Head and Neck Medicine by Alexandros G.Sfakianakis: 05/17/18

Πέμπτη 17 Μαΐου 2018

NonScarring Diffuse Hair Loss in Women: a Clinico‐Etiological Study from tertiary care center in North‐West India

Journal of Cosmetic Dermatology, EarlyView.

https://ift.tt/2IPhltR

Violaceous papules on the hands

Clinical and Experimental Dermatology, EarlyView.

https://ift.tt/2wR9MOv

A simple and cost‐efficient adherent culture platform for human gastric primary cells, as an in vitro model for Helicobacter pylori infection

Helicobacter, EarlyView.

https://ift.tt/2L5DXot

Facial Fractures as a Result of Falls in the Elderly: Concomitant Injuries and Management Strategies

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0038-1642034

Mechanical falls are a common cause of facial trauma in the elderly population. It has been shown that the likelihood of sustaining a facial fracture due to a fall or activities of daily life significantly increases with age. Craniomaxillofacial fractures are most common during the first three decades of life; however, elderly patients more frequently require lengthy hospital stays and surgical intervention, and have shown increased complication rates compared with younger patients. The objective of this study was to examine the prevalence of facial fractures secondary to mechanical falls in the elderly population to analyze mechanism of injury, comorbidities, and fracture management. A retrospective review of all facial fractures as a result of falls in the elderly population in a level 1 trauma center in an urban environment was performed for the years 2002 to 2012. Patient demographics were collected, as well as location of fractures, concomitant injuries, and surgical management strategies. During the time period examined, 139 patients were identified as greater than 60 years of age and having sustained a fracture of the facial skeleton as the result of a fall. The average age was 75.7 (range, 60–103) years, with no gender predominance of 50.4% female and 49.6% male. There were a total of 205 fractures recorded. The most common fractures were those of the orbit (42.0%), nasal bone (23.4%), zygoma (13.2%), and zygomaticomaxillary complex (7.32%). The average Glasgow Coma Scale on arrival was 12.8 (range, 3–15). Uncontrolled hemorrhage was noted on presentation to the trauma bay in five patients. Twenty-one patients were intubated on, or prior to, arrival to the trauma bay, and 44 required a surgical airway. The most common concomitant injury was a long bone fracture (23.5%), followed by cervical spine fracture (18.5%), skull fracture (17.3%), intracerebral hemorrhage (17.3%), rib fracture (17.3%), ophthalmologic injuries (6.2%), short bone fracture (4.9%), pelvic fracture (2.9%), thoracic spine fracture (1.2%), and lumbar spine fracture (1.2%). Of the 114 patients admitted to the hospital, 53 were admitted to an intensive care setting. The average hospital length of stay was 8.97 days (range, 0–125). Sixteen patients expired. Surgical management of fractures in the operating room was required in 47 of the 139 patients. Of the patients treated, 36.2% required an open reduction and internal fixation procedure. Facial fractures as a result of falls in the geriatric population represent an increasing number of cases in clinical practice as life expectancy steadily rises. These patients require a specific standard of treatment since they are more susceptible to nosocomial infections, as well as have higher complication rates and longer recovery time. Concomitant injuries such as cervical spine and pelvic fractures can greatly increase risk of mortality. Surgical and soft tissue management must be approached with caution to optimize function and aesthetics while preventing secondary infection. The authors hope that this study can provide some insight and further investigation as there is a dearth of literature to the management of facial fractures in falls in elderly patients.
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Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents | Abstract | Full text

https://ift.tt/2wOUTMN

Aesthetic Nasal Reconstruction Principles and Practice

Cranial Maxillofac Trauma Reconstruction
DOI: 10.1055/s-0038-1645865

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Article in Thieme eJournals:
Table of contents | Full text

https://ift.tt/2rOSYTl

Kardioanästhesie: Monitoring und aktuelle hämodynamische Konzepte

Anästhesiol Intensivmed Notfallmed Schmerzther 2018; 53: 332-345
DOI: 10.1055/s-0043-106281

Die Krankheitsschwere herzchirurgischer Patienten und die Komplexität der Eingriffe haben in den letzten Jahren deutlich zugenommen. Dies stellt nicht nur erhöhte Anforderungen an die neurologische und hämodynamische Überwachung, sondern macht es auch erforderlich, die hämodynamische Therapie – unter Berücksichtigung aktueller pharmakologischer Entwicklungen – individuell dem höheren Risikoprofil der Patienten anzupassen.
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