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Minor Injuries (minor + injury)
Selected AbstractsHP38P MANAGEMENT OF TRAUMATIC PANCREATIC INJURYANZ JOURNAL OF SURGERY, Issue 2007A. M. Warwick Background Trauma to the pancreas is a challenging area both in initial diagnosis and longer-term management. The retroperitoneal location makes clinical diagnosis of injury difficult and delayed diagnosis has morbid complications. Methods A review of patients with a diagnosis of traumatic pancreatic injury was performed, over a period of five years, from 2002 to 2006. We assessed the type of injury that occurred in the pancreas after both blunt and penetrating trauma; the diagnosis and timing of pancreatic injury; the need for operative/radiological intervention; and the complications of these injuries. Specifically patients with complex injuries were evaluated and these cases were critically reviewed. Results We identified 45 of cases of pancreatic trauma, aged 16,85, with a mean ISS of 27.8. Minor injury to the pancreas was found in 29 patients, and 16 patients had severe trauma to the pancreas, either major laceration or transection. Four particularly complex cases were identified, two of which required a Whipple's procedure following gunshot wounds involving the pancreatic head. Two patients with abdominal crush injuries required multiple interventions. Conclusions Patients with pancreatic trauma often have other significant injuries and one should have a high degree of suspicion of pancreatic injury in multiply injured patients. Penetrating injury to the pancreas can result in catastrophic injury requiring radical surgery. Blunt injury should be assessed by magnetic resonance cholangio-pancreatography or at laparotomy. The management of pancreatic trauma is complex and these patients should be managed in a tertiary hospital with involvement by both specialised pancreatic and trauma surgeons. [source] Dento-alveolar and maxillofacial injuries: a 5-year multi-center study.DENTAL TRAUMATOLOGY, Issue 1 2008Part 2: Severity, location These injuries may cause morbidity and demand meticulously planned treatment. Part 1 of this study focused on the incidence of general trauma injuries, as well as facial or dental trauma. The aim of part 2 is to evaluate the severity and location of the dento-alveolar and maxillofacial injuries over 5 years. A retrospective cohort study was conducted based on data from the Israel National Trauma Registry. Patients admitted and hospitalized due to trauma injuries during the years 2000,2004, totaled 111 010 in which 5886 (5.3%) were maxillofacial or dental injuries. Most of these injuries were traffic-related (54.5%), followed by events at home (18.7%). Facial injuries combined with injuries to other organs involved occurred in 3721 (63.2%) of the patients. Most minor injuries were noted when no other organs were involved, while severe injuries were more common when multiple organs were involved. More than 25% of facial injuries required surgery. Meticulous epidemiologic studies are needed to support the leading role, extent, and severity of maxillofacial trauma. [source] Health and Safety in the Medieval Monasteries of BritainHISTORY, Issue 309 2008JULIE KERR The arduous nature of monastic life could impact on the monks' physical and mental well-being, causing minor injuries but also fatalities. Back problems might develop from ringing the heavy monastery bells, digestive disorders could result from years of fasting, and those holding important offices invariably suffered from stress and strain. There has been significant discussion of healthcare in the monastery , of disease and illness, the treatment of the sick, the infirmary, and the role of professional practitioners within the monastery. Less consideration has been given to the various hazards that might affect the monks on a daily basis, from the obstacles that caused them to trip and tumble to the injuries and fatalities that could result from natural disasters, outbreaks of fire and faulty repair work. This article seeks to explore more fully the perils and pitfalls that the religious community might face, but includes a brief discussion of the general impact of monastic observance on the monks' well-being, and the spiritual and physical recourse they sought to prevent mishaps and to treat casualties. Analysis centres on the monastic houses of Britain in the high middle ages, but refers to later and continental examples for comparative purposes and where they are likely to be indicative of conditions in Britain in the twelfth and thirteenth centuries. [source] The clinical effectiveness of nurse practitioners' management of minor injuries in an adult emergency department: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 1 2009Anne Wilson PhD, FRCNA Abstract Background, The increasing cost of healthcare in Australia demands changes in the way healthcare is delivered. Nurse practitioners have been introduced into specialty areas including emergency departments. Specific interventions are known to include the treatment and management of minor injuries, but little has been reported on their work. Objectives, Examine the best available evidence to determine the clinical effectiveness of emergency department nurse practitioners in the assessment, treatment and management of minor injuries in adults. Inclusion criteria, For inclusion studies had to include adult patients treated for minor injuries by nurse practitioners in emergency departments. All study designs were included. Search strategy, English language articles from 1986 onwards were sought using MEDLINE, CINAHL, Embase and Science Citation Index. Methodological quality, Two independent reviewers critically appraised the quality of the studies and extracted data using standardised tools. Data collection, Two independent reviewers assessed the eligibility of each study for inclusion into the review and the study design used. Where any disagreement occurred, consensus was reached by discussion with an independent researcher. Data synthesis, Studies were assessed for homogeneity by considering populations, interventions and outcomes. Where heterogeneity was present, synthesis was undertaken in a narrative format; otherwise a meta-analysis was conducted. For each outcome measure, results were tabulated by intervention type and discussed in a narrative summary. Results from randomised controlled trials were pooled in meta-analyses where appropriate. Results, Nine studies from a total of 55 participants met the inclusion criteria. Two were randomised controlled trials. Metasynthesis of research findings generated five synthesised findings derived from 16 study findings aggregated into seven categories. Evidence comparing the clinical effectiveness of nurse practitioners to mainstream management of minor injuries was fair to poor methodological quality. When comparable data were pooled, there were no significant differences (P < 0.05) between nurse practitioners and junior doctors. Conclusions, The results emphasise the need for more high-quality research using appropriate outcome measures in the area of clinical effectiveness of nurse practitioners, particularly interventions that improve outcomes for presentations to emergency departments and address issues of waiting and congestion. [source] Psychogenic movement disorders in children: A report of 15 cases and a review of the literature,,MOVEMENT DISORDERS, Issue 13 2008Petra Schwingenschuh MD Abstract Data on psychogenic movement disorders (PMD) in children are scarce, with most existing literature relating to adults only. We report 15 cases with the aim of highlighting the clinical characteristics, risk factors, comorbidity, treatment, outcome, and prognosis of PMD in children. Only 13% of cases had onset before age 10, with the mean age at onset being 12.3 years. Females were predominantly affected (F:M = 4:1). The most common types of movement disorders seen were dystonia (47%), tremor (40%), and gait disorders (13%). Multiple hyperkinetic phenomenologies were observed in many cases. Abrupt onset and precipitation by minor injuries, and stressful life events were commonly reported. Clinical clues on examination suggesting a psychogenic origin were similar to those identified in adults. A distinct feature of PMD in children was the predominant involvement of the dominant limb. The underlying psychiatric diagnosis was conversion disorder in the majority of cases. Time from symptom onset until diagnosis of a PMD varied broadly (between 2 weeks and 5 years). Treatment with cognitive and behavioral therapy and rehabilitation by a multidisciplinary team led to improvement in most cases. However, treatment was much more effective in children with a short time from symptom onset to diagnosis and treatment. © 2008 Movement Disorder Society [source] Pycnogenol® accelerates wound healing and reduces scar formationPHYTOTHERAPY RESEARCH, Issue 7 2004G. Blazsó Abstract Pycnogenol® was applied topically to experimental wounds in,icted on healthy rats by means of a branding iron. The wound-healing time was taken as the number of days required for 50% of the scabs to separate spontaneously from the animals. Application of a gel formulation containing 1% Pycnogenol® signi,cantly shortened the wound healing time, by 1.6 days compared with the group treated with gel only (15.4 days). The application of 2% Pycnogenol® decreased the healing time by almost 3 days, while 5% Pycnogenol® further accelerated the wound-healing process. In parallel, Pycnogenol® gels reduced the diameter of the scars remaining following complete scab loss in a concentration-dependent manner. In conclusion, Pycnogenol® is a potent active ingredient for the treatment of minor injuries. Copyright © 2004 John Wiley & Sons, Ltd. [source] Near miss and minor occupational injury: Does it share a common causal pathway with major injury?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Hasanat Alamgir MBA Abstract Background An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. Methods The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. Results For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Conclusions Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. Am. J. Ind. Med. 52:69,75, 2009. © 2008 Wiley-Liss, Inc. [source] Alteration of inflammatory response following small-volume resuscitationBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2000F. Gebhard Background Small-volume resuscitation is rather effective in the primary volume treatment of major trauma. Blood pressure stabilizing effects occur immediately but last for a limited period only. Influences on inflammatory reactions in humans have not been reported so far. This prospective randomized study therefore analysed the inflammatory response in the very early (pre)clinical period after administration of crystalloids plus starch, hyperosmolar/hyperoncotic starch and lyophilized plasma solutions. Methods Upon approval of the ethics committee, 41 patients were enrolled with multiple injuries (injury severity score (ISS) mean 34 (range 9,75)). The patients received randomly either standard solutions, i.e. starch plus crystalloids (group C (control); n = 14), hyperosmolar/hyperoncotic starch (group S (small volume); n = 14) or lyophilized plasma (group L (lyoplasma); n = 13). Subsets were performed according to the different solutions as well as to the severity of trauma (ISS below 17, 18,31, 32 or more) and survivors/non-survivors. The first blood sample was obtained at the scene of the accident before cardiopulmonary resuscitation, when appropriate. Subsequently, blood samples were collected hourly. All samples were spun immediately at 4°C and stored at ,70°C. Interleukin (IL) 6 as well as several different prostaglandins (PGI2, thromboxane A2, PGE2) were determined to characterize the overall inflammatory response. Results Eleven casualties (seven men and four women, mean age 31 years) died because of major trauma within 24 h after the incident. In all patients IL-6 levels promptly increased within the first 2 h, most pronounced in patients with the severest trauma (ISS greater than 32) and non-survivors. Patients in groups C and S had a comparable time course of IL-6 plasma levels with a slightly higher release in minor injuries (ISS less than 30). The same was true for prostaglandins. In contrast, patients in group L had clearly higher IL-6 concentrations during the first 2,12 h, again most pronounced in those with the severest trauma (ISS greater than 32). Conclusion These results demonstrate that the early systemic inflammatory response after small-volume resuscitation is rather similar to that of patients infused with standard-volume therapy after trauma. In contrast, lyoplasma seems to increase the inflammatory response regardless of the injury severity. © 2000 British Journal of Surgery Society Ltd [source] Factors that distinguish serious versus less severe Strain and sprain injuries: An analysis of electric utility workersAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 3 2009Michael A. Kelsh PhD Abstract Background Occupational sprain and strain injuries are one of the most common types of nonfatal occupational injuries and a significant source of lost workdays. This study examines factors associated with severe work-related sprain/strain injuries to the back, shoulder, and knees. Methods A synthetic case,control study was performed (controls were selected from the same pool of utility workers as cases). Cases included all electric utility workers who had experienced a severe work-related sprain/strain injury to the back, knee, or shoulder. Primary controls were selected from all workers who had sustained a minor injury. Secondary controls were selected from employees with a minor sprain/strain injury to the back, knee, or shoulder. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals. Results Workers 41 years and older were more likely to have experienced severe shoulder sprain/strain injuries [Age 41,50: OR,=,3.62, 95% CI: 1.71,7.65; age 51 and older: OR,=,4.49, 95% CI: 1.89,10.67] and severe back sprain/strain injuries [Age 41,50: OR,=,1.70, 95% CI: 1.06,2.33; age 51 and older: OR,=,1.5, 95% CI: 0.90,2.52]. Line workers and maintenance workers had an increased risk of serious sprain/strain injuries. Gender and day of week were not significantly associated with sprain/strain injuries. Discussion Though this study is limited by available data, future studies may benefit from this preliminary examination of occupational and demographic characteristics associated with serious sprain/strain injuries among electric utility workers. Am. J. Ind. Med. 52:210,220, 2009. © 2008 Wiley-Liss, Inc. [source] Near miss and minor occupational injury: Does it share a common causal pathway with major injury?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2009Hasanat Alamgir MBA Abstract Background An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. Methods The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. Results For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. Conclusions Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs. Am. J. Ind. Med. 52:69,75, 2009. © 2008 Wiley-Liss, Inc. [source] Clinical Images: Gout revealed on arthroscopy after minor injuryARTHRITIS & RHEUMATISM, Issue 3 2010Joseph F. Baker MRCSEd No abstract is available for this article. [source] Safety of Paramedics with Extended SkillsACADEMIC EMERGENCY MEDICINE, Issue 7 2008Suzanne Mason MBBS Abstract Background:, The role of paramedics with extended skills is evolving, enabling them to assess and treat patients in the community. A United Kingdom service led by extended-role paramedic practitioners (PPs) is aimed at managing minor acute illness and injury among older people in the home when appropriate, avoiding unnecessary transfer to the emergency department (ED). Objectives:, The objectives were to evaluate the safety of clinical decisions made by PPs operating within the new service. Methods:, As part of a cluster-randomized controlled trial, patients aged >60 years contacting the emergency medical services (EMS) with a minor injury or illness were included in the study. The safety of the new PP intervention was compared with standard practice of EMS transfer and ED treatment. Outcomes included unplanned ED attendance within 7 days of the index episode. Clinical records were rated independently by two senior ED clinicians to identify related episodes, avoidable subsequent episodes, and suboptimal care. Results:, Of the 2,025 patients included in this analysis, 219 (10.9%) went on to have an unplanned ED attendance within 7 days. Of these, 162 (74.0%) re-presented with a condition related to their index episode. The independent raters agreed on suboptimal care 83.4% of the time. There were 16 agreed upon episodes related to suboptimal care (0.80%). No significant differences were found between intervention and control groups in relation to re-presentation at hospital within 7 days for a related condition or rates of assessed suboptimal care. Conclusions:, This study suggests that appropriately trained paramedics with extended skills treating older people with minor acute conditions in the community are as safe as standard EMS transfer and treatment within the ED. [source] | ||||||||||