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[PMID]:28460647
[Au] Autor:Ono Y; Kunii M; Miura T; Shinohara K
[Ad] Endereço:Emergency and Critical Care Medical Center, Fukushima Medical University Hospital, 1 Hikarigaoka, Fukushima, Fukushima, 960-1295, Japan. windmill@fmu.ac.jp.
[Ti] Título:"Cannot ventilate, cannot intubate" situation after penetration of the tongue root through to the epipharynx by a surfboard: a case report.
[So] Source:J Med Case Rep;11(1):121, 2017 May 01.
[Is] ISSN:1752-1947
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Surfing is an increasingly popular activity and surfing-related injuries have increased accordingly. However, to the best of our knowledge, there are no reports of penetrating upper airway injuries in surfers. We present a "cannot ventilate, cannot intubate" situation following penetrating neck injury by a surfboard fin. CASE PRESENTATION: A previously healthy 29-year-old Japanese man was swept off his board by a large wave and his left mandible, tongue root, and right epipharynx were penetrated by the surfboard fin. He presented with severe hypovolemic shock because of copious bleeding from his mouth. Direct laryngoscopy failed, as did manual ventilation, because of the exacerbated upper airway bleeding and distorted upper airway anatomy. Open cricothyrotomy was immediately performed, followed by surgical exploration, which revealed extensive ablation of his tongue root and laceration of his lingual artery. After definitive hemostasis and intensive care, he returned home with no sequelae. CONCLUSIONS: The long, semi-sharp surfboard fin created both extensive crushing upper airway lesions and a sharp vascular injury, resulting in a difficult airway. This case illustrates that surfing injuries can prompt a life-threatening airway emergency and serves as a caution for both surfers and health care professionals.
[Mh] Termos MeSH primário: Tratamento de Emergência
Intubação Intratraqueal/instrumentação
Lesões do Pescoço/terapia
Língua/lesões
Traqueotomia/métodos
Esportes Aquáticos/lesões
Ferimentos Penetrantes/terapia
[Mh] Termos MeSH secundário: Adulto
Cartilagem Cricoide
Cuidados Críticos
Tratamento de Emergência/instrumentação
Tratamento de Emergência/métodos
Seres Humanos
Intubação Intratraqueal/métodos
Masculino
Lesões do Pescoço/fisiopatologia
Glândula Tireoide
Resultado do Tratamento
Ferimentos Penetrantes/fisiopatologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170503
[St] Status:MEDLINE
[do] DOI:10.1186/s13256-017-1284-5


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[PMID]:29229116
[Au] Autor:Ibraheem K; Khan M; Rhee P; Azim A; O'Keeffe T; Tang A; Kulvatunyou N; Joseph B
[Ad] Endereço:Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.
[Ti] Título:"No zone" approach in penetrating neck trauma reduces unnecessary computed tomography angiography and negative explorations.
[So] Source:J Surg Res;221:113-120, 2018 Jan.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The most recent management guidelines advocate computed tomography angiography (CTA) for any suspected vascular or aero-digestive injuries in all zones and give zone II injuries special consideration. We hypothesized that physical examination can safely guide CTA use in a "no zone" approach. METHODS: An 8-year retrospective analysis of all adult trauma patients with penetrating neck trauma (PNT) was performed. We included all patients in whom the platysma was violated. Patients were classified into three groups as follows: hard signs, soft signs, and asymptomatic. CTA use, positive CTA (contrast extravasation, dissection, or intimal flap) and operative details were reported. Primary outcomes were positive CTA and therapeutic neck exploration (TNE) (defined by repair of major vascular or aero-digestive injuries). RESULTS: A total of 337 patients with PNT met the inclusion criteria. Eighty-two patients had hard signs and all of them went to the operating room, of which 59 (72%) had TNE. One hundred fifty-six patients had soft signs, of which CTA was performed in 121 (78%), with positive findings in 12 (10%) patients. The remaining 35 (22%) underwent initial neck exploration, of which 14 (40%) were therapeutic yielding a high rate of negative exploration. Ninty-nine patients were asymptomatic, of which CTA was performed in 79 (80%), with positive findings in 3 (4%), however, none of these patients required TNE. On sub analysis based on symptoms, there was no difference in the rate of TNE between the neck zones in patients with hard signs (P = 0.23) or soft signs (P = 0.51). Regardless of the zone of injury, asymptomatic patients did not require a TNE. CONCLUSIONS: Physical examination regardless of the zone of injury should be the primary guide to CTA or TNE in patients with PNT. Following traditional zone-based guidelines can result in unnecessary negative explorations in patients with soft signs and may need rethinking.
[Mh] Termos MeSH primário: Angiografia por Tomografia Computadorizada/utilização
Lesões do Pescoço/diagnóstico por imagem
Ferimentos Penetrantes/diagnóstico por imagem
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Estudos Retrospectivos
Procedimentos Desnecessários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171220
[Lr] Data última revisão:
171220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE


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[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


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[PMID]:28964302
[Au] Autor:Swords C; Tan NC; Jonas N
[Ad] Endereço:Department of Paediatric Otolaryngology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
[Ti] Título:The implications of pneumomediastinum and subcutaneous emphysema for the paediatric otolaryngologist.
[So] Source:Int J Pediatr Otorhinolaryngol;101:241-245, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Three patients presented within a 6-month period with pneumomediastinum. The underlying cause in each was distinct. One case occurred due to blunt laryngeal trauma and required urgent surgical intervention due to a decompensating airway. The second case was related to tracheal perforation secondary to a myofibroblastic tracheal tumour and the final case was related to adenovirus upper respiratory tract infection. Pneumomediastinum may be spontaneous or secondary to an underlying cause. Children should be managed using a multidisciplinary approach. Investigation and management should be influenced by clinical stability and invasive procedures should only be considered in patients who exhibit respiratory distress.
[Mh] Termos MeSH primário: Enfisema Mediastínico/etiologia
Enfisema Subcutâneo/etiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Seres Humanos
Laringe/lesões
Masculino
Lesões do Pescoço/complicações
Otorrinolaringologistas
Tomografia Computadorizada por Raios X
Traqueia/lesões
Ferimentos não Penetrantes/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


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[PMID]:28857769
[Au] Autor:Francisco GE; Yozbatiran N; Berliner J; OʼMalley MK; Pehlivan AU; Kadivar Z; Fitle K; Boake C
[Ad] Endereço:From the Department of Physical Medicine and Rehabilitation, University of Texas Health Science Center McGovern Medical School at Houston and the NeuroRecovery Research Center at TIRR Memorial Hermann, Houston, Texas (GEF, NY, JB, CB); Department of Mechanical Engineering, Rice University, Houston, Texas (MKO, AUP, ZK, KF); and The Institute for Rehabilitation and Research/Memorial Hermann, Houston, Texas (MKO).
[Ti] Título:Robot-Assisted Training of Arm and Hand Movement Shows Functional Improvements for Incomplete Cervical Spinal Cord Injury.
[So] Source:Am J Phys Med Rehabil;96(10 Suppl 1):S171-S177, 2017 Oct.
[Is] ISSN:1537-7385
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of the study was to demonstrate the feasibility, tolerability, and effectiveness of robotic-assisted arm training in incomplete chronic tetraplegia. DESIGN: Pretest/posttest/follow-up was conducted. Ten individuals with chronic cervical spinal cord injury were enrolled. Participants performed single degree-of-freedom exercise of upper limbs at an intensity of 3-hr per session for 3 times a week for 4 wks with MAHI Exo-II. Arm and hand function tests (Jebsen-Taylor Hand Function Test, Action Research Arm Test), strength of upper limb (upper limb motor score, grip, and pinch strength), and independence in daily living activities (Spinal Cord Independence Measure II) were performed at baseline, end of training, and 6 mos later. RESULTS: After 12 sessions of training, improvements in arm and hand functions were observed. Jebsen-Taylor Hand Function Test (0.14[0.04]-0.21[0.07] items/sec, P = 0.04), Action Research Arm Test (30.7[3.8]-34.3[4], P = 0.02), American Spinal Injury Association upper limb motor score (31.5[2.3]-34[2.3], P = 0.04) grip (9.7[3.8]-12[4.3] lb, P = 0.02), and pinch strength (4.5[1.1]-5.7[1.2] lb, P = 0.01) resulted in significant increases. Some gains were maintained at 6 mos. No change in Spinal Cord Independence Measure II scores and no adverse events were observed. CONCLUSIONS: Results from this pilot study suggest that repetitive training of arm movements with MAHI Exo-II exoskeleton is safe and has potential to be an adjunct treatment modality in rehabilitation of persons with spinal cord injury with mild to moderate impaired arm functions.
[Mh] Termos MeSH primário: Vértebras Cervicais/lesões
Lesões do Pescoço/reabilitação
Modalidades de Fisioterapia/instrumentação
Robótica/métodos
Traumatismos da Medula Espinal/reabilitação
[Mh] Termos MeSH secundário: Adulto
Braço/fisiopatologia
Estudos de Viabilidade
Feminino
Mãos/fisiopatologia
Seres Humanos
Masculino
Meia-Idade
Movimento/fisiologia
Lesões do Pescoço/fisiopatologia
Projetos Piloto
Força de Pinça
Recuperação de Função Fisiológica
Traumatismos da Medula Espinal/fisiopatologia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170901
[St] Status:MEDLINE
[do] DOI:10.1097/PHM.0000000000000815


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[PMID]:28828914
[Au] Autor:Lanigan A; Lindsey B; Maturo S; Brennan J; Laury A
[Ad] Endereço:1 Department of Otolaryngology-Head & Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA.
[Ti] Título:The Joint Facial and Invasive Neck Trauma (J-FAINT) Project, Iraq and Afghanistan: 2011-2016.
[So] Source:Otolaryngol Head Neck Surg;157(4):602-607, 2017 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective Define the number and type of facial and penetrating neck injuries sustained in combat operations in Iraq and Afghanistan from 2011 to 2016. Compare recent injury trends to prior years of modern conflict. Study Design Case series with chart review. Setting Tertiary care hospital. Methods The Joint Theater Trauma Registry (JTTR) was queried for facial and neck injuries from Iraq and Afghanistan from June 2011 to May 2016. Injury patterns, severity, and patient demographics were analyzed and compared to previously published data from combat operations during January 2003 to May 2011. Results A total of 5312 discrete facial and neck injuries among 922 service members were identified. There were 3842 soft tissue injuries (72.3%) of the head/neck and 1469 (27.7%) facial fractures. Soft tissue injuries of the face/cheek (31.4%) and neck/larynx/trachea (18.8%) were most common. The most common facial fractures were of the orbit (26.3%) and maxilla/zygoma (25.1%). Injuries per month were highest in 2011 to 2012 and steadily declined through 2016. The percentage of nonbattle injuries trended up over time, ranging from 14.7% to 65%. Concurrent facial/neck soft tissue trauma or fracture was associated with an overall mortality rate of 2.44%. Comparison of our data to that previously published revealed no statistical difference in concurrent mortality (3.5%-2.2%, P = .053); an increase in orbital fractures ( P < .005), facial nerve injury ( P < .0005), and ear/tympanic membrane perforations ( P < .0005); and a decrease in mandible fractures ( P < .005). Conclusion Penetrating neck and facial injuries remain common in modern warfare. Assessing injury characteristics and trends supports continued improvements in battlefield protection and identifies areas requiring further intervention.
[Mh] Termos MeSH primário: Traumatismos Faciais/diagnóstico
Militares
Lesões do Pescoço/diagnóstico
Fraturas Cranianas/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Campanha Afegã de 2001-
Afeganistão/epidemiologia
Traumatismos Faciais/epidemiologia
Feminino
Seguimentos
Seres Humanos
Incidência
Iraque/epidemiologia
Guerra do Iraque 2003-2011
Masculino
Meia-Idade
Lesões do Pescoço/epidemiologia
Estudos Retrospectivos
Fraturas Cranianas/diagnóstico
Fatores de Tempo
Índices de Gravidade do Trauma
Ferimentos Penetrantes/diagnóstico
Ferimentos Penetrantes/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170823
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817725713


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[PMID]:28692478
[Au] Autor:Legaz Pérez I; Falcón M; Gimenez M; Diaz FM; Pérez-Cárceles MD; Osuna E; Nuno-Vieira D; Luna A
[Ad] Endereço:From the *Department of Legal and Forensic Medicine, Biomedical Research Institute, Regional Campus of International Excellence "Campus Mare Nostrum," Faculty of Medicine, University of Murcia, Murcia, Spain; †Institute for Legal Medicine, Sao Paulo, Brazil; and ‡Institute for Legal Medicine, Coimbra, Portugal.
[Ti] Título:Diagnosis of Vitality in Skin Wounds in the Ligature Marks Resulting From Suicide Hanging.
[So] Source:Am J Forensic Med Pathol;38(3):211-218, 2017 Sep.
[Is] ISSN:1533-404X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ascertaining the vital origin of skin wounds is one of the most challenging problems in forensic pathology. The forensic literature describes biomarkers and methods for differentiating vital and postmortem wounds, although no clear conclusions have been reached. The aim of this study was to characterize human vital wounds by analyzing the concentrations of metallic ions and the expression of P-selectin and cathepsin D in skin wounds in the ligature marks in a cohort of suicidal hangings for which vitality was previously demonstrated.A total of 71 skin wounds were analyzed within a postmortem interval of 19 to 36 hours. The concentration of Fe, Zn, Mg, and Ca and the expression of P-selectin and cathepsin D were analyzed together and separately. The majority of autopsied suicidal hangings were men (86%) with complete hanging mode (60.7%) in which there was a high frequency of subcutaneous injuries (78.3%). High concentrations of Ca and Mg compared with Fe and Zn were found. Ca and Zn concentrations decreased, and Fe concentration increased with the seriousness of the injury. A high percentage of moderately negative expression of both proteins was correlated with subcutaneous injury and low or medium concentrations of Fe.In conclusion, the joint study of metallic ions and proteins allows to characterize and to differentiate an injured vital wound of noninjured skin, especially when the damage in the tissue affects to the majority of the structures of the skin, but these results will need to be complemented with other biomarkers in time-controlled samples to further help in the differentiation of vital and postmortem wounds.
[Mh] Termos MeSH primário: Asfixia/patologia
Lesões do Pescoço/patologia
Pele/metabolismo
Suicídio
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Cálcio/metabolismo
Catepsina D/metabolismo
Feminino
Seres Humanos
Imuno-Histoquímica
Ferro/metabolismo
Magnésio/metabolismo
Masculino
Meia-Idade
Selectina-P/metabolismo
Mudanças Depois da Morte
Pele/lesões
Adulto Jovem
Zinco/metabolismo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (P-Selectin); E1UOL152H7 (Iron); EC 3.4.23.5 (Cathepsin D); I38ZP9992A (Magnesium); J41CSQ7QDS (Zinc); SY7Q814VUP (Calcium)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170711
[St] Status:MEDLINE
[do] DOI:10.1097/PAF.0000000000000322


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[PMID]:28672416
[Au] Autor:Valentin ML; Thalhammer C
[Ti] Título:[25-Year-Old Man after a Gunshot Injury at the Neck].
[Ti] Título:25-jähriger Mann nach Schussverletzung am Hals..
[So] Source:Dtsch Med Wochenschr;142(13):949, 2017 Jul.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Mh] Termos MeSH primário: Lesões das Artérias Carótidas
Lesões do Pescoço
Pescoço
Ferimentos por Arma de Fogo
[Mh] Termos MeSH secundário: Adulto
Implante de Prótese Vascular
Lesões das Artérias Carótidas/diagnóstico por imagem
Lesões das Artérias Carótidas/cirurgia
Seres Humanos
Masculino
Pescoço/irrigação sanguínea
Pescoço/diagnóstico por imagem
Lesões do Pescoço/diagnóstico por imagem
Lesões do Pescoço/cirurgia
Ultrassonografia Doppler
Ferimentos por Arma de Fogo/diagnóstico por imagem
Ferimentos por Arma de Fogo/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170704
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-106768


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[PMID]:28662866
[Au] Autor:Angrigiani C; Artero G; Sereday C; Khouri RK; French ZP
[Ad] Endereço:Fundacion Marko, Centenario 133, Buenos Aires, Argentina.
[Ti] Título:Refining the extended circumflex scapular flap for neck burn reconstruction: A 30-year experience.
[So] Source:J Plast Reconstr Aesthet Surg;70(9):1252-1260, 2017 Sep.
[Is] ISSN:1878-0539
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Neck burn sequelae remain a major challenge for the reconstructive surgeon. To achieve satisfactory functional and aesthetic results, the anterior neck aesthetic unit must be covered as a single unit. In cases where free flaps are required, harvesting a flap of sufficient size can cause major donor site morbidity. In 1994, we published our favorable 6-year experience of reconstructing neck burn sequelae with an extended circumflex scapular flap (ECSF). Since then, we have made several modifications to the technique, resulting in improved long-term functional and aesthetic results. Herein, we present our 30-year, 150-patient experience with the ECSF flap for the treatment of anterior neck burn sequelae. METHODS: We retrospectively reviewed the records of 150 consecutive patients who underwent ECSF procedure for neck resurfacing performed or supervised by the senior author from 1986 to 2015. All cases were assessed for function, aesthetics, satisfaction, and complications. RESULTS: A total of 160 ECSFs were used in 150 patients. Ninety-nine patients were available for updated follow-up [1-30 years (mean, 15.3)]. At the last follow-up, 92 patients regained full range of motion, and 90 patients had acceptable cervicomental angle (<110°). The mean patient satisfaction score was 4.8/5. Nine flaps (5.6%) failed completely and were successfully replaced. Twenty-two patients (15%) had distal necrosis of the flap. Fifteen of these 22 patients underwent complementary flaps to replace the necrotic area, and all 15 patients regained full range of motion. CONCLUSIONS: For neck burn sequelae, the ECSF provides safe and effective long-term functional and aesthetic results with minimal donor site morbidity.
[Mh] Termos MeSH primário: Queimaduras/cirurgia
Lesões do Pescoço/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Adulto
Árvores de Decisões
Feminino
Seres Humanos
Estudos Retrospectivos
Escápula
Fatores de Tempo
Adulto Jovem
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170914
[Lr] Data última revisão:
170914
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE


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[PMID]:28659112
[Au] Autor:Lukaszyk C; Harvey LA; Sherrington C; Close JC; Coombes J; Mitchell RJ; Moore R; Ivers R
[Ad] Endereço:George Institute for Global Health, University of Sydney, Sydney, NSW clukaszyk@georgeinstitute.org.au.
[Ti] Título:Fall-related hospitalisations of older Aboriginal and Torres Strait Islander people and other Australians.
[So] Source:Med J Aust;207(1):31-35, 2017 Jul 03.
[Is] ISSN:1326-5377
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To compare the socio-demographic characteristics and type of injury sustained, the use of hospital resources and rates of hospitalisation by injury type, and survival following fall injuries to older Aboriginal people and non-Indigenous Australian people hospitalised for fall-related injuries. DESIGN: Population-based retrospective cohort data linkage study. Setting, participants: New South Wales residents aged 50 years or more admitted to a public or private NSW hospital for a fall-related injury during 1 January 2003 - 31 December 2012. MAIN OUTCOME MEASURES: Proportions of patients with defined injury types, mean hospital length of stay (LOS), 30-day mortality, age-standardised hospitalisation rates and age-adjusted rate ratios, 28-day re-admission rates. RESULTS: There were 312 758 fall-related injury hospitalisations for 234 979 individuals; 2660 admissions (0.85%) were of Aboriginal people. The proportion of hospitalisations for fall-related fracture injuries was lower for Aboriginal than for non-Indigenous Australians (49% v 60% of fall-related hospitalisations; P < 0.001). The major injury type for Aboriginal patients was non-fracture injury to head or neck (19% of hospitalisations); for non-Indigenous patients it was hip fractures (18%). Age-adjusted LOS was lower for Aboriginal than for non-Indigenous patients (9.1 v 14.0 days; P < 0.001), as was 30-day mortality (2.9% v 4.2%; P < 0.001). For Aboriginal people, fall injury hospitalisations increased at an annual rate of 5.8% (95% CI, 4.0-7.7%; P < 0.001); for non-Indigenous patients, the mean annual increase was 2.5% (95% CI, 2.1-3.0; P < 0.001). CONCLUSIONS: The patterns of injury and outcomes of fall injury hospitalisations were different for older Aboriginal people and other older Australians, suggesting that different approaches are required to prevent and treat fall injuries.
[Mh] Termos MeSH primário: Acidentes por Quedas/estatística & dados numéricos
Traumatismos Craniocerebrais/etnologia
Fraturas do Quadril/etnologia
Lesões do Pescoço/etnologia
Grupo com Ancestrais Oceânicos/estatística & dados numéricos
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Hospitais Privados/estatística & dados numéricos
Hospitais Públicos/estatística & dados numéricos
Seres Humanos
Tempo de Internação
Modelos Lineares
Masculino
Meia-Idade
New South Wales/epidemiologia
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170724
[Lr] Data última revisão:
170724
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170630
[St] Status:MEDLINE



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