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Engaging Parents and Caregivers in the Prevention of Child Sexual Abuse 让父母和照顾者参与预防儿童性虐待
Pub Date : 2017-03-27 DOI: 10.4172/2167-1222.1000367
J. Foster
Engaging parents and caregivers in the prevention of child sexual abuse (CSA) is “a type of maltreatment that refers to the involvement of the child in sexual activity to provide sexual gratification or financial benefit to the perpetrator, including contacts for sexual purposes, molestation, statutory rape, prostitution, pornography, exposure, incest, or other sexually exploitative activities”. CSA includes contact and noncontact sexually abusive acts that are both overt and covert in nature.
让父母和照顾者参与预防儿童性虐待(CSA)是“一种虐待,指的是儿童参与性活动,为犯罪者提供性满足或经济利益,包括以性为目的的接触、骚扰、法定强奸、卖淫、色情、暴露、乱伦或其他性剥削活动”。CSA包括接触性和非接触性虐待行为,本质上既有公开的,也有隐蔽的。
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引用次数: 9
Sequential trauma education programs (STEPS):The experience of advanced trauma care education in low and middle income countries 顺序创伤教育计划(STEPS):中低收入国家先进创伤护理教育的经验
Pub Date : 2017-03-20 DOI: 10.4172/2167-1222.C1.004
Mohamed Abbasy
Therefore why even life-threatening conditions are easily overlooked on scene or during patient`s medevac operations. The majority of victims are transported unwittingly from scene to a rural hospital first, instead of rushing them directly to a specialized pediatric trauma center. In addition, mechanisms of accident and etiologies vary, making recognition of the leading clinical signs and key symptomes sometimes nearly impossible
因此,即使是危及生命的情况也很容易在现场或在病人的医疗后送手术中被忽视。大多数受害者都是在不知情的情况下从现场被送往农村医院,而不是直接送往专门的儿科创伤中心。此外,事故机制和病因各不相同,使得识别主要临床体征和关键症状有时几乎是不可能的
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引用次数: 2
Survey of Traumatic Glaucoma in a Tertiary Hospital 某三级医院外伤性青光眼的调查
Pub Date : 2017-03-18 DOI: 10.4172/2167-1222.1000366
K. Ajite, Funmilayo Christianah Fadamiro, I. Ajayi, Omotoye Olusola Joseph, Emmanuel Abah
Background: Traumatic eye injury is one of the most common causes of unilateral blindness worldwide and it remains a core root of avoidable blindness worldwide. Traumatic glaucoma can result in severe visual impairment. Recognition of factors related to poor visual outcome, appropriate medical therapy, surgical intervention when indicated and careful follow up will help in preserving vision in these patients. This study is aimed at determining the frequency, clinical forms and types of therapy of traumatic glaucomas as seen in our hospital. Methods: All consecutive patients with ocular injury who received treatment at the eye clinic of Ekiti state university teaching hospital, Ado Ekiti, from January 2012 to December 2014 were selected for the study. All subjects had thorough ophthalmic examinations. The patients with ocular injury and subsequently developed glaucoma were selected extracting from the medical records the demographic data, visual acuity at presentation, clinical form of glaucoma and various therapies for management. The data were analysed using SPSS version 18 (Illinois, Chicago, USA) and presented as tables, and figures, in frequencies, percentage. Result: A total of 5568 patients were seen during this study at the ophthalmology clinic, 365 of them had ocular trauma out of which 31(8.5%) was traumatic glaucoma. Peripheral anterior synerchae (29%), adherent leucoma (16.1%) and Hyphema (16.1%) were the common clinical manifestations (anatomic changes) of traumatic glaucoma. The clinical types of traumatic glaucoma are secondary open angle glaucoma (54.8%) which is higher than the secondary closed angle type (45.2%). 22 (71%) of these patients had medical interventions with antiglaucoma drugs. Conclusion: The prevalence of traumatic glaucoma is 8.5%, this glaucoma may result in severe visual impairment if treatment is not instituted early.
背景:外伤性眼损伤是世界范围内单侧失明最常见的原因之一,也是世界范围内可避免失明的核心根源。外伤性青光眼可导致严重的视力损伤。识别与视力不良相关的因素,适当的药物治疗,必要时的手术干预和仔细的随访将有助于这些患者保持视力。本研究旨在确定我院外伤性青光眼的发病率、临床表现和治疗类型。方法:选择2012年1月至2014年12月在阿多·埃基提埃基提州立大学教学医院眼科诊所接受治疗的所有连续眼损伤患者进行研究。所有受试者都进行了彻底的眼科检查。从医疗记录中提取人口统计学数据、表现时的视力、青光眼的临床形式和各种治疗方法,选择眼损伤和随后发展为青光眼的患者。使用SPSS第18版(伊利诺伊州,芝加哥,美国)对数据进行分析,并以表格、数字、频率和百分比的形式呈现。结果:本研究共有5568名患者在眼科诊所就诊,其中365人有眼外伤,其中31人(8.5%)为外伤性青光眼。外伤性青光眼常见的临床表现(解剖改变)有周围性前粘连(29%)、粘连性白带(16.1%)和前房积血(16.1%。外伤性青光眼的临床类型为继发性开角型青光眼(54.8%),高于继发性闭角型(45.2%)。其中22例(71%)患者接受了抗青光眼药物的药物干预。结论:外伤性青光眼的患病率为8.5%,如果不及早治疗,这种青光眼可能会导致严重的视力损伤。
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引用次数: 0
Post-Traumatic Peritoneopericardial Diaphragmatic Hernia: A CaseReport 外伤性腹膜心包膈疝一例报告
Pub Date : 2017-03-11 DOI: 10.4172/2167-1222.1000364
Katarzyna Szwalbe, P. Misiak, Artur Terlecki
Objective: Bisphenol-A (BPA) is a xenoestrogen used in many consumer products. Here we present a case of dysfunctional uterine bleeding after exposure to dental sealant containing BPA. Design: Case Report Setting: Academic Medical Center Intervention: Dysfunctional uterine bleeding was diagnosed, and no therapy was initiated. Results: The patient continued to experience bleeding following each exposure. Conclusion: Female patients undergoing dental procedures that use BPA containing compounds may experience dysfunctional bleeding.
目的:双酚a (BPA)是一种用于许多消费品的雌激素。在这里,我们提出一个病例功能失调子宫出血后,暴露于牙科密封胶含有双酚a。设计:病例报告设置:学术医疗中心干预:诊断为功能失调性子宫出血,未开始治疗。结果:每次暴露后患者持续出血。结论:使用含BPA化合物的牙科手术的女性患者可能会出现功能失调出血。
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引用次数: 1
Activation State of the Circulating Neutrophil in Isolated Chest Trauma Patients: Characterization of Surface Receptor Expression 胸部创伤患者循环中性粒细胞活化状态的表面受体表达特征
Pub Date : 2017-03-09 DOI: 10.4172/2167-1222.1000363
E. Nasreldin, M. Khairy
The pathogenesis of inflammatory complication after chest trauma and pulmonary injury is incompletely understood. Injury can trigger a systemic inflammatory response, which leads to pre-activation of neutrophils in blood. The aim of this study was to determine the specific expression profiles of neutrophil receptors in relation to the systemic inflammatory response after chest trauma. Blood samples from fifty patients with isolated thoracic injury were analysed for changes in the neutrophil phenotype within 3, 6 and 24 hours after injury. Study patients was assessed for any inflammatory complications during the first 24 hours. L-Selectin expression remained decreased until 24 hrs while CXCR1, CXCR2 and C5aR levels gradually increased. Expression of FcγRII and expression of the active form were lower in trauma patients, no patients developed ARDS. Thoracic trauma leads to activation of the circulating neutrophils which is transient accompanied by mobilization of young neutrophils into the circulation which leads to systemic inflammatory reactions which need a second stimulus to cause inflammatory complications like ARDS.
胸部创伤和肺损伤后炎症并发症的发病机制尚不完全清楚。损伤可引发全身炎症反应,从而导致血液中中性粒细胞的预激活。本研究的目的是确定中性粒细胞受体的特异性表达谱与胸部创伤后全身炎症反应的关系。对50名孤立性胸部损伤患者的血样进行分析,以了解损伤后3、6和24小时内中性粒细胞表型的变化。对研究患者在最初24小时内的任何炎症并发症进行评估。L-选择素的表达一直下降到24小时,而CXCR1、CXCR2和C5aR水平逐渐升高。FcγRII的表达和活性形式的表达在创伤患者中较低,没有患者发展为ARDS。胸部创伤导致循环中性粒细胞的激活,这是短暂的,伴随着年轻中性粒细胞进入循环,这导致全身炎症反应,需要第二次刺激才能引起ARDS等炎症并发症。
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引用次数: 1
Smart-Draping-A Validated Novice Technique to Prevent Drapes Peeling off During Hip Fracture Fixation Surgery: A Prospective Randomized Controlled Study Smart-Draping-一种经验证的新手技术,可防止髋关节骨折固定手术中的药物脱落:一项前瞻性随机对照研究
Pub Date : 2017-03-08 DOI: 10.4172/2167-1222.1000361
H. A. Hussainy
The contamination of the surgical field can be a potential risk of infection that can be devastating to patients undergoing hip fracture fixation surgery. Drapes peeling off during such operation is a recognized challenge that can lead to such a contamination. We describe and validate a simple technique to prevent drapes peeling off the operative field during hip fracture fixation surgery using the smart-draping technique. The smart-draping entails applying a sterile disposable single large adhesive op-sheet to the inferior aspect of the thigh, just under the proposed surgical incision, followed by applying the usual plastic vertical isolation drape. Fourteen neck-of-femur fracture patients undergoing dynamic hip screw (DHS) fixation were recruited and randomized into a study and control groups to measure fluid leakage, as an indirect measurement of the vertical drapes peeling off the surgical site. Incontinence pads were placed on the floor to collect all leaked fluid in all patients. The average weight of the fluid collected in the study groups was 11.4 gm (SD ± 12.1) while that of the control group was 354.3 gm (SD ± 175). There was a statistical significant difference between the two methods favoring the smart-draping method over the control one. (P<0.001) We conclude that smart-draping technique will make it harder for the drapes to peel off thus, avoiding the potential contamination of the surgical field and ultimately avoiding potential infection of the surgical site in hip fracture fixation surgery.
手术野的污染可能是一种潜在的感染风险,对接受髋部骨折固定手术的患者来说是毁灭性的。在这种操作过程中,窗帘脱落是一个公认的挑战,可能导致这种污染。我们描述并验证了一种简单的技术,可以使用智能悬垂技术在髋部骨折固定手术中防止手术野的悬垂脱落。智能悬垂需要在大腿的下侧面,就在拟议的手术切口下方,应用一个无菌的一次性大粘胶上膜片,然后应用通常的塑料垂直隔离悬垂。14例股骨颈骨折患者接受动力髋螺钉(DHS)固定,随机分为研究组和对照组,测量液体泄漏,作为间接测量手术部位垂直垂膜剥离的方法。在地板上放置尿失禁垫,收集所有患者的漏液。研究组采集的液体平均重量为11.4 gm (SD±12.1),对照组采集的液体平均重量为354.3 gm (SD±175)。两种方法之间存在统计学上的显著差异,智能悬垂法优于对照法。(P<0.001)我们认为,在髋部骨折固定手术中,智能悬垂技术将使悬垂物更难脱落,从而避免了手术野的潜在污染,最终避免了手术部位的潜在感染。
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引用次数: 0
The Influence of Antithrombotic Drug Application on IntracranialHemorrhage 抗血栓药物应用对颅内出血的影响
Pub Date : 2017-03-08 DOI: 10.4172/2167-1222.1000362
Ying-Ying Xu
Thrombosis is caused by many diseases or complications, such as cerebrovascular disease, coronary heart disease, pulmonary thromboembolism, deep vein thrombosis after surgery and trauma, thus effective antithrombotic therapy has very important significance to the health of human beings. However, more and more clinical reports showed hemorrhage issues induced by antithrombotic treatment, especially in the central nervous system. Accordingly, in this paper, the relationship between common oral anticoagulants applied in clinic and the related problems about intracerebral hemorrhage will be reviewed.
血栓形成是由许多疾病或并发症引起的,如脑血管疾病、冠心病、肺血栓栓塞、深静脉血栓形成等手术和外伤后发生的血栓形成,因此有效的抗血栓治疗对人类的健康具有非常重要的意义。然而,越来越多的临床报告显示抗栓治疗引起的出血问题,特别是在中枢神经系统。因此,本文就临床常用的口服抗凝剂与脑出血相关问题的关系作一综述。
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引用次数: 0
Intraocular Silicone Oil Masquerading as Eye Hemorrhage 眼内硅油冒充眼出血
Pub Date : 2017-02-22 DOI: 10.4172/2167-1222.1000360
Y. Yamakawa, H. Naito, K. Tsukahara, Atsuyoshi Iida, T. Yumoto, Taihei Yamada, T. Osako, A. Nakao
An 87-year-old man presented to the emergency department complaining of a frontal head injury. Brain computed tomography scan revealed hyperdensity in the vitreous cavity of the right eye, suggesting intraocular hemorrhage. The patient’s family reported that he had a history of retinal detachment, which was presumably treated by tamponade with silicone oil. Eye examination by an ophthalmologist indicated no vitreous or retinal hemorrhage. Since intraocular silicone oil is being increasingly used for treatment of retinal detachment, emergency physicians must become familiar with its unique characteristic of mimicking hemorrhage in medical imaging.
一位87岁的老人因头部前部受伤而到急诊科就诊。脑部计算机断层扫描显示右眼玻璃体腔内密度过高,提示眼内出血。患者家属报告称,他有视网膜脱离史,可能是用硅油填塞治疗的。眼科医生的眼科检查显示没有玻璃体或视网膜出血。由于眼内硅油越来越多地用于治疗视网膜脱离,急诊医生必须熟悉其在医学成像中模拟出血的独特特征。
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引用次数: 0
From Rare to Reality: The Challenge of Controlling Pain in Patients onBuprenorphine in the Acute Care Setting 从罕见到现实:丁丙诺啡在急性护理环境中控制患者疼痛的挑战
Pub Date : 2017-02-20 DOI: 10.4172/2167-1222.1000359
T. Atkinson, Meredith W. Crumb, M. Raouf
Prescription opioid use has increased dramatically in the past 20 years with prescriptions for opioids and overdoses both increasing by 400% in what is now being called an opioid epidemic. The CDC’s Guidelines for Prescribing Opioids for Chronic Pain were released in March 2016 and the result has been increasing scrutiny of opioid prescriptions. For pain patients, this means minimizing opioid use and decreasing reliance, while others are being tapered off opioids altogether. Opioid tapers are predictably revealing unanticipated levels of opioid use disorder and unsupportable demand for enrollment in opioid assisted treatment (OAT) via buprenorphine/naloxone (Suboxone®) or methadone treatment programs. In July 2016, the Department of Health and Human Services released a final rule increasing prescribing limits of buprenorphine/naloxone (Suboxone®) to allow qualifying providers to treat up to 275 patients rather than capping panel size at 100. In addition to increased use in the treatment of opioid use disorder, there are new formulations of buprenorphine approved for chronic pain management. Therefore, while opioid use overall is decreasing, use of buprenorphine itself is dramatically increasing and introducing new challenges to treatment in trauma and acute pain settings based on its unique pharmacology. In recent years, case reports highlighting the challenge of managing pain when patients are treated with buprenorphine were published but until now were rarely seen in practice. It is, therefore, incumbent on all providers in these settings to become intimately familiar with buprenorphine and prepare to safely and effectively manage pain in these challenging patients.
处方阿片类药物的使用在过去20年中急剧增加,阿片类和过量的处方都增加了400%,现在被称为阿片类流行病。美国疾病控制与预防中心的《慢性疼痛阿片类药物处方指南》于2016年3月发布,其结果是加强了对阿片类处方的审查。对于疼痛患者来说,这意味着最大限度地减少阿片类药物的使用和减少依赖,而其他患者则完全停止使用阿片类。阿片类药物的减量可以预见地揭示了阿片类物质使用障碍的意外水平,以及通过丁丙诺啡/纳洛酮(Suboxone®)或美沙酮治疗计划参与阿片类辅助治疗(OAT)的不可支持的需求。2016年7月,卫生与公众服务部发布了一项最终规则,提高了丁丙诺啡/纳洛酮(Suboxone®)的处方限制,允许符合条件的提供者治疗多达275名患者,而不是将小组规模限制在100人。除了增加用于治疗阿片类药物使用障碍外,还有丁丙诺啡的新配方被批准用于慢性疼痛管理。因此,尽管阿片类药物的使用总体上正在减少,但丁丙诺啡本身的使用却在急剧增加,并基于其独特的药理学给创伤和急性疼痛环境中的治疗带来了新的挑战。近年来,一些病例报告强调了丁丙诺啡治疗患者时管理疼痛的挑战,但到目前为止,在实践中很少见到。因此,在这些环境中,所有提供者都有责任熟悉丁丙诺啡,并准备安全有效地管理这些具有挑战性的患者的疼痛。
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引用次数: 1
From Trauma to Resiliency 从创伤到恢复
Pub Date : 2017-02-17 DOI: 10.4172/2167-1222.1000358
Christine Roullière-Le Lidec, Éric Rouhard, L. Crocq
In the context of last attacks affecting many countries, a medical and psychological coverage must be organized for all who are concerned, soldiers, emergency and security team and of course, victims. It leads on the development of resiliency.
在上次袭击影响到许多国家的背景下,必须为所有有关人员、士兵、应急和安全小组,当然还有受害者组织医疗和心理覆盖。它引导了弹性的发展。
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引用次数: 2
期刊
Journal of trauma & treatment
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