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9161. Assessment of the lower limit for cerebral perfusion pressure in severe head injuries by bedside monitoring of regional energy metabolism. (Abstract)

areas.Fifty patients with severe head injury were included after evacuation of an intracranial hematoma and/or focal brain contusion. They were treated according to intensive care routine (Lund concept), including continuous monitoring of intracranial pressure. One microdialysis catheter was inserted in less-injured brain tissue ("better" position), and one or two catheters were inserted into the boundary of injured cerebral cortex ("worse" position). Concentrations of glucose, pyruvate, and lactate were

2003 Anesthesiology

9162. Defining the effects of an inhaled corticosteroid and long-acting beta-agonist on therapeutic targets. (Abstract)

dysfunction/bronchoconstriction and airway inflammation, respectively. Despite the documented benefits of ICSs, they remain underutilized because of a variety of physician- and patient-associated reasons including safety concerns. Underlying these concerns are published reports that suggest systemic effects of high doses of ICSs: skin bruising, reduction of bone mineral density, cataracts, glaucoma, and impaired short-term growth in children. Simple strategies to reduce the potential adverse effects

2003 Allergy and Asthma Proceedings

9163. Apocrine carcinoma of the vulva in a band-like arrangement with inflammatory and telangiectatic metastasis via local lymphatic channels. (Abstract)

Apocrine carcinoma of the vulva in a band-like arrangement with inflammatory and telangiectatic metastasis via local lymphatic channels. Primary adenocarcinomas of the vulva have been classified as sweat gland carcinomas, extramammary Paget's disease, and primary breast carcinomas of the vulva. They share some common histopathologic features.We describe a 72-year-old Japanese woman with apocrine carcinoma of the vulva and local lymphatic metastasis.The patient presented with a bruise on her

2003 International Journal of Dermatology

9164. Cushing's syndrome due to medullary thyroid carcinoma: diagnosis by proopiomelanocortin messenger ribonucleic acid in situ hybridization. Full Text available with Trip Pro

Cushing's syndrome due to medullary thyroid carcinoma: diagnosis by proopiomelanocortin messenger ribonucleic acid in situ hybridization. Medullary thyroid carcinoma (MTC) rarely causes ectopic ACTH syndrome. We describe a 38-yr-old man with renal stones who had a 5-cm MTC removed in 1992. He was RET-protooncogene positive (codon 618). Serum calcitonin was 1597 pg/ml postoperatively. In 1996 he had rib fractures, bruising, weakness, and three to four stools per day. Laboratory studies revealed

2003 Journal of Clinical Endocrinology and Metabolism

9165. Cutaneous angiosarcoma of the face and scalp presenting as alopecia. (Abstract)

Cutaneous angiosarcoma of the face and scalp presenting as alopecia. An 83-year-old woman presented with a 6-month history of hair loss and painless bruising involving her forehead and scalp. She was otherwise well. Skin biopsy of her scalp confirmed angiosarcoma with a significant increase in miniaturized and telogen hair follicles and some tumour-associated scarring hair loss. She was commenced on the chemotherapeutic agent paclitaxel and then subsequently the semi-synthetic taxane docetaxol

2003 Australasian Journal of Dermatology

9166. Blastic natural killer-cell lymphoma of the skin associated with myelodysplastic syndrome or myelogenous leukaemia: a coincidence or more? (Abstract)

features in common, namely multiple skin lesions with a bruise-like appearance, involvement of the oral mucosa, and good general status at presentation but very rapid deterioration in the course of the disease. All patients died of disease 4-14 months after the diagnosis. Histopathologically, there were cutaneous infiltrates of slightly pleomorphic medium-sized cells expressing CD4, CD56, terminal deoxynucleotidyl transferase (focally) and being negative for surface CD3, cytotoxic molecules, B-cell

2003 British Journal of Dermatology

9167. Botulinum toxin type B for dynamic glabellar rhytides refractory to botulinum toxin type A. (Abstract)

a total dose of 2,500 U. Patients were evaluated at pretreatment and 48 to 72 hours, 1 week, and 2 and 4 months after injection.All glabellar rhytides improved after treatment with BTX-B injections. Peak clinical effect was noted 1 month after treatment, with 50% of peak effect evident at the 2-month follow-up. Near complete dissolution of effect was seen at 4 months after treatment. Side effects were transient and were limited to moderate injectional pain and rare bruising and frontal brow

2003 Dermatologic Surgery

9168. Treatment of reticular leg veins with a 1064 nm long-pulsed Nd:YAG laser. (Abstract)

images 1 month and 3 months after treatment. Patients also performed a self-assessment of their results.Two-thirds of vessels measuring 1 to 3 mm in diameter cleared more than 75% with one treatment. Larger vessels appeared to improve more than smaller vessels. Immediate treatment discomfort was tolerable. Side effects were minimal and included superficial thrombosis, delayed bruising, hyperpigmentation, and matting.Millisecond-pulsed Nd:YAG lasers used with 50 millisecond pulses are effective

2003 Journal of American Academy of Dermatology

9169. Childhood behavior disorders and injuries among children and youth: a population-based study. (Abstract)

in BC: International Classification of Diseases, Ninth Revision N-codes (fractures, open wounds, poisoning/toxic effect, concussion, intracranial, burns) and E-codes (falls, postoperative complications, motor vehicle accidents, struck by object, adverse effects of drugs, suffocation, drowning).BC Linked Health Data Set and the BC Triplicate Prescription Program.After controlling for known demographic correlates, odds for injury was greater among those treated with MPH and presumed to have

2003 Pediatrics

9170. Survey of the injury rate for children in community sports. (Abstract)

different. Across sports, contusions were the most frequent type of injury. Contact with equipment was the most frequent method of injury, except in football where contact with another player was the most frequent method. In baseball, 3% of all injuries reported were considered serious (fracture, dislocation, concussion); in soccer, 1% were considered serious; and in football, 14% were considered serious. The frequency of injury per team per season (FITS), an estimation of injury risk, was 3 (...) through 2 seasons showed areas where immediate modifications could reduce injury risk. The first recommendation is that youth sports leagues provide and require first aid training for coaches. Training could be done by sports medicine professionals and include recognition and immediate response to head, neck, and spine injuries, as well as heat-related illnesses. The second recommendation is that youth sports leagues have clear, enforceable return to play guidelines for concussions, neck and back

2002 Pediatrics

9171. Incidence and description of stroller-related injuries to children. (Abstract)

treated in hospital emergency departments in the United States during the 5-year study period. The median age at the time of the injury was 11 months; 51% were males. The annual rate of injury among children <1 year old was 184.4 per 100 000. Seventy-six percent of injuries resulted from a fall from the stroller. A motor vehicle was involved in <1% of cases. Most injuries involved the head (44%) or face (43%). Injury diagnoses included contusions or abrasions (38%), lacerations (24%), closed head

2002 Pediatrics

9172. Neuroimaging of intraparenchymal lesions predicts outcome in shaken baby syndrome. (Abstract)

, namely, contusions, infarcts, and other lesions within the white matter. Presence of intraparenchymal brain lesions within the first 3 months was significantly associated with neurodevelopmental impairment. Severity of motor and cognitive dysfunctions was related to the extent of intraparenchymal lesions.Early clinical and radiologic findings in NAHI are of prognostic value for neurodevelopmental outcome.

2003 Pediatrics

9173. Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database. Full Text available with Trip Pro

patients sustained contusions of the extremities, the back, and the trunk. In nine patients an isolated facial injury was diagnosed. Five of nine patients needed referrals to the department of plastic surgery because of the complexity of the facial soft tissue wounds. Three underwent maxillofacial surgery.Clinical: the equestrian community may underestimate the risk of severe injuries attributable to hoof kicks, especially while handling the horse. Educational lectures and the distribution

2002 Emergency Medicine Journal

9174. Do resuscitation attempts in children who die, cause injury? Full Text available with Trip Pro

%) of children who had no resuscitation (p<0.0001) chi(2) test. All but two of these injuries were of a minor nature consisting principally of bruises or abrasions. Two significant injuries were identified both occurring as a result of readily identifiable resuscitation procedures. The likelihood of injury increased with the length of resuscitation. In children resuscitated for less than 60 minutes the incidence of injury was 27% compared with 62% for children resuscitated for longer ( p<0.0001).This study (...) has shown that cardiopulmonary resuscitation commonly causes minor injuries such as superficial bruises and abrasions and the likelihood of such injury increases with the duration of the cardiopulmonary resuscitation. This information should reassure parents and caregivers that basic life support may be instituted without fear of causing significant injury or adversely affecting outcome in the child with cardiorespiratory arrest. Caution must be exercised when attributing significant injuries

2003 Emergency Medicine Journal

9175. Persistent inner ear injury after diving. (Abstract)

of the round window was found intraoperatively. In the other patient, no rupture of the round or oval window was seen intraoperatively. In spite of sealing of the round window and application of vasoactive rheologic therapy, hearing did not improve significantly in either of the patients.Rupture of the round window may occur after diving even if the dive is performed from a low height into the water and the bottom of the pool is not contacted. Besides direct contusion to the external ear and barotrauma

2003 Otology and Neurotology

9176. Facial fractures and concomitant injuries in trauma patients. (Abstract)

the most common isolated fracture (23.2%). Cerebral hematoma occurred in 43.7% of patients, with subdural hematoma being the most frequent. Pulmonary injury was the second most commonly associated injury (31.1%) with lung contusion being the most frequent. Seventy-two patients (42%) required intubation, and 22 (14.8%) required tracheostomy during their hospital stay. The hospital complication rate was 50.3% and included primarily pulmonary complications, septicemia, renal failure, and severe anemia

2003 Laryngoscope

9177. Patterns in childhood sports injury. (Abstract)

in October 1999 and April 2000 were prospectively studied. Information collected included age, sex, injury type, anatomical injury site, and cause of injury (sports-related or otherwise). Information about patient outcome and disposition was also obtained.There were a total of 1421 injuries in 1275 patients. Musculoskeletal injuries were more common in male patients (790/62%) than in female patients. The mean age of the patients was 12.2 years (95% CI, 12.0-12.4). Sprains, contusions, and fractures were (...) the most common injury types (34, 30, and 25%, respectively). Female patients experienced a greater percentage of sprains (44% vs 36%) and contusions (37% vs 33%) and fewer fractures (22% vs 31%) than male patients. Sports injuries accounted for 41% (521) of all musculoskeletal injuries and were responsible for 8% (495/6173) of all ED visits. Head, forearm, and wrist injuries were most commonly seen in biking, hand injuries in football and basketball, knee injuries in soccer, and ankle and foot

2003 Pediatric Emergency Care

9178. Characterization of nonfatal events and injuries resulting from youth violence in patients presenting to an emergency department. (Abstract)

hundred twenty-six patients were included in the study. Most events were fights and most occurred in the street. Fists, hands, and feet were the most common weapon, and contusions or abrasions the most common injury. Most events involved only 2 people, and most incidents involved friends or acquaintances. Events involving 8 to 14 year olds were more likely to occur in school, to involve only fists, hands, or feet, and involve a friend. Eight to 14 year olds were less likely to use a firearm. Among (...) the younger group, females were more likely than males to be injured in an assault, sustain a contusion or abrasion, and be involved in an incident with multiple participants. Older females were more likely than males to be involved in an event in the home, and sustain a contusion, abrasion, or bite.This study characterizes the circumstances of youth intentional violence that result in emergency department visits for injuries. Although similarities exist between different age groups and genders, some key

2003 Pediatric Emergency Care

9179. Injury patterns related to use of less-lethal weapons during a period of civil unrest. (Abstract)

-seven patients were identified. Two were excluded due to lack of signed consent for treatment. Mean age was 28.4 +/- 11.7 years; 76% of patients were male. Significant morbidity was found in 7 (28%) cases with no fatalities. Three (12%) individuals, with the diagnoses of pulmonary contusion, liver laceration, and Achilles tendon rupture, required admission. Two (8%) individuals had delayed complications of pneumonia and post-concussive syndrome. Reports of injury patterns associated with beanbag

2003 Journal of Emergency Medicine

9180. Pulmonary air embolism in severe head injury. (Abstract)

infiltrates. Pneumothorax, haemothorax, pulmonary aspiration, various forms of pulmonary oedema and pulmonary contusion could be excluded. Furthermore, there was an open laceration of the frontal sinus and maxillo-facial fractures. The history of spontaneous respiration in sitting position at the scene, rapid improvement of pulmonary function within 30 h, small amounts of air in the brain parenchyma, and circulatory shock despite elevated central venous pressure in the initial phase led to the diagnosis

2003 Resuscitation

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