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Introduction. Traumatic brain injuries (TBI) are a real social problem, with an upward trend worldwide. TBI is the leading cause of death and disability, especially among young men. Each year in Europe, and also in Poland, 243 per 100,000 individuals suffer from TBI. Assessing prognosis after traumatic brain injury is very important in order to help clinicians to make a decision about the implementation of specific methods of treatment, and to make communication with the patient and the patient’s family easier. Objective. The objective of this review was to present prognostic factors, to assess outcomes within a short time after a moderate to severe traumatic brain injury, as well as to predict functional outcome. The most important independent variables were: age, Glasgow Coma Scale (GCS) motor score, pupil response, Marshall CT classification and traumatic subarachnoid haemorrhage. Other important prognostic factors included hypotension, hypoxia, glucose, coagulopathy, haemoglobin and category of CT characteristic, such as midline shift, mass lesion, basal cistern. Conclusions. Gender and intraventricular haemorrhage did not have predictive value. This subject needs much more research in the area of new prognostic factors which would be better associated with outcome after traumatic brain injury.
The objective of the study was to describe the characteristics of agriculture and forestry related injury cases admitted to an Emergency Department (ED), and to asses factors related to injury severity and hospital admission. Retrospective analysis of ED case records in Teaching Hospital No 1 in Lublin, from January 2004 to December 2005 were utilized. Inclusion criteria: patient >14 years old, with agriculture and forestry related injuries. Univariate and bivariate descriptive analyses and multiple logistic regressions were performed. 3791 cases were included, 63.1% males, 53.3% cases younger than 30 years and 47.1% of the patients sustained injuries related to machines or falls. After adjusting for age, sex and the presence of multiple injuries, animal related injuries, followed by machine related injuries and falls, were at higher risk of a more severe injury (OR: 1.77, 1.61 and 1.50, respectively). This groups also showed a higher likelihood of hospital admission (OR: 2.03, 192 and 2.00, respectively). Patients attended to in the ED during night hours (OR: 2.06) were also at a higher risk of hospitalization. It was concluded that animal related injuries, agriculture machine operators, and falls, besides accounting for two thirds of analyzed cases, are the mechanism of injury with a greater risk of a more severe injury and higher likelihood of a hospitalization.
Despite urbanization of contemporary society and limitation on the environmental areas, the threat of animal attacks on people is still an important social and medical problem. Although they usually do not have serious consequences, they are nevertheless disturbing and alarming enough to make people seek professional, medical help. The aim of this study was to estimate the epidemiology and the risk rate of animal related injuries in the urban and rural population, as well as to select the characteristics of such injuries, which are distinguishable from injuries caused by other factors. The work presents a retrospective analysis of the medical records of 1,872 patients treated at the Department of Trauma and Emergency Department between 2001-2004, who suffered from animal related injuries. Our analysis led to the following conclusions: Most animal related injuries, reported to doctors, are mild injuries. The threat of animal attack is similar in urban and in rural areas, and concerns mostly men between the ages of 22-40. Injuries caused by large animals, such as a horse or a cow, require hospitalization and should be considered as high-energy injuries. The vast majority were patients who after the treatment could return to their social and occupational activities; the mortality rate in hospitalized patients with animal related injuries was higher then in other injuries, but the difference was statistically irrelevant.
Four patients, with an average age of 58 years, hospitalised in 2008 because of bite wounds to the lower leg, were analysed. The study was based on the analysis of medical records and the results of laboratory and microbiological tests. Precise wound cleansing and dressing, appropriate to each case, are principal elements of management in the treatment of dog bite wounds. Potential complications include limb infection, deformation, and amputation.
Ziarniniak Wegenera jest chorobą autoimmunologiczną, charakteryzującą się martwiczym i ziarniniakowym zapaleniem małych naczyń. Schorzenie to dotyczy górnych i dolnych dróg oddechowych, nerek, gałki ocznej. W 50% przypadków choroba zajmuje skórę, prowadząc do powstawania trudno gojących się owrzodzeń. W poniższej pracy przedstawiamy przypadek 23-letniej pacjentki, u której rozpoznano ziarniniaka Wegenera z zajęciem skóry małżowiny usznej prawej, z naciekiem na śluzówce jamy ustnej i asymetrią twarzy. W leczeniu, obok pulsów sterydowych oraz leczenia immunosupresyjnego, stosowano tlenoterapię hiperbaryczną, uzyskując bardzo dobry efekt terapeutyczny oraz całkowite ustąpienie zmian skórnych.
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