total, 14,707 patients with injuries were included. The lockdown did not lead to a significant decrease in fractures but, instead, yielded a highly significant increase in mild traumatic brain injuries when compared to all injuries that occurred (p = 0.082 and p = 0.0001) as well as acute injuries (excluding contusions, distortions and miscellaneous non-acute injuries) (p = 0.309 and p = 0.034). CONCLUSIONS: The percentage of paediatric fractures did not decrease at the level 1 trauma centre, and a highly significant proportional increase in paediatric patients with mild traumatic brain injuries was observed during the COVID-19 lockdown. Therefore, medical resources should be maintained to treat paediatric trauma patients and provide neurological monitoring during pandemic lockdowns.


Assuntos
59585 , Centros de Traumatologia , Ferimentos e Lesões , Criança , Controle de Doenças Transmissíveis , Europa (Continente) , Humanos , Pandemias , Estudos Retrospectivos , 59565
3.
BMC Med Inform Decis Mak ; 21(1): 155, 2021 05 13.
Artigo em Inglês | MEDLINE | ID: mdl-33985494

RESUMO

BACKGROUND: Injuries are a major health issue worldwide and their prevention requires access to accurate statistics in this regard. This can be achieved by classifying the collected data using the international classification systems. This study aimed at investigating the content coverage rate of the International Classification of External Causes of Injury (ICECI) regarding the external causes of injury in a hospital. METHODS: This cross-sectional descriptive-analytical study was performed on 322 injured individuals visiting the emergency unit of a hospital which is the biggest truma center in the southeast of Iran. The required data were collected via a designed questionnaire by the researcher visiting the Emergency ward. The collected data were encoded based on the ICECI textbook by two encoders. Their agreement rate was calculated using the Kappa estimate of agreement. The content coverage of the classification system and the degree of completeness of the required data for encoding in the patients' records were measured. Data were analyzed by the SPSS software, ver 19. RESULTS: The findings showed that 70% of the external causes of injury were covered by ICECI. Among the 322 cases, 138 (43%) had been referred due to a car crash. The injured were mostly drivers of land transport vehicles who had been unintentionally involved in a car crash. The least mechanism for injury was bite injury with 5 (2%). ICECI was capable of classifying 92% of the data related to the external causes of the injuries. The most un-covered data has belonged to the "activity when injured" axis (n = 18). Lack of precise data recording in the medical records resulted in missing data about at least one of the axis of the external causes in most records. CONCLUSION: The findings of the present study showed that ICECI has good content coverage for encoding the external causes of injuries. Before implementing ICECI for encoding the external causes of injuries, it is required to train clinicians regarding how to document all aspects of an injury incidence.


Assuntos
Serviço Hospitalar de Emergência , Ferimentos e Lesões , Causalidade , Estudos Transversais , Humanos , Irã (Geográfico) , Registros Médicos , Ferimentos e Lesões/epidemiologia
5.
ACS Biomater Sci Eng ; 7(5): 1827-1835, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33966376

RESUMO

The progressively increasing degree of multiple antibiotic resistance in Gram-negative bacteria challenges the treatment of severe bacterial infection-induced chronic skin wounds. To address this problem, we developed a straightforward strategy to prepare a composite film consisting of antibacterial nanoparticles (4,6-diamino-2-pyrimidinethiol-functionalized gold nanoparticles, DAPT-Au NPs) and a silk fibroin (SF) mixed-matrix membrane (DAPT-Au-SF MMM) as a wound dressing for treating multidrug-resistant (MDR) E. coli- induced infection. The good hydrophilicity of SF allows the highly effective release of DAPT-Au NPs from the composite film to combat pathogens within minutes. The antibacterial activity of the composite film is maintained regardless of antimicrobial susceptibility. DAPT-Au-SF MMMs also promote healing in rat wounds infected by clinically isolated MDR E. coli. Our findings provide a new strategy to extend the use of gold nanomaterials and SF-based wound dressings, especially against drug-resistant bacterial infections.


Assuntos
Antibacterianos/uso terapêutico , Infecções por Escherichia coli/tratamento farmacológico , Fibroínas , Nanopartículas Metálicas , Ferimentos e Lesões/tratamento farmacológico , Ferimentos e Lesões/microbiologia , Animais , Escherichia coli , Ouro , Ratos
6.
Isr Med Assoc J ; 23(5): 286-290, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34024044

RESUMO

BACKGROUND: Consent rates for organ donation remain one of the most important factors determining the number of organs available for transplantation. Trauma casualties constitute a substantial part of the deceased organ donor pool and have unique characteristics that distinguish them from the general donor population. However, this group has not been extensively studied. OBJECTIVES: To identify donor factors associated with positive familial consent for solid organ donation among trauma casualties. METHODS: This retrospective study included all trauma casualties who were admitted to the Rabin Medical Center, Beilinson hospital, during the period from January 2008 to December 2017, who were potential organ donors. Data collected included demographic features, the nature of the injury, surgical interventions, and which organs were donated. Data was collected from the Rabin Medical Center Trauma Registry. RESULTS: During the study period 24,504 trauma patients were admitted and 556 died over their hospital course. Of these 76 were potential donors, of whom 32 became actual donors and donated their organs. Two factors showed a statistically significant correlation to donation, namely female gender (P = 0.018) and Jewish religion of the deceased (P = 0.032). CONCLUSIONS: Only a small group of in hospital trauma deaths were potential solid organ donors (13.7%) and less than half of these became actual donors. Consent rates were higher when the deceased was female or Jewish.


Assuntos
Consentimento Livre e Esclarecido/estatística & dados numéricos , Transplante de Órgãos/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Família , Feminino , Hospitais , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Religião e Medicina , Estudos Retrospectivos , Fatores Sexuais , Doadores de Tecidos/provisão & distribução , Ferimentos e Lesões/epidemiologia , Adulto Jovem
7.
BMC Public Health ; 21(1): 858, 2021 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-33941136

RESUMO

BACKGROUND: In India, the construction sector provides the main alternative to agricultural work - seasonal migration to and from construction work is widespread and construction work remains the second-largest employer of women in the country behind agriculture. Occupational injuries, which kill over 300,000 people annually, are a serious public health concern. However, data on construction site injuries to women are lacking, as India does not publish statistics on occupational injuries and illnesses. Our objectives were to: Estimate the number of women injured in construction site accidents in Delhi; and to estimate and compare the annual construction site injury rates per 100,000 workers of males and females in Delhi. METHODS: We conducted a two-sample capture-recapture study using data for accidents reported to the Delhi Police, Employee State Insurance Corporation (ESIC), and Commissioners of Workmen Compensation (CWC) of Delhi Government. The capture-recapture method has been used in epidemiology, to estimate morbidity and mortality using multiple, overlapping, but incomplete data sources. This study is based on the injuries reported from construction site accidents in Delhi in 2017. We linked the data from each of the data sources using the name, gender, and age of each injured person, the date and place of the accident, and the name of the employer. We used the Chapman estimator to estimate the total incidence of construction injuries in Delhi. RESULTS: We estimated that there was a total of 37 female construction site workers injured (17 fatal and 20 non-fatal) in Delhi in 2017. There was a total of 1043 male construction site workers injured (236 fatal and 807 non-fatal). FIRs ascertained two-thirds (68%) of all injuries to females but only one third (34%) of those to males. The annual construction site injury rate per 100,000 workers of females was 82.26 (95%CI: 57.92 to 113.39). The annual construction site injury rate per 100,000 workers of males was 146.5 (95%CI: 137.7 to 155.6). There was strong evidence (p = 0.001) that the overall construction site injury rate per 100,000 workers of females was about one half the rate of males [rate ratio 0.56 (95%CI: 0.40 to 0.78)]. There was no evidence (p = 0.601) that the rates of fatal injuries differed in males and females (rate ratio 1.14 (95%CI: 0.70 to 1.87). CONCLUSIONS: This study is the first to estimate the incidence of injuries to female construction site workers in India. The overall injury rate of female construction workers was over half as great as the rate of males. This implies that female construction workers face a not insignificant risk. Hence, safety measures (e.g., personal protective equipment) that are appropriate and culturally acceptable to Indian women are needed.


Assuntos
Traumatismos Ocupacionais , Ferimentos e Lesões , Acidentes , Acidentes de Trabalho , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Traumatismos Ocupacionais/epidemiologia , Indenização aos Trabalhadores , Ferimentos e Lesões/epidemiologia
8.
Molecules ; 26(9)2021 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-33946933

RESUMO

Leaf mechanical wounding triggers a rapid release-within minutes-of a blend of volatile organic compounds. A wounding-induced VOC blend is mainly composed of oxygenated ubiquitous stress volatiles such as methanol and volatile products of lipoxygenase (LOX) pathway (mainly C5 and C6 alcohols and aldehydes and their derivatives), but also includes multiple minor VOCs that collectively act as infochemicals, inducing defences in non-damaged plant leaves and neighbouring plants and attracting herbivore enemies. At present, the interspecific variability of the rate of induction and magnitude of wounding-induced emissions and the extent to which plant structural traits and physiological activity alter these emissions are poorly known. Particularly scarce is information on the induced emissions in tropical agricultural plant species, despite their economic importance and large area of cultivation at regional and global scales. We chose five tropical crops with varying photosynthetic activity and leaf structural characteristics-Abelmoschus esculentus, Amaranthus cruentus, Amaranthus hybridus, Solanum aethiopicum, and Telfairia occidentalis-to characterize the kinetics and magnitude of wounding-induced emissions, hypothesizing that the induced emission response is greater and faster in physiologically more active species with greater photosynthetic activity than in less active species. Rapid highly repeatable leaf wounds (12 mm cuts) were generated by a within-leaf-chamber cutting knife. Wounding-induced VOC emissions were measured continuously with a proton-transfer reaction time-of-flight mass spectrometer and gas-chromatography mass spectrometry was used to separate isomers. Twenty-three ion VOCs and twelve terpenoid molecule structures were identified, whereas ubiquitous stress volatiles methanol (on average 40% of total emissions), hexenal (24%), and acetaldehyde (11%) were the main compounds across the species. Emissions of low-weight oxygenated compounds (LOC, 70% of total) and LOX products (29%) were positively correlated across species, but minor VOC components, monoterpenoids and benzenoids, were negatively correlated with LOC and LOX, indicating a reverse relationship between signal specificity and strength. There was a large interspecific variability in the rate of induction and emission magnitude, but the hypothesis of a stronger emission response in physiologically more active species was only partly supported. In addition, the overall emission levels were somewhat lower with different emission blend compared to the data reported for wild species, as well as different shares for the VOCs in the blend. The study demonstrates that wounding-dependent emissions from tropical agricultural crops can significantly contribute to atmospheric volatiles, and these emissions cannot be predicted based on current evidence of wild plant model systems.


Assuntos
Plantas/química , Plantas/metabolismo , Compostos Orgânicos Voláteis/química , Ferimentos e Lesões/metabolismo , Biodiversidade , Cromatografia Gasosa-Espectrometria de Massas , Herbivoria , Fotossíntese , Folhas de Planta/química , Folhas de Planta/metabolismo , Plantas/anatomia & histologia , Característica Quantitativa Herdável , Compostos Orgânicos Voláteis/metabolismo
9.
Ann R Coll Surg Engl ; 103(6): 390-394, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33974459

RESUMO

The COVID-19 pandemic is the most serious health crisis of our time. Global public measures have been enacted to try to prevent healthcare systems from being overwhelmed. The trauma and orthopaedic (T&O) community has overcome challenges in order to continue to deliver acute trauma care to patients and plan for challenges ahead. This review explores the lessons learnt, the priorities and the controversies that the T&O community has faced during the crisis. Historically, the experience of major incidents in T&O has focused on mass casualty events. The current pandemic requires a different approach to resource management in order to create a long-term, system-sustaining model of care alongside a move towards resource balancing and facilitation. Significant limitations in theatre access, anaesthetists and bed capacity have necessitated adaptation. Strategic changes to trauma networks and risk mitigation allowed for ongoing surgical treatment of trauma. Outpatient care was reformed with the uptake of technology. The return to elective surgery requires careful planning, restructuring of elective pathways and risk management. Despite the hope that mass vaccination will lift the pressure on bed capacity and on bleak economic forecasts, the orthopaedic community must readjust its focus to meet the challenge of huge backlogs in elective caseloads before looking to the future with a robust strategy of integrated resilient pathways. The pandemic will provide the impetus for research that defines essential interventions and facilitates the implementation of strategies to overcome current barriers and to prepare for future crises.


Assuntos
/epidemiologia , Prioridades em Saúde , Procedimentos Ortopédicos , Ferimentos e Lesões/cirurgia , Procedimentos Cirúrgicos Ambulatórios , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Prioridades em Saúde/organização & administração , Prioridades em Saúde/normas , Humanos , Procedimentos Ortopédicos/estatística & dados numéricos , Traumatologia/organização & administração , Traumatologia/normas
10.
BMJ Open ; 11(5): e042572, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33952536

RESUMO

INTRODUCTION: There is currently no defined method for assessing injury severity using population-based data, which limits our understanding of the burden of non-fatal injuries and community-based approaches for primary prevention of injuries. This study describes a systematic approach, Population-based Injury Severity Assessment (PISA) index, for assessing injury severity at the population level. METHODS: Based on the WHO International Classification of Functionality conceptual model on health and disability, eight indicators for assessing injury severity were defined. The eight indicators assessed anatomical, physiological, postinjury immobility, hospitalisation, surgical treatment, disability, duration of assisted living and days lost from work or school. Using a large population-based survey conducted in 2013 including 1.16 million individuals from seven subdistricts of rural Bangladesh, information on the eight indicators were derived for all non-fatal injury events, and these were summarised into a single injury severity index using a principal component analysis (PCA). Principal component loadings derived from the PCA were used to predict the severity (low, moderate, high) of non-fatal injuries, and were applied to the fatal injury data to assess the criterion validity of the index. The determinants of non-fatal injury severity were determined using ordered logistic regression. RESULTS: There were 119 703 non-fatal injuries and 14% were classified as high severity based on the PISA index. The PISA index accurately predicted 82% of all fatal injuries as highly severe. Non-fatal injuries of high severity were frequent with unintentional poisoning (57%) and violence (35%). Injuries of high severity were commoner among males (OR 1.16, 95% CI 1.12 to 1.21), adults 65 years and older (OR 1.30, 95% CI 1.23 to 1.36), lower socioeconomic status and intentional injuries. Education was associated with reduced odds of high severe injuries. CONCLUSION: The PISA index provides a valid and systematic approach for assessing injury severity at the population level, and is relevant for improving the characterisation of the burden and epidemiology of injuries in non-health facility-based settings. Additional testing of the PISA index is needed to further establish its validity and reliability.


Assuntos
População Rural , Ferimentos e Lesões , Adulto , Bangladesh/epidemiologia , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Violência , Ferimentos e Lesões/epidemiologia
11.
MMWR Morb Mortal Wkly Rep ; 70(18): 661-666, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33956783

RESUMO

Approximately 60,000 older adults (aged ≥65 years) die from unintentional injuries each year; in 2019 these included 34,000 fall deaths, 8,000 traffic-related motor vehicle crash deaths, and 3,000 drug poisoning deaths (1). In addition, >9,000 suicide deaths occur among older adults each year (1). Deaths among older adults account for 33% of these unintentional injury deaths and 19% of suicide deaths among all age groups (1). Nonfatal injuries from these causes are more common in this age group and can lead to long-term health consequences, such as brain injury and loss of independence. This study included 2018 data from the Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project (HCUP) to determine the prevalence of selected nonfatal injuries among older adults treated in emergency departments (EDs) and hospitals. Injury mechanisms among the leading causes of injury death in older adults were studied, including unintentional falls, unintentional traffic-related motor vehicle crashes, unintentional opioid overdoses, and self-harm (suicidal and nonsuicidal by any mechanism). In 2018, an estimated 2.4 million ED visits and >700,000 hospitalizations from these injuries occurred among adults aged ≥65 years. Unintentional falls accounted for >90% of the selected ED visits and hospitalizations. Injuries among older adults can be prevented (2). Educational campaigns, such as CDC's Still Going Strong* awareness campaign, that use positive messages can encourage older adults to take steps to prevent injuries. Health care providers can help prevent injuries by recommending that older patients participate in effective interventions, including referrals to physical therapy and deprescribing certain medications.†.


Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Ferimentos e Lesões/terapia , Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Comportamento Autodestrutivo/epidemiologia , Estados Unidos/epidemiologia , Ferimentos e Lesões/epidemiologia
12.
BJS Open ; 5(3)2021 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-34021327

RESUMO

BACKGROUND: The COVID-19 pandemic has had a major impact on healthcare in many countries. This study assessed the effect of a nationwide lockdown in France on admissions for acute surgical conditions and the subsequent impact on postoperative mortality. METHODS: This was an observational analytical study, evaluating data from a national discharge database that collected all discharge reports from any hospital in France. All adult patients admitted through the emergency department and requiring a surgical treatment between 17 March and 11 May 2020, and the equivalent period in 2019 were included. The primary outcome was the change in number of hospital admissions for acute surgical conditions. Mortality was assessed in the matched population, and stratified by region. RESULTS: During the lockdown period, 57 589 consecutive patients were admitted for acute surgical conditions, representing a decrease of 20.9 per cent compared with the 2019 cohort. Significant differences between regions were observed: the decrease was 15.6, 17.2, and 26.8 per cent for low-, intermediate- and high-prevalence regions respectively. The mortality rate was 1.92 per cent during the lockdown period and 1.81 per cent in 2019. In high-prevalence zones, mortality was significantly increased (odds ratio 1.22, 95 per cent c.i. 1.06 to 1.40). CONCLUSION: A marked decrease in hospital admissions for surgical emergencies was observed during the lockdown period, with increased mortality in regions with a higher prevalence of COVID-19 infection. Health authorities should use these findings to preserve quality of care and deliver appropriate messages to the population.


Assuntos
/prevenção & controle , Admissão do Paciente/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Doença Aguda , Adulto , Idoso , Doenças do Sistema Digestório/cirurgia , Emergências , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/tendências , Procedimentos Cirúrgicos Operatórios/mortalidade , Cálculos Urinários/cirurgia , Ferimentos e Lesões/cirurgia
13.
Pan Afr Med J ; 38: 190, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33995796

RESUMO

Introduction: road traffic injuries represent accounts for significant cause of morbidity and mortality around the globe, particularly in developing countries like Ethiopia. Poor pre-hospital care system and delays in hospitals before getting aids added to the woes of mortality. However, there are no study that determine the types of injury, management and outcome of road traffic accidents and associated factors in this study area. Methods: a hospital based retrospective cross sectional study was conducted among patients attending to Adama Hospital Medical College with accidental injuries from January to December 2015. Data were retrieved from 556 patients registry selected by systematic random sampling from 11,120 injuries visiting the hospital. Data were coded, cleaned and entered to SPSS version 20 for analysis. Factors associated with the management outcome of injury related to road traffic accident were analyzed and statistical significance was declared with p < 0.05 with CI of 95%. Results: out of 556 trauma victims, 304 (54.7%) were due to road traffic accidents followed by personal violence (24%) and falling accident (10.3%). The majorities (74.8%) of patients were male and urban residents (55%). Soft tissue injury was the most frequent type of injury (51%) followed by extremity fracture and dislocation (26%). Delay to come to hospital (over 24 hours), severity of injuries and management types were factors influencing management outcome of injuries related to traffic accidents. About 90.1%, 4.6% and 5.3% of the patients were discharged without any prominent disability, permanent disability and died respectively. Conclusion: road traffic accidents are preventable causes of morbidity and mortality. Practices of strict road safety measures and appropriate use of roadways by pedestrians should be in place, while establishing and strengthening early access to hospital and pre-hospital care to save life of injuries.


Assuntos
Acidentes por Quedas/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Violência/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes de Trânsito/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Etiópia , Feminino , Humanos , Lactente , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Pedestres/estatística & dados numéricos , Estudos Retrospectivos , Ferimentos e Lesões/mortalidade , Ferimentos e Lesões/terapia , Adulto Jovem
14.
J Clin Neurosci ; 88: 128-134, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33992171

RESUMO

Early COVID-19-targeted legislations reduced public activity and elective surgery such that local neurosurgical care greatly focused on emergent needs. This study examines neurosurgical trauma patients' dispositions through two neighboring trauma centers to inform resource allocation. We conducted a retrospective review of the trauma registries for two Level 1 Trauma Centers in Santa Clara County, one academic and one community center, between February 1st and April 15th, 2018-2020. Events before a quarantine, implemented on March 16th, 2020, and events from 2018 to 19 were used for reference. Encounters were characterized by injuries, services, procedures, and disposition. Categorical variables were analyzed by the χ2 test, proportions of variables by z-score test, and non-parametric variables by Fisher's exact test. A total of 1,336 traumas were identified, with 31% from the academic center and 69% from the community center. During the post-policy period, relative to matching periods in years prior, there was a decrease in number of TBI and spinal fractures (24% versus 41%, p < 0.001) and neurosurgical consults (27% versus 39%, p < 0.003), but not in number of neurosurgical admissions or procedures. There were no changes in frequency of neurosurgery consults among total traumas, patients triaged to critical care services, or patients discharged to temporary rehabilitation services. Neurosurgical services were similarly rendered between the academic and community hospitals. This study describes neurosurgical trauma management in a suburban healthcare network immediately following restrictive quarantine during a moderate COVID-19 outbreak. Our data shows that neurosurgery remains a resource-intensive subspeciality, even during restrictive periods when overall trauma volume is decreased.


Assuntos
Neurocirurgia/tendências , Pandemias , Quarentena , Centros de Traumatologia/tendências , Centros Médicos Acadêmicos , Adulto , Lesões Encefálicas Traumáticas/epidemiologia , Lesões Encefálicas Traumáticas/cirurgia , California/epidemiologia , Criança , Centros Comunitários de Saúde , Feminino , Humanos , Masculino , Neurocirurgia/estatística & dados numéricos , Estudos Retrospectivos , Traumatismos da Medula Espinal/epidemiologia , Traumatismos da Medula Espinal/cirurgia , Centros de Traumatologia/estatística & dados numéricos , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/terapia
15.
Arq. Ciênc. Vet. Zool. UNIPAR (Online) ; 24(1, cont.): e2402, jan-jun. 2021. ilus
Artigo em Português | LILACS, VETINDEX | ID: biblio-1222351

RESUMO

O abutre real (Sarcoramphus papa) é um pássaro compacto de cor extraordinária, cabeça nua, possui carúnculas e papilas carnudas vermelhas e alaranjadas em torno do bico, a íris é branca com um anel orbital vermelho. Em cativeiro, o estresse é uma condição bastante observada, o que pode levar a automutilação, podendo evoluir para lesões graves na pele e músculos. O objetivo do presente relato é descrever os procedimentos adotados em um caso de automutilação em Sarcoramphus papa, mantido em cativeiro, e a importância do manejo adequado para essa espécie em cativeiro. Foi atendido em um Hospital Veterinário Universitário, um urubu-rei apresentando ferimento contaminado, com exposição óssea na asa direita. Após tratamento o animal foi encaminhado para uma reserva conservacionista para que fosse condicionada a voltar para seu habitat natural.(AU)


The king vulture (Sarcoramphus papa) is a large bird with extraordinary color, bold head, presenting red and orange fleshy papules and papillae around its beak, with white iris and a red orbital ring. In captivity, stress is a condition that is widely observed, which can lead to self-mutilation. Such mutilation, in turn, can progress to severe skin and muscle injuries. The purpose of this report is to describe the procedures adopted in a case of self-mutilation in Sarcoramphus papa, kept in captivity, and the importance of proper management for this species in captivity. The king vulture presenting a contaminated wound with bone exposure on the right wing was treated at a University Veterinary Hospital. After treatment, the bird was sent to a conservation reserve to be conditioned to return to its natural habitat.(AU)


El buitre real (Sarcoramphus papa) es un ave compacta de extraordinario color, cabeza descubierta, tiene carúnculas y papilas carnosas rojas y anaranjadas alrededor del pico, el iris es blanco con un anillo orbital rojo. En cautiverio, el estrés es una condición ampliamente observada, que puede conducir a la automutilación, pudiendo progresar lesiones graves en la piel y músculos. El propósito de este informe es describir los procedimientos adoptados en un caso de automutilación en Sarcoramphus papa, mantenida en cautiverio, y la importancia del manejo adecuado de esta especie en cautiverio. Se atendió en un Hospital Veterinario Universitario, un buitre real presentando una herida contaminada, con exposición ósea en el ala derecha. Luego después del tratamiento, se envió el animal a una reserva de conservación para que fuera condicionado a volver a su hábitat natural.(AU)


Assuntos
Animais , Automutilação , Ferimentos e Lesões , Aves/lesões , Bem-Estar do Animal
16.
Medicine (Baltimore) ; 100(17): e25616, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33907115

RESUMO

BACKGROUND: Post-traumatic stress disorder (PTSD) is one of the most commonly reported mental health consequences, followed by disasters and traumatic events, either natural or man-made. At present, there are no unified results for the prevalence rate of PTSD in patients suffering from acute trauma and related influencing factors. Therefore, the purpose of this study is to systematically evaluate the existing literatures, thus obtaining a comprehensive estimation of the combined prevalence rate of PTSD and related factors in trauma patients, so as to provide evidence support for clinical disease prediction models and intervention strategies. METHODS: Published articles will be retrieved from PubMed, Embase, Cochrane Library, Web of Science, China Biology Medicine Database, China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Database. Research reports will be searched in March 2021. STATA 14.0 software will be applied for data analysis. Mantel-Haenszel fixed effect model or DerSimonian-Laird random effect model will be selected to estimate the pooled prevalence of PTSD in patients with acute trauma and associated factors. RESULTS: We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals. CONCLUSIONS: The results of this analysis can be used to establish a risk prediction model of PTSD in patients experiencing acute trauma, so as to provide intervention strategies. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/Z275U.


Assuntos
Testes Psicológicos , Medição de Risco , Transtornos de Estresse Pós-Traumáticos/etiologia , Avaliação de Sintomas , Ferimentos e Lesões/psicologia , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Metanálise como Assunto , Projetos de Pesquisa , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Revisões Sistemáticas como Assunto , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-33915935

RESUMO

External causes of injury are major contributors to mortality among people with disabilities. We analyzed the 10-year trend (2008-2017) of mortality attributed to external causes of injury among people with disabilities. We conducted an observational, population-based, retrospective, cross-sectional study among people with disabilities in South Korea. The database was compiled by merging two data sets: registered people with disabilities during 2008-2017 from the Ministry of Health and Welfare, and the data published by the Korea National Statistical Office. Between 2008 and 2017, the all-cause mortality among people with disabilities showed a rising trend and increased from 2641 per 100,000 in 2008 to 2751 per 100,000 in 2017. During this 10-year period, 6.5-9.2% of the total number of deaths were caused by injuries. Disabilities that were associated with a high crude mortality rate shared the same three most frequent causes of death: suicide, motor vehicle crashes, and falling. Mortality due to external causes of injury increased among older people with disabilities. Thus, effective strategies are required to decrease preventable deaths caused by unintentional injuries among people with disabilities.


Assuntos
Pessoas com Deficiência , Mortalidade/tendências , Suicídio , Ferimentos e Lesões , Idoso , Idoso de 80 Anos ou mais , Causas de Morte , Estudos Transversais , Humanos , República da Coreia/epidemiologia , Estudos Retrospectivos
18.
Biosensors (Basel) ; 11(3)2021 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-33800856

RESUMO

The rapid detection of pathogens in infected wounds can significantly improve the clinical outcome. Wound exudate, which can be collected in a non-invasive way, offers an attractive sample material for the detection of pathogens at the point-of-care (POC). Here, we report the development of a nucleic acid lateral flow immunoassay for direct detection of isothermally amplified DNA combined with fast sample preparation. The streamlined protocol was evaluated using human wound exudate spiked with the opportunistic pathogen Pseudomonas aeruginosa that cause severe health issues upon wound colonization. A detection limit of 2.1 × 105 CFU per mL of wound fluid was achieved, and no cross-reaction with other pathogens was observed. Furthermore, we integrated an internal amplification control that excludes false negative results and, in combination with the flow control, ensures the validity of the test result. The paper-based approach with only three simple hands-on steps has a turn-around time of less than 30 min and covers the complete analytical process chain from sample to answer. This newly developed workflow for wound fluid diagnostics has tremendous potential for reliable pathogen POC testing and subsequent target-oriented therapy.


Assuntos
Técnicas Biossensoriais , Imunoensaio , Ácidos Nucleicos , Exsudatos e Transudatos/microbiologia , Humanos , Limite de Detecção , Técnicas de Amplificação de Ácido Nucleico , Sistemas Automatizados de Assistência Junto ao Leito , Ferimentos e Lesões/microbiologia
19.
BMJ Case Rep ; 14(4)2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33811091

RESUMO

We report a case of a 55-year-old man presenting with diplopia, masticatory weakness and dysarthria several weeks post multitrauma. The clinical suspicion of myasthenia gravis (MG) was supported with positive acetylcholine receptor antibodies and abnormal repetitive stimulation study. He responded well to pyridostigmine, intravenous immunoglobulin and oral prednisolone. In this report, we describe the timing and progression of MG in our patient, and review the literature pertaining to the relationship between trauma and MG. The search for definitive evidence of causation may be impractical, but should not delay the recognition and management of a treatable condition.


Assuntos
Blefaroptose , Miastenia Gravis , Diplopia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Miastenia Gravis/complicações , Miastenia Gravis/diagnóstico , Miastenia Gravis/tratamento farmacológico , Prednisolona/uso terapêutico , Brometo de Piridostigmina/uso terapêutico , Ferimentos e Lesões/complicações
20.
Emerg Med Clin North Am ; 39(2): 257-271, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33863458

RESUMO

Geriatric trauma patients will continue to increase in prevalence as the population ages, and many specific considerations need to be made to provide appropriate care to these patients. This article outlines common presentations of trauma in geriatric patients, with consideration to baseline physiologic function and patterns of injury that may be more prevalent in geriatric populations. Additionally, the article explores specific evidence-based management practices, the significance of trauma team and geriatrician involvement, and disposition decisions.


Assuntos
Ferimentos e Lesões/epidemiologia , Acidentes por Quedas , Idoso , Envelhecimento/fisiologia , Doenças Cardiovasculares/fisiopatologia , Comorbidade , Fragilidade/fisiopatologia , Geriatras , Acesso aos Serviços de Saúde , Humanos , Pneumopatias/fisiopatologia , Doenças Musculoesqueléticas/fisiopatologia , Transtornos Neurocognitivos/fisiopatologia , Manejo da Dor , Alta do Paciente , Centros de Traumatologia , Sinais Vitais , Ferimentos e Lesões/fisiopatologia
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