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Significant Injury (significant + injury)
Selected AbstractsEsophageal Hematoma Complicating Catheter Ablation for Atrial FibrillationJOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 2 2009REBECCA McCALL B.V.C.Des Significant injury to the esophagus during ablation for atrial fibrillation is rare but may be devastating. Esophageal fistulas and injury to branches of the vagus nerve resulting in gastric stasis have previously been described. In this case report, we describe another type of esophageal injury associated with catheter ablation for atrial fibrillation. The patient experienced chest pain and vomiting on recovery from anesthesia. Echocardiography and computerized tomography were used to identify a large esophageal hematoma. The hematoma was treated conservatively and the patient recovered fully after several weeks. [source] Ultrasonographic examination of the caudal structures of the distal antebrachium in the horseEQUINE VETERINARY EDUCATION, Issue 3 2010J. S. Jorgensen Summary Evaluation of the caudal distal antebrachium using ultrasound is a very useful diagnostic procedure for identification of soft tissue abnormalities in flexor structures of the equine limb. In this article we describe how ultrasonographic imaging may be used to complement radiography of the carpus in evaluating horses that present with peri-carpal swelling and/or lameness localised to the carpal region. Ultrasonographic examination assists with the identification or exclusion of significant injuries to muscular, tendonous and ligamentous structures within the distal antebrachium and enables practitioners to proceed with appropriate therapeutic and rehabilitation plans for the immediate benefit for their patients while also recognising pathology that could progress to cause long-term, chronic lameness issues without aggressive and effective intervention. [source] Improving health through youth sports: Is participation enough?NEW DIRECTIONS FOR YOUTH DEVELOPMENT, Issue 115 2007Michael F. Bergeron The health benefits of engaging in regular physical activity are widely known: enhanced cardiorespiratory fitness, increased muscular strength and endurance, and favorable cholesterol and other profiles. Nevertheless, particularly in youth sports programs run by volunteer, and perhaps inadequately trained, coaches, many youth may not realize the health benefits of sports participation due to a number of factors, among them, inappropriate coach-child ratios, limited space, or mismatched expectations between coaches and those of children and their parents. There are specific strategies that can be implemented to ensure that youth receive the maximize benefits from participation in sports. These strategies are presented in the following areas: frequency, intensity, and duration; cross-training or complementary exercise; access points; utilization of space and time; nutrition; and rest. For instance, with regard to the frequency of physical activity, some sports, including soccer, basketball, and singles tennis, require extensive physical effort over an extended period of time, while others, such as baseball and football, have a lot of downtime. Thus, in order for children and youth to meet the recommendation of participating in moderate or vigorous physical activity at least four times per week, sports programs need to have opportunities for all athletes to practice hard. Finally, the author discusses the point at which participation in sports might be too much, leading to significant injuries, frustration, and resentment. [source] HP38P 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] Paediatric lap-belt injury: A 7 year experienceEMERGENCY MEDICINE AUSTRALASIA, Issue 1 2006Michael Shepherd Abstract Objective:, To highlight the injuries that result from lap-belt use and make recommendations for prevention, the recent experience of a regional paediatric trauma centre was reviewed. Methods:, Retrospective review of admissions to Starship Children's Hospital from 1996 to 2003, with significant injury following involvement in a motor vehicle crash, while wearing a lap-belt. Patients were identified from two prospectively collected databases and discharge coding data. Results:, In total, 19 patients were identified over the 7 year period. The morbidity sustained includes 15 patients with hollow viscus injury, 13 laparotomies, 7 spinal fractures, 2 paraplegia and 1 fatality. A total of 11 patients required laparotomy with a median delay of 24 h. Of patients in the present series, 58% were aged less than 8 years and thus were inappropriately restrained. Conclusions:, Lap-belt use can result in a range of life-threatening injuries or permanent disability in the paediatric population. The incidence of serious lap-belt injury does not appear to be decreasing. Morbidity and mortality could be reduced by the use of three-point restraints, age appropriate restraints and booster seats. [source] Critical ischemic time for the rat ovary: Experimental study evaluating early histopathologic changesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2009Ayhan Coskun Abstract The aim of the present study was to determine a critical ischemic time for ovary in an experimental study in rats. An experimental model using slip-knot tying of all ovarian arteries and veins in cycling female rats was developed. Rat ovaries were tied using the technique through an explorative laparotomy. Complete ischemia times of 1, 2 and 3 h were used for the study. At the end of the ischemic times, the ovaries were harvested following 1 h of reperfusion. Histology indicated a gradually increased congestion correlating with the respective increased ischemic times. According to the present findings 2 h complete ischemia yields a significant injury. The model used in the present study may be used for complete ischemia,reperfusion injury of the rat ovary. [source] Healing of subfailure ligament injury: comparison between immature and mature ligaments in a rat modelJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 5 2002Paolo P. Provenzano This study evaluated biomechanical properties of healing ligament following subfailure (grade II) injury by comparing young and mature animals in a rat lateral collateral ligament (LCL) model. One randomly selected LCL was stretched in situ using a custom designed device in eighteen young (21 days) and eighteen skeletally mature (8 months) male rats. Animals were euthanized at 0, 7, and 14 days post-surgery, and ligament ultimate stress, strain at failure and laxity were determined (n = 6 pairs per group). At time 0 after introduction of stretch injury, ligament laxity was present in both groups. The mature rats had 54 ± 9% strength of the control while the immature rats had 58 ± 11% of the strength of the control, representing a consistent and significant injury. The immature and mature ligaments showed similar patterns of cellular damage post-injury and had similar modes of mechanical failure. Ligament laxity decreased in each group as healing time increased, however ligament laxity did not completely recover in either group after 2 weeks of healing. After 7 and 14 days of healing, the mature rats, respectively, had only 63 ± 14% and 80 ± 8% strengths of the controls while the immature rats had 94 ± 6% and 94 ± 10%. Hence, mechanical data showed that immature animals recovered their strength after a grade II sprain at a faster rate than mature animals. However, ligament laxity was still present in both groups two weeks after the injury and was not completely removed by growth in the immature group. These findings are clinically relevant since joint laxity after injury is common, and these results may explain the presence of continued instability in a joint injured at a young age. Hence, this study, with a new injury model, showed differences in ligament healing associated with maturity and quantified the clinically observed persistance of ligament laxity. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source] Stridor is not a scientifically valid outcome measure for assessing airway injuryPEDIATRIC ANESTHESIA, Issue 2009JOSEF HOLZKI MD Summary Since about a decade cuffed intubation is becoming more popular in pediatric anesthesia. Studies supporting cuffed intubation compared cuffed and uncuffed intubation by using stridor as main outcome measure after extubation. No differentiations were made between benign (oedema) and severe (ulceration of mucosa) lesions. Stridor was considered to represent all relevant injuries. Far reaching conclusions for daily practice were drawn from these studies. Pediatric endoscopists and , ENT-surgeons with extensive experience in this field have warned against this opinion because significant injury of the airway is not always accompanied by stridor! The symptom of stridor might develop weeks and months after injury when silent ulcerations of the mucosa retract to significant stenosis. Only endoscopy can evidently detect all airway injuries. Studies describing airway injury by endoscopic control are urgently needed to find the best way of preventing airway injury by intubation. [source] | ||||||||||