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Examining the Relationship between Salivary Amylase Level, Head Trauma Severity and CT Scan Results in Patients with Isolated Mild Head Trauma 孤立性轻度颅脑损伤患者唾液淀粉酶水平、颅脑损伤严重程度及CT扫描结果的关系研究
Pub Date : 2022-04-01 DOI: 10.30476/BEAT.2022.94151.1330
M. Ebrahimi, Behrang Rezvani Kakhki, Baharak Davoudpour, Z. Abbasi Shaye, Hossein Zakeri, S. Mousavi, S. Sadrzadeh, S. A. Shamsian, Azadeh Mahmoudi Gharaee
Objective: To investigate the relationship between salivary amylase level and computed tomoraphy (CT scan) findings in patients with isolated mild traumatic Brain Injury (mTBI) referred to the emergency department of Shahid Hasheminejad Hospital. Methods: Patients with isolated mTBI and indication for brain CT scan who referred to the trauma center of Shahid Hasheminejad Hospital, Mashhad, Iran in 2019 were included in a cross-sectional study. In the initial examination, the patient’s level of consciousness was measured using the Glasgow Coma Scale (GCS), and saliva samples were taken at the emergency department to determine the level of salivary amylase. A brain CT scan was performed for all patients. Age, gender, cause of trauma, the trauma severity and CT scan results were recorded. Statistical analysis was performed on the data. Results: One-hundred fifty patients were enrolled in this study (men=101, women=49). The trauma causes were included accidents (n=88; 58%), falls (n=37; 25%) and miscellaneous factors (e.g., quarrels; n=25; 17%). GCS was 15 in 142 patients and 14 in the rest. In all patients, the trauma severity was mild to high risk (Minor). CT scan results unfolded pathology in 10 cases (7%), while the residues (93%) had normal CT scans with no pathological evidence. Salivary amylase level in the patients’ saliva samples was between 137 to 8000 units per liter. Using the t-test to evaluate the relationship between salivary amylase levels and CT scan results uncovered a significant relationship. Spearman correlation revealed no significant relationship between the amylase and GCS levels. Conclusion: Data statistical analysis from 150 patients with isolated head trauma manifested that salivary amylase levels were significantly higher in the patients with pathological findings on CT scans. However, no significant relationship was found between salivary amylase level and age, gender, cause of trauma, and level of consciousness.
目的:探讨沙希德·哈什米内贾德医院急诊科孤立性轻度创伤性脑损伤(mTBI)患者唾液淀粉酶水平与CT表现的关系。方法:选取2019年在伊朗马什哈德沙希德·哈什米内贾德医院创伤中心转诊的孤立性mTBI患者,并进行脑CT扫描指征的横断面研究。在初步检查中,使用格拉斯哥昏迷量表(GCS)测量患者的意识水平,并在急诊科采集唾液样本以确定唾液淀粉酶水平。所有患者均行脑部CT扫描。记录年龄、性别、创伤原因、创伤严重程度及CT扫描结果。对数据进行统计分析。结果:150例患者入组研究(男性101例,女性49例)。创伤原因包括意外事故(n=88;58%),跌倒(n=37;25%)和其他因素(如争吵;n = 25;17%)。142例患者GCS为15,其余14例。所有患者的创伤严重程度均为轻度至高危(轻度)。10例(7%)CT扫描结果未显示病理,其余(93%)CT扫描正常,无病理证据。患者唾液样本中的唾液淀粉酶水平在每升137至8000单位之间。使用t检验来评估唾液淀粉酶水平与CT扫描结果之间的关系,发现了显著的关系。Spearman相关性显示淀粉酶与GCS水平无显著相关性。结论:对150例孤立性颅脑外伤患者的数据进行统计分析,发现有CT病理表现的患者唾液淀粉酶水平明显增高。然而,唾液淀粉酶水平与年龄、性别、创伤原因和意识水平之间没有显著关系。
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引用次数: 1
Impact of Peer-Assisted Learning in Chest Tube Insertion Education on Surgical Residents 同行辅助学习对外科住院医师胸管插入教育的影响
Pub Date : 2022-04-01 DOI: 10.30476/BEAT.2022.94348.1336
Iman Deilamy, M. Amini, H. Abbasi, Shahram Bolandparvaz, Shahram Paydar
Objective: To investigate the impact of peer-assisted learning (PAL) in chest tube insertion education on surgical residents. Methods: This study is a quasi-experimental study conducted on thirty general surgeon residents enrolled in the PAL program. They were divided into two learner groups (A and B) based on the period of residency start. Group A and B had six and one months of general surgery residency experience, respectively. All participants received adequate training for chest tube insertion by a recently graduated general surgeon. Chest tubes insertion skill was assessed using the tool for assessing chest tube insertion competency (TACTIC) test. Results: Post-TACTIC test score was significantly higher (p=0.001) than Pre-TACTIC test score in both groups. However, a comparison of mean Pre-TACTIC test scores and mean Post-TACTIC test scores between group A and group B showed that PAL effectiveness in group A was significantly higher (p=0.001) than group B. Conclusion: There was a positive relationship between the PAL program and the improvement of chest tube insertion technical skills in surgical residents. Based on our findings and similar studies, it can be concluded that the PAL program can increase the chest tube insertion skill of surgical residents.
目的:探讨同伴辅助学习(PAL)对外科住院医师胸管插入教育的影响。方法:本研究是一项准实验研究,对30名参加PAL计划的普通外科住院医师进行研究。根据开始实习的时间分为A组和B组。A组和B组分别有6个月和1个月的普外科住院医师经验。所有参与者都接受了由刚毕业的普通外科医生进行的胸管插入的充分培训。采用胸管插入能力(战术)测试评估工具评估胸管插入技能。结果:两组患者策略后测试得分均显著高于策略前测试得分(p=0.001)。然而,比较a组和B组的策略前测试和策略后测试的平均得分,a组的PAL有效性显著高于B组(p=0.001)。结论:PAL计划与外科住院医师胸管插入技术技能的提高呈正相关。根据我们的发现和类似的研究,可以得出结论,PAL计划可以提高外科住院医师的胸管插入技能。
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引用次数: 0
Heart Rate Variability May Predict the Severity of Appendicitis: A Cross-Sectional Study 心率变异性可以预测阑尾炎的严重程度:一项横断面研究
Pub Date : 2022-04-01 DOI: 10.30476/BEAT.2022.91590.1282
A. Bananzadeh, Abtin Vahidi, S. Salahi, A. Foroutan, L. Ghahramani
Objective: To evaluate the role of heart rate variability (HRV) in predicting pre-operative severity of appendicitis. Methods: In this cross-sectional study, 171 cases of acute appendicitis who underwent appendectomy were enrolled. Pre-anesthetic pulse rate of included patients were documented while the severity of appendicitis was determined by intra-operative evidences reported by two independent surgeons. Demographic characteristics, laboratory variables, and Alvarado criteria were recorded. Results: The mean age of patients was 28.75±4.21 years; 54% were men. HRV negatively associated the severity of appendix inflammation. A positive association was found between HRV and omental wrapping and Alvarado score (p<0.01). The receiver operating characteristic (ROC) curve analysis demonstrated that HRV could differentiate simple and complicated appendicitis with a sensitivity of 78.5% and specificity of 97.2%. Conclusion: The present findings revealed that HRV may predict the pre-operative severity of appendicitis and help differentiate simple and complicated appendicitis.
目的:探讨心率变异性(HRV)在预测阑尾炎术前严重程度中的作用。方法:对171例行阑尾切除术的急性阑尾炎患者进行横断面研究。记录入选患者的麻醉前脉搏率,根据两名独立外科医生报告的术中证据确定阑尾炎的严重程度。记录人口统计学特征、实验室变量和阿尔瓦拉多标准。结果:患者平均年龄28.75±4.21岁;54%是男性。HRV与阑尾炎症的严重程度负相关。HRV与网膜包裹和Alvarado评分呈正相关(p<0.01)。受试者工作特征(ROC)曲线分析表明,HRV鉴别单纯性阑尾炎和复杂性阑尾炎的敏感性为78.5%,特异性为97.2%。结论:HRV可预测术前阑尾炎的严重程度,有助于区分单纯性阑尾炎和复杂性阑尾炎。
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引用次数: 0
Assessment of Neck Characteristics for Laryngeal Mask Airway Size Selection in Patients Who Underwent an Elective Ocular Surgery; A Cross-Sectional Study 择期眼科手术患者喉罩气道尺寸选择的颈部特征评估横断面研究
Pub Date : 2022-04-01 DOI: 10.30476/BEAT.2022.94356.1338
O. Aghadavoudi, H. Shetabi, H. Saryazdi, Susan Babayi
Objective: To investigate the neck features for laryngeal mask airway (LMA) size selection. Methods: This cross-sectional study was conducted on 160 patients referred for elective surgeries to Feiz Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran (April 2016 to September 2018). Patients underwent ventilation using LMA whose size was determined through a weighted-based approach. All of the patients’ neck characteristics including circumference, thyromental distance, and opening mouth were measured. Ventilation factors were recorded including numbers of attempts for successful LMA insertion, quality of ventilation, and sealing. Results: Neck circumference and thyromental distance were significantly different with the size of LMA (p<0.0001 and p=0.005, respectively), but not mouth opening (p=0.21). Neck circumference, thyromental distance, and mouth opening were not significantly different with the times of insertion attempts (p>0.05 for all comparisons). However, the thyromental distance was significantly different with the quality ventilation status (p<0.0001). The total assessment of insertion attempts, ventilation efficacy and sealing was significantly different with the neck circumference (p<0.001), but thyromental distance did not show a significant difference (p>0.05). Conclusion: Findings demonstrated that neck circumference might be considered as an appropriate indicator for the selection of LMA size but neither the thyromental distance nor mouth opening. Further studies with a larger sample size are strongly recommended.
目的:探讨喉罩气道(LMA)尺寸选择的颈部特征。方法:对2016年4月至2018年9月在伊朗伊斯法罕医科大学附属菲兹医院转诊的160例择期手术患者进行横断面研究。患者使用LMA进行通气,LMA的大小通过加权方法确定。测量所有患者的颈部特征,包括围度、甲状腺距离和开口。记录通气因素,包括成功插入LMA的次数、通气质量和密封。结果:颈围、甲状腺距离与LMA大小差异有统计学意义(p < 0.05)。然而,甲状腺距离与通气质量有显著性差异(p0.05)。结论:颈围可作为选择LMA大小的合适指标,而甲状腺距离和开口均不能作为选择LMA大小的合适指标。强烈建议进行更大样本量的进一步研究。
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引用次数: 0
Trauma Registry Data as a Policy-Making Tool: A Systematic Review on the Research Dimensions 创伤登记数据作为决策工具:研究维度的系统回顾
Pub Date : 2021-08-22 DOI: 10.30476/BEAT.2021.91755.1286
M. Mobinizadeh, Farzan Berenjian, E. Mohamadi, F. Habibi, A. Olyaeemanesh, K. Zendedel, M. Sharif-Alhoseini
Objective: To review the research dimensions of trauma registry data on health policy making. Methods: PubMed and EMBASE were searched until July 2020. Keywords were used on the search process included Trauma, Injury, Registry and Research, which were searched by using appropriate search strategies. The included articles had to: 1. be extracted from data related to trauma registries; 2- be written in English; 3- define a time period and a patient population; 4- preferably have more details and policy recommendations; and 5- preferably have a discussion on how to improve diagnosis and treatment. The results obtained from the included studies were qualitatively analyzed using thematic synthesis and comparative tables. Results: In the primary round of search, 19559 studies were retrieved. According to PRISMA statement and also performing quality appraisal process, 30 studies were included in the final phase of analysis. In the final papers’ synthesis, 14 main research domains were extracted and classified in terms of the policy implication and research priority. The domains with the highest frequency were “The relationship between trauma registry data and hospital care protocols for trauma patients” and “The causes of Disability Adjusted Life Years (DALYs) due to trauma”. Conclusion: Using trauma registry data as a tool for policy-making could be helpful in several ways, namely increasing the quality of patient care, preventing injuries and decreasing their number, figuring out the details of socioeconomic status effects, and improving the quality of researches in practical ways. Also, follow-up of patients after trauma surgery as one of the positive effects of the trauma registry can be the focus of attention of policy-making bodies.
目的:回顾创伤登记数据对卫生政策制定的研究维度。方法:检索PubMed和EMBASE至2020年7月。检索过程中使用的关键词包括创伤(Trauma)、损伤(Injury)、注册表(Registry)和研究(Research),并采用适当的检索策略进行检索。纳入的文章必须:1。从创伤登记的相关数据中提取;2-能用英语写作;3-确定时间段和患者人群;4-最好有更多的细节和政策建议;5-最好就如何提高诊断和治疗进行讨论。从纳入的研究中获得的结果使用专题综合和比较表进行定性分析。结果:在第一轮检索中,检索到19559项研究。根据PRISMA声明和执行质量评估过程,30项研究被纳入最后分析阶段。在最后的论文综合中,提取了14个主要研究领域,并根据政策含义和研究重点进行了分类。频率最高的领域是“创伤登记数据与创伤患者医院护理方案之间的关系”和“创伤导致残疾调整生命年(DALYs)的原因”。结论:利用创伤登记数据作为决策工具,可以提高患者护理质量,预防和减少伤害,了解社会经济地位影响的细节,并在实践中提高研究质量。此外,创伤手术后患者的随访作为创伤登记的积极影响之一,可以成为决策机构关注的焦点。
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引用次数: 4
Do Avoid Unnecessary Procedure in A Trauma Patient? A Case Report 创伤患者应避免不必要的手术吗?病例报告
Pub Date : 2021-07-13 DOI: 10.30476/BEAT.2021.89885.1238
Mehdi Torabi
Endotracheal intubation is more commonly performed in the right main bronchus; however, it may rarely be performed in the left side. A 52-years-old man was brought to the emergency department by emergency medical services (EMS) after multiple trauma injury. There was a decrease in the right lung’s sound. Lung computed tomography (CT) scan revealed total pulmonary atelectasis. This scan was at the time that patient did not mention any recent history or complaint of pulmonary problems or diseases. In CT scan, we observed the white lung in the right side, the trachea which was deviated to the right, and the collapse-consolidation of the right lung was seen. The endotracheal tube image was observed in the left main bronchus which is a rare phenomenon. Decreasing of the right lung sound may not always be due to pneumothorax or hemothorax in trauma patients. In these patients, the rare phenomenon of left lung intubation should be considered as well. Left lung intubation may occur because of the lesion presence in the right lung.
气管内插管多见于右主支气管;然而,它可能很少在左侧进行。一名52岁男子在多处外伤后被紧急医疗服务(EMS)带到急诊室。右肺的声音减弱了。肺部计算机断层扫描(CT)显示全肺不张。该扫描是在患者没有提及任何近期病史或肺部问题或疾病的投诉。CT扫描可见右侧白色肺,气管向右偏,右肺萎陷实变。在左主支气管可见气管内管像,这是一种罕见的现象。创伤患者的右肺音减弱不一定是由于气胸或血胸所致。在这些患者中,也应考虑罕见的左肺插管现象。由于右肺出现病变,可能需要左肺插管。
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引用次数: 0
Gunshot Wounds Causing Distal Arterial Bullet Embolisms 枪伤导致远端动脉子弹栓塞
Pub Date : 2021-06-01 DOI: 10.30476/BEAT.2021.88434.1206
M. González-Urquijo, Ernesto Cordoba-Chamorro, Susana Moreno-Díaz, Gabriel Fernando Mejia-Villate, M. A. Fabiani
We report two cases involving small-caliber gunshot wounds to the chest with embolization of the bullet which complete occluding arterial circulation into the left lower extremity. A 30-years-old and 19-years-old men suffered gunshots wound to the thorax and abdomen with subsequent arterial embolisms into their left legs. Image studies revealed the left popliteal and femoral arteries occlusion by the missiles. Arteriotomies were auspiciously performed to retrieve the projectiles along with Fogarty catheters thrombectomies which conclude successful outcomes. At a 6 and 36 months’ follow-up, the patients were doing well without any vascular associated complications. Bullet embolization of the arterial or venous systems is a rare complication of penetrating gunshot injuries with diagnostic and therapeutic challenges. This complication’s suspicion should rise when there is a gunshot injury without an exit wound and with sudden pain or ischemia in an extremity. Individualized treatment should be urgently performed to avoid irreversible damage to the affected area.
我们报告两例涉及小口径枪伤到胸部与栓塞子弹完成闭塞动脉循环进入左下肢。一名30岁的男子和一名19岁的男子胸部和腹部中枪,随后左腿动脉栓塞。图像研究显示左腘动脉和股动脉被导弹阻塞。动脉切开术和福格蒂导管取栓术均取得成功。在6个月和36个月的随访中,患者表现良好,没有任何血管相关并发症。子弹栓塞的动脉或静脉系统是一种罕见的并发症穿透枪伤的诊断和治疗的挑战。当发生无出口伤且肢体突然疼痛或缺血的枪伤时,这种并发症应引起怀疑。应紧急进行个体化治疗,以避免对患处造成不可逆转的损害。
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引用次数: 0
期刊
Bulletin of Emergency & Trauma
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