Base de dados : MEDLINE
Pesquisa : C26.088 [Categoria DeCS]
Referências encontradas : 4976 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 498 ir para página                         

  1 / 4976 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29190257
[Au] Autor:Scerbo MH; Holcomb JB; Taub E; Gates K; Love JD; Wade CE; Cotton BA
[Ad] Endereço:From the Center for Translational Injury Research (CeTIR) (M.H.S., J.B.H., C.E.W., B.A.C.), Department of Surgery (M.H.S., J.B.H., E.T., J.D.L., C.E.W., B.A.C.), and Department of Emergency Medicine (K.G.), The University of Texas Health Science Center, Houston, Texas; and Life Flight, Memorial Hermann Hospital, Houston, Texas (J.D.L.).
[Ti] Título:The trauma center is too late: Major limb trauma without a pre-hospital tourniquet has increased death from hemorrhagic shock.
[So] Source:J Trauma Acute Care Surg;83(6):1165-1172, 2017 Dec.
[Is] ISSN:2163-0763
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: To date, no civilian studies have demonstrated that pre-hospital (PH) tourniquets improve survival. We hypothesized that late, trauma center (TC) tourniquet use would increase death from hemorrhagic shock compared to early (PH) placement. METHODS: All patients arriving to a Level 1, urban TC between October 2008 and January 2016 with a tourniquet placed before (T-PH) or after arrival to the TC (T-TC) were evaluated. Cases were assigned the following designations: indicated (absolute indication [vascular injury requiring repair/ligation, operation within 2 hours for extremity injury, or traumatic amputation] or relative indication [major musculoskeletal/soft tissue injury requiring operation 2-8 hours after arrival, documented large blood loss]) or non-indicated. Outcomes were death from hemorrhagic shock, physiology upon arrival to the TC, and massive transfusion requirements. After univariate analysis, logistic regression was carried out to assess independent predictors of death from hemorrhagic shock. RESULTS: A total of 306 patients received 326 tourniquets for injuries to 157 upper and 147 lower extremities. Two hundred eighty-one (92%) had an indication for placement. Seventy percent of patients had a blunt mechanism of injury. T-TC patients arrived with a lower systolic blood pressure (SBP, 101 [86, 123] vs. 125 [100, 145] mm Hg, p < 0.001), received more transfusions in the first hour of arrival (55% vs. 34%, p = 0.02), and had a greater mortality from hemorrhagic shock (14% vs. 3.0%, p = 0.01). When controlling for year of admission, mechanism of injury and shock upon arrival (SBP ≤90 mm Hg or HR ≥120 bpm or base deficit ≤ 4) indicated T-TC had a 4.5-fold increased odds of death compared to T-PH (OR 4.5, 95% CI 1.23-16.4, p = 0.02). CONCLUSIONS: Waiting until TC arrival to control hemorrhage with a tourniquet was associated with worsened blood pressure and increased transfusion within the first hour of arrival. In routine civilian trauma patients, delaying to T-TC was associated with 4.5-fold increased odds of mortality from hemorrhagic shock. LEVEL OF EVIDENCE: Level IV.
[Mh] Termos MeSH primário: Serviços Médicos de Emergência/métodos
Hemorragia/complicações
Técnicas Hemostáticas/instrumentação
Choque Hemorrágico/mortalidade
Tempo para o Tratamento/tendências
Torniquetes/utilização
[Mh] Termos MeSH secundário: Adulto
Traumatismos do Braço/complicações
Feminino
Seguimentos
Hemorragia/mortalidade
Hemorragia/terapia
Seres Humanos
Traumatismos da Perna/complicações
Masculino
Meia-Idade
Estudos Retrospectivos
Choque Hemorrágico/etiologia
Choque Hemorrágico/terapia
Taxa de Sobrevida/tendências
Texas/epidemiologia
Centros de Traumatologia
População Urbana
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE
[do] DOI:10.1097/TA.0000000000001666


  2 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29132576
[Au] Autor:Evans C; Chaplin T; Zelt D
[Ad] Endereço:Trauma Services, Department of Emergency Medicine, Kingston General Hospital, Queen's University, Kingston, Ontario K7L 2V7, Canada. Electronic address: c.evans@queensu.ca.
[Ti] Título:Management of Major Vascular Injuries: Neck, Extremities, and Other Things that Bleed.
[So] Source:Emerg Med Clin North Am;36(1):181-202, 2018 Feb.
[Is] ISSN:1558-0539
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Vascular injuries represent a significant burden of mortality and disability. Blunt injuries to the neck vessels can present with signs of stroke either immediately or in a delayed fashion. Most injuries are detected with computed tomography angiography and managed with either antiplatelet medications or anticoagulation. In contrast, patients with penetrating injuries to the neck vessels require airway management, hemorrhage control, and damage control resuscitation before surgical repair. The keys to diagnosis and management of peripheral vascular injury include early recognition of the injury; hemorrhage control with direct pressure, packing, or tourniquets; and urgent surgical consultation.
[Mh] Termos MeSH primário: Hemorragia/terapia
Lesões do Sistema Vascular/terapia
[Mh] Termos MeSH secundário: Traumatismos do Braço/diagnóstico
Traumatismos do Braço/terapia
Angiografia por Tomografia Computadorizada
Hemorragia/diagnóstico
Hemorragia/etiologia
Seres Humanos
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/terapia
Pescoço/irrigação sanguínea
Lesões do Pescoço/diagnóstico
Lesões do Pescoço/terapia
Lesões do Sistema Vascular/diagnóstico
Lesões do Sistema Vascular/diagnóstico por imagem
Ferimentos não Penetrantes/diagnóstico
Ferimentos não Penetrantes/diagnóstico por imagem
Ferimentos não Penetrantes/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171115
[St] Status:MEDLINE


  3 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28825959
[Au] Autor:Lien J
[Ad] Endereço:Private Practice; Associate Physician, University of California San Diego, Rady Children's Hospital, San Diego, CA
[Ti] Título:Pediatric orthopedic injuries: evidence-based management in the emergency department
[So] Source:Pediatr Emerg Med Pract;14(9):1-28, 2017 09.
[Is] ISSN:1549-9650
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Upper and lower extremity injuries are common in children, with an overall risk of fracture estimated at just under 1 in 5 children. Pediatric bone anatomy and physiology produce age specific injury patterns and conditions that are unique to children, which can make accurate diagnosis difficult for emergency clinicians. This issue reviews the etiology and pathophysiology of child-specific fractures, as well as common injuries of the upper and lower extremities. Evidence-based recommendations for management of pediatric fractures, including appropriate diagnostic studies and treatment, are also discussed.
[Mh] Termos MeSH primário: Traumatismos do Braço/diagnóstico
Traumatismos do Braço/terapia
Serviço Hospitalar de Emergência
Medicina Baseada em Evidências
Fixação de Fratura/métodos
Fraturas Ósseas/diagnóstico
Fraturas Ósseas/terapia
Traumatismos da Perna/diagnóstico
Traumatismos da Perna/terapia
Sistema Musculoesquelético/lesões
[Mh] Termos MeSH secundário: Traumatismos do Braço/fisiopatologia
Criança
Pré-Escolar
Diagnóstico Diferencial
Fraturas Ósseas/fisiopatologia
Seres Humanos
Lactente
Recém-Nascido
Traumatismos da Perna/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170822
[St] Status:MEDLINE


  4 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28363171
[Au] Autor:Kaufman R; Fraade-Blanar L; Lipira A; Friedrich J; Bulger E
[Ad] Endereço:Harborview Injury Prevention and Research Center, University of Washington, P.O. Box 359960, 325 Ninth Avenue, Seattle, WA 98104, United States. Electronic address: rkaufman@uw.edu.
[Ti] Título:Severe soft tissue injuries of the upper extremity in motor vehicle crashes involving partial ejection: the protective role of side curtain airbags.
[So] Source:Accid Anal Prev;102:144-152, 2017 May.
[Is] ISSN:1879-2057
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Partial ejection (PE) of the upper extremity (UE) can occur in a motor vehicle crash (MVC) resulting in complex and severe soft tissue injuries (SSTI). This study evaluated the relationship between partial ejection and UE injuries, notably SSTIs, in MVCs focusing on crash types and characteristics, and further examined the role of side curtain airbags (SCABs) in the prevention of partial ejection and reducing SSTI of the UE. METHODS: Weighted data was analyzed from the National Automotive Sampling System Crashworthiness Data System (NASS-CDS) from 1993 to 2012. Logistic regression models were used to assess the relationship of PE with SSTI of the UE and the effect of SCABs in both nearside impacts and rollover collisions. Crash Injury Research and Engineering Network (CIREN) case studies illustrated PE involving SSTI of the UE, and long term treatment. RESULTS: Rollover and nearside impact collisions had the highest percentages of partial ejection, with over half occurring in rollover collisions. Annually over 800 SSTIs of the UE occurred in all MVCs. For nearside lateral force impacts, a multivariable analysis adjusting for belt use and delta V showed a 15 times (OR 15.35, 95% CI 4.30, 54.79) greater odds of PE for occupants without SCABs compared to those with a SCAB deployment. No occupants (0 of 51,000) sustained a SSTI of the UE when a SCAB deployed in nearside impacts, compared to 0.01% (114 of 430,000) when SCABs were unavailable or did not deploy. In rollover collisions, a multivariable analysis adjusted for number of quarter turns and belt use showed 3 times the odds (OR 3.02, 95% CI 1.22, 7.47) of PE for occupants without SCABs compared to those with a SCAB deployment. Just 0.17% (32 of 19,000) of the occupants sustained a SSTI of the UE in rollovers with a SCAB deployment, compared to 0.53% (2294 of 431,000) of the occupants when SCABs were unavailable or did not deploy. CIREN case studies illustrated the injury causation of SSTI of the UE due to partial ejection, and the long term treatment and medical costs associated with a SSTI to the UE. CONCLUSIONS: The majority of severe soft tissue injuries (SSTI) of the upper extremity (UE) involved partial ejection out the nearside window of outboard seated occupants in nearside impacts and rollover collisions. Real world case studies showed that SSTIs of the upper extremity require extensive treatment, extended hospitalization and are costly. Occupants without a side curtain airbag (SCAB) deployment had an increase in the odds of partial ejection. SCAB deployments provided protection against partial ejection and prevented SSTIs of the UE, with none occurring in nearside impacts, and a small percentage and reduction occurring in rollover collisions compared to those where SCABs were unavailable or did not deploy.
[Mh] Termos MeSH primário: Acidentes de Trânsito
Air Bags
Traumatismos do Braço/prevenção & controle
Veículos Automotores
Lesões dos Tecidos Moles/prevenção & controle
[Mh] Termos MeSH secundário: Adolescente
Adulto
Traumatismos do Braço/etiologia
Engenharia
Feminino
Hospitalização
Seres Humanos
Modelos Logísticos
Assistência de Longa Duração
Masculino
Meia-Idade
Cintos de Segurança
Lesões dos Tecidos Moles/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170531
[Lr] Data última revisão:
170531
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170401
[St] Status:MEDLINE


  5 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28340130
[Au] Autor:McDonough CM; Colla CH; Carmichael D; Tosteson ANA; Tosteson TD; Bell JE; Cantu RV; Lurie JD; Bynum JPW
[Ti] Título:Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.
[So] Source:Phys Ther;97(3):280-289, 2017 Mar 01.
[Is] ISSN:1538-6724
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Background: Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. Objective: The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Design: Observational cohort. Methods: Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. Results: There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Limitations: Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. Conclusions: A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population.
[Mh] Termos MeSH primário: Acidentes por Quedas
Traumatismos do Braço/terapia
Fraturas Ósseas/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Traumatismos do Braço/etiologia
Estudos de Coortes
Feminino
Fraturas Ósseas/etiologia
Marcha
Seres Humanos
Modelos Logísticos
Masculino
Medicare
Medição de Risco
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170325
[St] Status:MEDLINE
[do] DOI:10.1093/ptj/pzx009


  6 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28314473
[Au] Autor:Mewa Kinoo S; Singh B
[Ad] Endereço:King Edward VIII Hospital and Department of Surgery, University of KwaZulu-Natal, Durban, South Africa. Electronic address: smewakinoo@gmail.com.
[Ti] Título:Complex regional pain syndrome in burn pathological scarring: A case report and review of the literature.
[So] Source:Burns;43(3):e47-e52, 2017 May.
[Is] ISSN:1879-1409
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:Chronic pain in burn pathological scarring is not an uncommon occurrence. The mechanisms of pain are not clearly understood and hence the management approach is often a daunting task. However, meticulous physical examination of these patients may classify them as complex regional pain syndrome, type I. We present a patient with classic signs and symptoms of complex regional pain syndrome associated with burn pathological scarring of her left forearm that had a favourable response to a thoracoscopic sympathectomy. The possible pathological mechanisms of burn pathological scarring, mechanisms of pain, and complex regional pain syndrome are reviewed.
[Mh] Termos MeSH primário: Traumatismos do Braço/complicações
Queimaduras/complicações
Cicatriz Hipertrófica/etiologia
Síndromes da Dor Regional Complexa/cirurgia
Simpatectomia/métodos
Toracoscopia/métodos
[Mh] Termos MeSH secundário: Síndromes da Dor Regional Complexa/etiologia
Feminino
Antebraço
Seres Humanos
Hiperpigmentação/etiologia
Hipopigmentação/etiologia
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170319
[St] Status:MEDLINE


  7 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28299393
[Au] Autor:Wichelhaus A; Emmerich J; Mittlmeier T
[Ad] Endereço:Arbeitsbereich Handchirurgie, Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Schillingallee 35, 18055, Rostock, Deutschland. alice.wichelhaus@med.uni-rostock.de.
[Ti] Título:[Posttraumatic nerve entrapment syndromes in the upper extremities].
[Ti] Título:Posttraumatische Nervenkompressionssyndrome der oberen Extremität..
[So] Source:Unfallchirurg;120(4):329-343, 2017 Apr.
[Is] ISSN:1433-044X
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Nerve entrapment syndromes in the upper extremities are common clinical disease patterns, less often as direct results of accidents. The most frequent compression syndrome is the carpal tunnel syndrome followed by the cubital tunnel syndrome. If the cause of the compression cannot be eliminated by conservative treatment options, an operative therapy is necessary. As the prognosis becomes worse with the duration of the nerve compression, it is important to initiate therapy at an early stage.
[Mh] Termos MeSH primário: Traumatismos do Braço/diagnóstico
Traumatismos do Braço/terapia
Descompressão Cirúrgica/métodos
Eletrodiagnóstico/métodos
Imobilização/métodos
Síndromes de Compressão Nervosa/diagnóstico
[Mh] Termos MeSH secundário: Traumatismos do Braço/complicações
Terapia Combinada/métodos
Diagnóstico Diferencial
Medicina Baseada em Evidências
Seres Humanos
Síndromes de Compressão Nervosa/etiologia
Procedimentos Neurocirúrgicos/métodos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE
[do] DOI:10.1007/s00113-017-0340-3


  8 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
[PMID]:28234112
[Au] Autor:Warnack E; Heyer J; Sethi M; Tandon M; DiMaggio C; Pachter HL; Frangos SG
[Ad] Endereço:NYU School of Medicine, New York, New York 10016, USA.
[Ti] Título:Urban Bicyclist Trauma: Characterizing the Injuries, Consequent Surgeries, and Essential Sub-Specialties Providing Care.
[So] Source:Am Surg;83(1):16-22, 2017 Jan 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In the United States in 2013, nearly 500,000 bicyclists were injured and required emergency department care. The objectives of this study were to describe the types of injuries which urban bicyclists sustain, to analyze the number and type of surgeries required, and to better delineate the services providing care. This is an observational study of injured bicyclists presenting to a Level I trauma center between February 2012 and August 2014. Most data were collected within 24 hours of injury and included demographics, narrative description of the incident, results of initial imaging studies, Injury Severity Score, admission status, length of stay, surgical procedure, and admitting and discharging service. A total of 706 injured bicyclists were included in the study, and 187 bicyclists (26.4%) required hospital admission. Of those admitted, 69 (36.8%) required surgery. There was no difference in gender between those who required surgery and those who did not (P = 0.781). Those who required surgery were older (mean age 39.1 vs 34.1, P = 0.003). Patients requiring surgery had higher Abbreviated Injury Scores for head (P ≤ 0.001), face (P ≤ 0.001), abdomen (P = 0.012), and extremity (P ≤ 0.001) and higher mean Injury Severity Scores (12.6 vs 3.7, P < 0.001). Sixty-nine patients required surgery and were brought to the operating room 82 times for 89 distinct procedures. Lower extremity injuries were the reason for 43 (48.3%) procedures, upper extremity injuries for 14 (15.7%), and facial injuries for 15 (16.9%). Orthopedic surgery performed 50 (56.2%) procedures, followed by plastic surgery (15 procedures; 16.8%). Trauma surgeons performed five (5.6%) procedures in four patients. The majority of admitted patients were admitted and discharged by the trauma service (70.1%, 56.7%, respectively) followed by the orthopedics service (13.9%, 19.8%, respectively). Injured bicyclists represent a unique subset of trauma patients. Orthopedic surgeons are most commonly involved in their operative management and rarely are the operative skills of a general traumatologist required. From a resource perspective, it is more efficient to direct the inpatient care of bicyclists with single-system trauma to the appropriate surgical subspecialty service soon after appropriate initial evaluation and treatment by the trauma service.
[Mh] Termos MeSH primário: Traumatismos Abdominais/epidemiologia
Traumatismos do Braço/epidemiologia
Ciclismo/lesões
Traumatismos Craniocerebrais/epidemiologia
Traumatismos Faciais/epidemiologia
Escala de Gravidade do Ferimento
Traumatismos da Perna/epidemiologia
[Mh] Termos MeSH secundário: Escala Resumida de Ferimentos
Traumatismos Abdominais/cirurgia
Adulto
Fatores Etários
Idoso
Traumatismos do Braço/cirurgia
Ciclismo/estatística & dados numéricos
Traumatismos Craniocerebrais/cirurgia
Traumatismos Faciais/cirurgia
Feminino
Seres Humanos
Traumatismos da Perna/cirurgia
Tempo de Internação
Masculino
Meia-Idade
Cidade de Nova Iorque/epidemiologia
Procedimentos Ortopédicos/estatística & dados numéricos
Ortopedia/estatística & dados numéricos
Centros de Traumatologia/estatística & dados numéricos
Estados Unidos/epidemiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170310
[Lr] Data última revisão:
170310
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170225
[St] Status:MEDLINE


  9 / 4976 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28209508
[Au] Autor:Resnik L; Borgia M; Silver B; Cancio J
[Ad] Endereço:Providence VA Medical Center, Providence, RI; Health Services, Policy and Practice, Brown University, Providence, RI. Electronic address: Linda.Resnik@va.gov.
[Ti] Título:Systematic Review of Measures of Impairment and Activity Limitation for Persons With Upper Limb Trauma and Amputation.
[So] Source:Arch Phys Med Rehabil;98(9):1863-1892.e14, 2017 Sep.
[Is] ISSN:1532-821X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: (1) To identify outcome measures used in studies of persons with traumatic upper limb injury and/or amputation; and (2) to evaluate focus, content, and psychometric properties of each measure. DATA SOURCES: Searches of PubMed and CINAHL for terms including upper extremity, function, activities of daily living, outcome assessment, amputation, and traumatic injuries. STUDY SELECTION: Included articles had a sample of ≥10 adults with limb trauma or amputation and were in English. Measures containing most items assessing impairment of body function or activity limitation were eligible. DATA EXTRACTION: There were 260 articles containing 55 measures that were included. Data on internal consistency; test-retest, interrater, and intrarater reliability; content, structural, construct, concurrent, and predictive validity; responsiveness; and floor/ceiling effects were extracted and confirmed by a second investigator. DATA SYNTHESIS: The mostly highly rated performance measures included 2 amputation-specific measures (Activities Measure for Upper Limb Amputees and University of New Brunswick Test of Prosthetic Function skill and spontaneity subscales) and 2 non-amputation-specific measures (Box and Block Test and modified Jebsen-Taylor Hand Function Test light and heavy cans tests). Most highly rated self-report measures were Disabilities of the Arm, Shoulder and Hand; Patient Rated Wrist Evaluation; QuickDASH; Hand Assessment Tool; International Osteoporosis Foundation Quality of Life Questionnaire; and Patient Rated Wrist Evaluation functional recovery subscale. None were amputation specific. CONCLUSIONS: Few performance measures were recommended for patients with limb trauma and amputation. All top-rated self-report measures were suitable for use in both groups. These results will inform choice of outcome measures for these patients.
[Mh] Termos MeSH primário: Amputação/reabilitação
Amputados/reabilitação
Traumatismos do Braço/reabilitação
Avaliação da Deficiência
Medidas de Resultados Relatados pelo Paciente
[Mh] Termos MeSH secundário: Atividades Cotidianas
Amputação/métodos
Amputação/psicologia
Amputados/psicologia
Traumatismos do Braço/fisiopatologia
Traumatismos do Braço/psicologia
Seres Humanos
Psicometria
Qualidade de Vida
Reprodutibilidade dos Testes
Resultado do Tratamento
Extremidade Superior/lesões
Extremidade Superior/fisiopatologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170218
[St] Status:MEDLINE


  10 / 4976 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28148670
[Au] Autor:Macke C; Winkelmann M; Mommsen P; Probst C; Zelle B; Krettek C; Zeckey C
[Ad] Endereço:Trauma Department, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
[Ti] Título:Injuries to the upper extremities in polytrauma: limited effect on outcome more than ten years after injury - a cohort study in 629 patients.
[So] Source:Bone Joint J;99-B(2):255-260, 2017 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To analyse the influence of upper extremity trauma on the long-term outcome of polytraumatised patients. PATIENTS AND METHODS: A total of 629 multiply injured patients were included in a follow-up study at least ten years after injury (mean age 26.5 years, standard deviation 12.4). The extent of the patients' injury was classified using the Injury Severity Score. Outcome was measured using the Hannover Score for Polytrauma Outcome (HASPOC), Short Form (SF)-12, rehabilitation duration, and employment status. Outcomes for patients with and without a fracture of the upper extremity were compared and analysed with regard to specific fracture regions and any additional brachial plexus lesion. RESULTS: In all, 307 multiply-injured patients with and 322 without upper extremity injuries were included in the study. The groups with and without upper limb injuries were similar with respect to demographic data and injury pattern, except for midface trauma. There were no significant differences in the long-term outcome. In patients with brachial plexus lesions there were significantly more who were unemployed, required greater retraining and a worse HASPOC. CONCLUSION: Injuries to the upper extremities seem to have limited effect on long-term outcome in patients with polytrauma, as long as no injury was caused to the brachial plexus. Cite this article: Bone Joint J 2017;99-B:255-60.
[Mh] Termos MeSH primário: Traumatismos do Braço/reabilitação
Neuropatias do Plexo Braquial/reabilitação
Plexo Braquial/lesões
Fraturas Ósseas/reabilitação
Traumatismo Múltiplo/reabilitação
Lesões do Ombro/reabilitação
Extremidade Superior/lesões
[Mh] Termos MeSH secundário: Adolescente
Adulto
Neuropatias do Plexo Braquial/etiologia
Criança
Pré-Escolar
Estudos de Coortes
Feminino
Seguimentos
Seres Humanos
Escala de Gravidade do Ferimento
Masculino
Meia-Idade
Traumatismo Múltiplo/terapia
Condições Sociais
Fatores de Tempo
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170203
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B2.37999



página 1 de 498 ir para página                         
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde