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[PMID]:29205969
[Au] Autor:Zhang W
[Ad] Endereço:Department of Forensic Medicine, National Police University of China, Shenyang 110035, China.
[Ti] Título:[Forensic Analysis of the Characteristics of Pelvic Fracture in 65 Road Traffic Accident Death Cases].
[So] Source:Fa Yi Xue Za Zhi;32(6):428-430, 2016 Dec.
[Is] ISSN:1004-5619
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:OBJECTIVES: To analyze the characteristics and mechanisms of pelvic fractures in the cases of road traffic accident deaths. METHODS: Total 65 cases of road traffic accident deaths with pelvic fracture were collected, and the sites, characteristics and injury mechanisms of pelvic fracture were statistically analyzed. RESULTS: Among the 65 cases of pelvic fracture, 38 cases of dislocation of sacroiliac joint were found, and most combined with pubis symphysis separation or fracture of pubis. In the fractures of pubis, ischium and acetabulum, linear fractures were most common, while comminuted fractures were most common in sacrum and coccyx fractures. There were 54 cases combined with pelvic soft tissue injury, and 8 cases with pelvic organ injury and 44 cases with abdominal organ injury. In the types of pelvic ring injury, 32 cases were separation, 49.32%, followed by compression, 26.15% and only one case was verticality, 1.54%. CONCLUSIONS: Detailed and comprehensive examination of the body and determination of the pelvic fracture type contribute to analyze the mechanisms of injury.
[Mh] Termos MeSH primário: Acidentes de Trânsito
Fraturas Ósseas/diagnóstico
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Acetábulo/lesões
Morte
Patologia Legal
Fraturas Cominutivas/diagnóstico
Seres Humanos
Ísquio/lesões
Lesões dos Tecidos Moles/diagnóstico
Fraturas da Coluna Vertebral/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.3969/j.issn.1004-5619.2016.06.008


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[PMID]:29390269
[Au] Autor:Wang J; Wang D; Du J; Lin Z
[Ti] Título:A new strategy to reconstruct type III acetabular bone defect associated with inflammatory pseudotumor: combined medial and lateral acetabular bone grafting: A case report.
[So] Source:Medicine (Baltimore);96(50):e8777, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Inflammatory pseudotumor has been commonly reported in patients undergoing total hip arthroplasty (THA). PATIENT CONCERNS: We reported a patient who had a massive intra-pelvic pseudotumour and acetabular bone defect underwent two-stage revision THA. DIAGNOSES: A new surgical strategy for pseudotumor after THA is performed. INTERVENTIONS: Thorough debridement intra-pelvic pseudotumour via Smith-Petersen approach, bone grafting on iliac medial surface and plate-screw internal fixation were performed in the first stage, followed by revision of the loosened prosthesis to a cementless primary prosthesis in the second stage. OUTCOMES: A follow-up for 5 years showed satisfactory recovery of function. LESSONS: This surgical revision is less invasive than conventional methods, resulting in a stable and well-functioning hip joint after mid-term follow-up for 5 years.
[Mh] Termos MeSH primário: Acetábulo/transplante
Artroplastia de Quadril/efeitos adversos
Doenças Ósseas/cirurgia
Granuloma de Células Plasmáticas/cirurgia
Ossos Pélvicos/cirurgia
[Mh] Termos MeSH secundário: Adulto
Desbridamento
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008777


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[PMID]:28463156
[Au] Autor:Demizu Y; Jin D; Sulaiman NS; Nagano F; Terashima K; Tokumaru S; Akagi T; Fujii O; Daimon T; Sasaki R; Fuwa N; Okimoto T
[Ad] Endereço:Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan. Electronic address: y_demizu@nifty.com.
[Ti] Título:Particle Therapy Using Protons or Carbon Ions for Unresectable or Incompletely Resected Bone and Soft Tissue Sarcomas of the Pelvis.
[So] Source:Int J Radiat Oncol Biol Phys;98(2):367-374, 2017 06 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To retrospectively analyze the treatment outcomes of particle therapy using protons or carbon ions for unresectable or incompletely resected bone and soft tissue sarcomas (BSTSs) of the pelvis. METHODS AND MATERIALS: From May 2005 to December 2014, 91 patients with nonmetastatic histologically proven unresectable or incompletely resected pelvic BSTSs underwent particle therapy with curative intent. The particle therapy used protons (52 patients) or carbon ions (39 patients). All patients received a dose of 70.4 Gy (relative biologic effectiveness) in 32 fractions (55 patients) or 16 fractions (36 patients). RESULTS: The median patient age was 67 years (range 18-87). The median planning target volume (PTV) was 455 cm (range 108-1984). The histologic type was chordoma in 53 patients, chondrosarcoma in 14, osteosarcoma in 10, malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma in 5, and other in 9 patients. Of the 91 patients, 82 had a primary tumor and 9 a recurrent tumor. The median follow-up period was 32 months (range 3-112). The 3-year rate of overall survival (OS), progression-free survival (PFS), and local control was 83%, 72%, and 92%, respectively. A Cox proportional hazards model revealed that chordoma histologic features and a PTV of ≤500 cm were significantly associated with better OS, and a primary tumor and PTV of ≤500 cm were significantly associated with better PFS. Ion type and number of fractions were not significantly associated with OS, PFS, or local control. Late grade ≥3 toxicities were observed in 23 patients. Compared with the 32-fraction protocol, the 16-fraction protocol was associated with significantly more frequent late grade ≥3 toxicities (18 of 36 vs 5 of 55; P<.001). CONCLUSIONS: Particle therapy using protons or carbon ions was effective for unresectable or incompletely resected pelvic BSTS, and the 32-fraction protocol was effective and relatively less toxic. Nevertheless, a longer follow-up period is needed to confirm these results.
[Mh] Termos MeSH primário: Neoplasias Ósseas/radioterapia
Radioterapia com Íons Pesados/métodos
Ossos Pélvicos
Terapia com Prótons/métodos
Sarcoma/radioterapia
[Mh] Termos MeSH secundário: Idoso
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/mortalidade
Neoplasias Ósseas/cirurgia
Condrossarcoma/mortalidade
Condrossarcoma/radioterapia
Condrossarcoma/cirurgia
Cordoma/diagnóstico por imagem
Cordoma/mortalidade
Cordoma/radioterapia
Cordoma/cirurgia
Feminino
Radioterapia com Íons Pesados/estatística & dados numéricos
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Meia-Idade
Osteossarcoma/mortalidade
Osteossarcoma/radioterapia
Osteossarcoma/cirurgia
Ossos Pélvicos/diagnóstico por imagem
Modelos de Riscos Proporcionais
Terapia com Prótons/estatística & dados numéricos
Planejamento da Radioterapia Assistida por Computador/métodos
Eficiência Biológica Relativa
Estudos Retrospectivos
Sarcoma/diagnóstico por imagem
Sarcoma/mortalidade
Sarcoma/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1707
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE


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[PMID]:29437067
[Au] Autor:Ohmori T; Kitamura T; Nishida T; Matsumoto T; Tokioka T
[Ad] Endereço:Kochi Health Sciences Center, 2125-1, Ike, Kochi 781-8555, Japan.
[Ti] Título:The impact of external fixation on mortality in patients with an unstable pelvic ring fracture: a propensity-matched cohort study.
[So] Source:Bone Joint J;100-B(2):233-241, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIM: There is not adequate evidence to establish whether external fixation (EF) of pelvic fractures leads to a reduced mortality. We used the Japan Trauma Data Bank database to identify isolated unstable pelvic ring fractures to exclude the possibility of blood loss from other injuries, and analyzed the effectiveness of EF on mortality in this group of patients. PATIENTS AND METHODS: This was a registry-based comparison of 1163 patients who had been treated for an isolated unstable pelvic ring fracture with (386 patients) or without (777 patients) EF. An isolated pelvic ring fracture was defined by an Abbreviated Injury Score (AIS) for other injuries of < 3. An unstable pelvic ring fracture was defined as having an AIS ≥ 4. The primary outcome of this study was mortality. A subgroup analysis was carried out for patients who required blood transfusion within 24 hours of arrival in the Emergency Department and those who had massive blood loss (AIS code: 852610.5). Propensity-score matching was used to identify a cohort like the EF and non-EF groups. RESULTS: With the use of propensity-score matching using the completed data, 346 patients were matched. When the propensity-score matching was adjusted, EF was associated with a significantly lower risk of death (p = 0.047). In the subgroup analysis of patients who needed blood transfusion within 24 hours and those who had massive blood loss, EF was associated with a significantly lower risk of death in patients who needed blood transfusion within 24 hours (p = 0.014) and in those with massive blood loss (p = 0.016). CONCLUSION: The use of EF to treat unstable pelvic ring fractures was associated with a significantly lower risk of death, especially in patients with severe fractures. Cite this article: 2018;100-B:233-41.
[Mh] Termos MeSH primário: Fixação de Fratura/métodos
Fraturas Ósseas/mortalidade
Fraturas Ósseas/terapia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Escala Resumida de Ferimentos
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Perda Sanguínea Cirúrgica/estatística & dados numéricos
Bases de Dados Factuais
Feminino
Seres Humanos
Japão/epidemiologia
Masculino
Meia-Idade
Pontuação de Propensão
Sistema de Registros
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0852.R1


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[PMID]:29252655
[Au] Autor:Park A; Cipriano CA; Hill K; Kyriakos M; McDonald DJ
[Ad] Endereço:Departments of Orthopaedic Surgery (A.P., C.A.C., and D.J.M.) and Pathology (K.H. and M.K.), Washington University School of Medicine, St. Louis, Missouri.
[Ti] Título:Malignant Transformation of a Giant Cell Tumor of Bone Treated with Denosumab: A Case Report.
[So] Source:JBJS Case Connect;6(3):e78, 2016 Jul-Sep.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: Giant cell tumor (GCT) of bone was first described almost 200 years ago, but the optimal treatment continues to evolve. We present a patient with a pelvic GCT who was treated with embolization, 20 months of denosumab therapy, and resection. Histologically, the tumor consisted of degenerated GCT, bone, and fibrous tissue. After 7 months, the patient was found to have osteosarcoma at the site of the initial lesion as well as pulmonary metastases. CONCLUSION: The apparent malignant transformation of a GCT of bone treated initially with denosumab indicates that close follow-up is warranted.
[Mh] Termos MeSH primário: Conservadores da Densidade Óssea/efeitos adversos
Neoplasias Ósseas/patologia
Denosumab/efeitos adversos
Tumor de Células Gigantes do Osso/patologia
Segunda Neoplasia Primária/patologia
Osteossarcoma/patologia
Ossos Pélvicos/patologia
[Mh] Termos MeSH secundário: Adulto
Neoplasias Ósseas/diagnóstico por imagem
Neoplasias Ósseas/tratamento farmacológico
Neoplasias Ósseas/cirurgia
Transformação Celular Neoplásica
Evolução Fatal
Feminino
Tumor de Células Gigantes do Osso/diagnóstico por imagem
Tumor de Células Gigantes do Osso/tratamento farmacológico
Tumor de Células Gigantes do Osso/cirurgia
Seres Humanos
Segunda Neoplasia Primária/etiologia
Osteossarcoma/etiologia
Ossos Pélvicos/diagnóstico por imagem
Ossos Pélvicos/efeitos dos fármacos
Ossos Pélvicos/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Bone Density Conservation Agents); 4EQZ6YO2HI (Denosumab)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.16.00024


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[PMID]:29237485
[Au] Autor:Maruhashi T; Minehara H; Takeuchi I; Kataoka Y; Asari Y
[Ad] Endereço:Department of Emergency and Critical Care Medicine, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa, 252-0375, Japan. tmaruhasi119@gmail.com.
[Ti] Título:Resuscitative endovascular balloon occlusion of the aorta may increase the bleeding of minor thoracic injury in severe multiple trauma patients: a case report.
[So] Source:J Med Case Rep;11(1):347, 2017 Dec 14.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The resuscitative endovascular balloon occlusion of the aorta, because of its efficacy and feasibility, has been widely used in treating patients with severe torso trauma. However, complications developing around the site proximal to the occlusion by resuscitative endovascular balloon occlusion of the aorta have almost never been studied. CASE PRESENTATION: A 50-year-old Japanese woman fell from a height of approximately 10 m. At initial arrival, her respiratory rate was 24 breaths/minute, her blood oxygen saturation was 95% under 10 L/minute oxygenation, her pulse rate was 90 beats per minute, and her blood pressure was 180/120 mmHg. Mild lung contusion, hemopneumothorax, unstable pelvic fracture, and retroperitoneal bleeding with extravasation of contrast media were observed in initial computed tomography. As her vital signs had deteriorated during computed tomography, a 7-French aortic occlusion catheter (RESCUE BALLOON®, Tokai Medical Products, Aichi, Japan) was inserted and inflated for aortic occlusion at the first lumbar vertebra level and transcatheter arterial embolization was performed for the pelvic fracture. Her bilateral internal iliac arteries were embolized with a gelatin sponge; however, the embolized sites presented recanalization as coagulopathy appeared. Her bilateral internal iliac arteries were re-embolized by n-butyl-2-cyanoacrylate. The balloon was deflated 18 minutes later. After embolization, repeat computed tomography was performed and a massive hemothorax, which had not been captured on arrival, had appeared in her left pleural cavity. Thoracotomy hemostasis was performed and a hemothorax of approximately 2500 ml was aspirated to search for the source of bleeding. However, clear active bleeding was not captured; resuscitative endovascular balloon occlusion of the aorta may have been the cause of the increased bleeding of the thoracic injury at the proximal site of the aorta occlusion. CONCLUSIONS: It is necessary to note that the use of resuscitative endovascular balloon occlusion of the aorta may increase bleeding in sites proximal to occlusions, even in the case of minor injuries without active bleeding at the initial diagnosis.
[Mh] Termos MeSH primário: Aorta
Oclusão com Balão/efeitos adversos
Embolização Terapêutica/métodos
Procedimentos Endovasculares/efeitos adversos
Hemopneumotórax/diagnóstico por imagem
Hemotórax/etiologia
Traumatismo Múltiplo/terapia
Ressuscitação/efeitos adversos
Choque Hemorrágico/terapia
Traumatismos Torácicos/terapia
[Mh] Termos MeSH secundário: Meios de Contraste
Contusões/diagnóstico por imagem
Progressão da Doença
Drenagem
Feminino
Fraturas Ósseas/diagnóstico por imagem
Hemorragia/diagnóstico por imagem
Seres Humanos
Artéria Ilíaca
Lesão Pulmonar/diagnóstico por imagem
Meia-Idade
Ossos Pélvicos/lesões
Espaço Retroperitoneal
Toracotomia
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contrast Media)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180130
[Lr] Data última revisão:
180130
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1511-0


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[PMID]:29310353
[Au] Autor:Zhou Y; Guo H; Cai Z; Zhang Y
[Ad] Endereço:Tianjin Medical University.
[Ti] Título:Complex pelvic ring injuries associated with floating knee in a poly-trauma patient: A case report.
[So] Source:Medicine (Baltimore);96(48):e8783, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Complex pelvic ring fracture associated with floating knee is comparatively rare which usually results from high-energy trauma including vehicle-related accidence, falls from height, and earthquake-related injury. To our knowledge, few literatures have documented such injuries in the individual patient. Management of both injuries present challenges for surgical management and postoperative care. The purpose of this study is to prove the feasibility and benefits of damage control orthopedics (DCO). PATIENT CONCERN: Our case involved a 45-year-old lady who was hit by a dilapidated building. The patient was anxious, pale and hemodynamically stable at the initial examination. The pelvis was unstable and there were obvious deformities in the left lower extremities. Significant degloved injuries in the left leg were noted. Her radiographs and physical examination verified the above signs. DIAGNOSES: Unstable pelvic fractures, multiple fractures of bilateral lower limbs with floating knee injury, multiple pelvic and rib fractures and multiple degloving injuries and soft tissue contusion formed the characteristics of the multiple-injury. INTERVENTIONS: The algorithm of DCO was determined as the treatment. Early simplified procedures such as wound debridement, pelvis fixation, closed reduction and EF of the right shoulder joint, and chest wall fixation were conducted as soon as possible. After a period of time, internal fixations were applied to the fracture sites. The subsequent functional exercise was also conducted in accordance with this algorithm. OUTCOMES: This patient got recovery after the treatments which were guided by the criterion of DCO. The restoration of limb functional and the quality of life greatly improved. LESSONS: The DCO plays a decisive role in the first aid and follow-up treatment of this patient. The guidelines of management of complex pelvic ring injuries and floating knee should be established by authorities.
[Mh] Termos MeSH primário: Fraturas Ósseas/terapia
Traumatismos do Joelho/terapia
Traumatismo Múltiplo/terapia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Contusões/etiologia
Contusões/terapia
Desbridamento
Feminino
Primeiros Socorros
Fraturas Ósseas/diagnóstico por imagem
Fraturas Ósseas/etiologia
Seres Humanos
Traumatismos do Joelho/diagnóstico por imagem
Traumatismos do Joelho/etiologia
Traumatismos da Perna/diagnóstico por imagem
Traumatismos da Perna/etiologia
Traumatismos da Perna/terapia
Meia-Idade
Traumatismo Múltiplo/diagnóstico por imagem
Traumatismo Múltiplo/etiologia
Ossos Pélvicos/diagnóstico por imagem
Fraturas das Costelas/diagnóstico por imagem
Fraturas das Costelas/etiologia
Fraturas das Costelas/terapia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008783


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[PMID]:29224655
[Au] Autor:Martin JG; Kassin M; Park P; Ermentrout RM; Dariushnia S
[Ad] Endereço:Department of Radiology and Imaging Sciences, Emory University Hospital, Atlanta, GA. Electronic address: jonathan.martin2@emory.edu.
[Ti] Título:Evaluation and Treatment of Blunt Pelvic Trauma.
[So] Source:Tech Vasc Interv Radiol;20(4):237-242, 2017 Dec.
[Is] ISSN:1557-9808
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Trauma is a significant contributor to mortality, especially in the young. Pelvic trauma with pelvic ring fractures may result in associated arterial injury, necessitating endovascular intervention. As a result, interventional radiology plays a critical role in partnering with trauma providers in the care of these patients. Management is determined by the acuity of the patient's clinical status, radiographs, ultrasound, and the results of computed tomography imaging when available. Numerous embolic agents are available for treatment of arterial hemorrhage.
[Mh] Termos MeSH primário: Traumatismos Abdominais/terapia
Embolização Terapêutica/métodos
Procedimentos Endovasculares/métodos
Ossos Pélvicos/lesões
Pelve/irrigação sanguínea
Radiografia Intervencionista
Lesões do Sistema Vascular/terapia
Ferimentos não Penetrantes/terapia
[Mh] Termos MeSH secundário: Traumatismos Abdominais/diagnóstico por imagem
Traumatismos Abdominais/fisiopatologia
Adolescente
Idoso
Angiografia Digital
Angiografia por Tomografia Computadorizada
Embolização Terapêutica/efeitos adversos
Procedimentos Endovasculares/efeitos adversos
Procedimentos Endovasculares/instrumentação
Feminino
Fraturas Ósseas/diagnóstico por imagem
Fraturas Ósseas/fisiopatologia
Hemodinâmica
Seres Humanos
Ossos Pélvicos/diagnóstico por imagem
Fluxo Sanguíneo Regional
Stents
Resultado do Tratamento
Ultrassonografia
Lesões do Sistema Vascular/diagnóstico por imagem
Lesões do Sistema Vascular/fisiopatologia
Ferimentos não Penetrantes/diagnóstico por imagem
Ferimentos não Penetrantes/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180105
[Lr] Data última revisão:
180105
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE


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[PMID]:29194450
[Au] Autor:Hsu SD; Lee SY; Lin KT; Lin CS; Chien WC; Chen CJ; Chung CH; Chang WK
[Ad] Endereço:Division of Traumatic and General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
[Ti] Título:Risk of infertility following pelvic angiographic embolization in female patients with pelvic fractures: A nationwide population-based cohort study in Taiwan.
[So] Source:PLoS One;12(12):e0174733, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Pelvic angiographic embolization is an effective procedure to provide haemostasis in patients with pelvic fractures. However, management with repeated follow-up radiographs may result in infertility. The study aimed to evaluate the risk of infertility following pelvic fracture treated with pelvic angiographic embolization in female patients. We used data from the National Health Insurance Research Database (NHIRD) provided by the Bureau of National Health Insurance of the Department of Health in Taiwan from the period of 1997-2010. A total of 36 and 18,029 patients were included in the case and control cohorts, respectively. The risk estimations for the case and control cohorts were compared using a Cox's proportional hazards regression model. The significance level was set at <0.05. After adjusting for possible confounding factors, the incidence of infertility in the case cohort was nearly 30.7-fold higher than that in the control cohort (adjust hazard ratio [HR] = 30.7, 95% confidence interval [CI] = 10.643-70.109). Patients between 15-35 years of age had a much higher incidence of infertility in the case cohort than in the control cohort (adjusted HR = 49.9, 95% CI = 15.177-64.099). Taken together, pelvic fractures in female patients treated with arterioembolization for haemostasis might be associated with a higher risk of infertility in Taiwan. Physicians should be aware of the link and inform patients of this risk prior to arterioembolization.
[Mh] Termos MeSH primário: Embolização Terapêutica/efeitos adversos
Fraturas Ósseas/terapia
Infertilidade Feminina/etiologia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Adolescente
Adulto
Angiografia
Estudos de Casos e Controles
Feminino
Seres Humanos
Meia-Idade
Taiwan
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171226
[Lr] Data última revisão:
171226
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171202
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0174733


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[PMID]:29212692
[Au] Autor:Herron J; Hutchinson R; Lecky F; Bouamra O; Edwards A; Woodford M; Eardley WGP
[Ad] Endereço:James Cook University Hospital, Middlesbrough TS4 3BW, UK.
[Ti] Título:The impact of age on major orthopaedic trauma: an analysis of the United Kingdom Trauma Audit Research Network database.
[So] Source:Bone Joint J;99-B(12):1677-1680, 2017 Dec.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients. RESULTS: Of 142 765 adults sustaining major trauma, 72 942 (51.09 %) had long bone or pelvic fractures and 45.81% of these were > 65 years old. Road traffic collision was the most common mechanism in the young (40.4%) and, in older people, fall from standing height (80.4%) predominated. The 30 day mortality in older patients with fractures is greater (6.8%  2.5%), although critical care episodes are more common in the young (18.2% 9.7%). Older people are less likely to be admitted to critical care beds and are often managed in isolation by surgeons. Orthopaedic surgery is the most common admitting and operating specialty and, in older people, fracture surgery accounted for 82.1% of procedures. CONCLUSION: Orthopaedic trauma in older people is associated with mortality that is significantly greater than for similar fractures in the young. As with the hip fracture population, major trauma in the elderly is a growing concern which highlights the need for a review of admission pathways and shared orthogeriatric care models. Cite this article: 2017;99-B:1677-80.
[Mh] Termos MeSH primário: Extremidades/lesões
Fraturas Ósseas/epidemiologia
Ossos Pélvicos/lesões
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Bases de Dados Factuais
Extremidades/cirurgia
Fraturas Ósseas/mortalidade
Fraturas Ósseas/cirurgia
Seres Humanos
Auditoria Médica
Meia-Idade
Traumatismo Múltiplo/epidemiologia
Traumatismo Múltiplo/mortalidade
Traumatismo Múltiplo/cirurgia
Ossos Pélvicos/cirurgia
Sistema de Registros
Reino Unido/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171213
[Lr] Data última revisão:
171213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B12.BJJ-2016-1140.R2



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