Progression of any crushable polyurethane foam design for individual trabecular bone tissue

Regarding the study methods, 19 (35.8%) articles were quantitative studies; 10 (18.9%) were qualitative or semiqualitative studies; 8 (15.1%) used questionnaire surveys; 3 (5.7%) were literature reviews; 3 (5.7%) used computer simulations; and 10 (18.9%) were descriptive/narrative or other types of studies. Though the number of academic publications related to disaster medicine from the EDs in Taiwan is relatively limited, the quality and diversity of research seem promising. The research environment and education programs on disaster medicine in Taiwan deserve thoughtful consideration.We reported the first case of lung herniation after cardiopulmonary resuscitation (CPR) with a mechanical chest compression device and a literature review. Older age, long CPR duration, mechanical ventilation, and rib fracture were risk factors. Subcutaneous emphysema was the most common manifestation and indication for further computed tomography to make a definite diagnosis. Despite its rarity, physicians should keep a high awareness of this possible fetal complication. Further studies comparing mechanical and manual CPR for the risk of lung herniation are warranted.
The gray-white-matter ratio (GWR) measured on brain computed tomography (CT) following return of spontaneous circulation (ROSC) has been reported to be helpful in the prognostication of mortality or comatose status of cardiac arrest victims. However, whether the use of GWR in predicting the outcomes in out-of-hospital cardiac arrest (OHCA) survivors in Taiwan population remains uninvestigated.
This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic OHCA adults (> 18 years old) with sustained ROSC (≥ 20 minutes) during the period from 2006 to 2014. Patients with following exclusion criteria were further excluded no brain CT within 24 hours following ROSC; the presence of intracranial hemorrhage, severe old insult, brain tumor, ventriculoperitoneal shunt, and severe image artifact. The GWR values were obtained from the density measurement of bilateral putamen, caudate nuclei, posterior limbs of internal capsule, corpus callosum, mediall outcomes.
The use of GWR measured on bran CT within 24 hours following ROSC can help in predicting survival-to-hospital discharge and neurological outcome in OHCA survivors.
The use of GWR measured on bran CT within 24 hours following ROSC can help in predicting survival-to-hospital discharge and neurological outcome in OHCA survivors.
Traumatic brain injuries (TBIs) is a leading cause of death, disability, and resources consumption. Cerebral hemorrhagic contusions are primary brain lesion and often one of the most visible lesions following TBIs. Interleukin-one beta (
) is pro-inflammatory cytokines it is circulatory level and gene have been implicated in secondary brain injury and worse outcome following TBIs. This study is to determine the significance role of
gene polymorphism (-511C/T) and circulatory level for prediction trauma severity and outcome in traumatic cerebral hemorrhagic contusion.
The study population includes 90 Sudanese patients with traumatic cerebral hemorrhagic and 90 apparently healthy individuals as control. IL-1β serum concentration was measured using enzyme-linked immunosorbent assay and
gene was genotyped using restriction fragment length polymorphism-polymerase chain reaction.
Significant elevation of IL-1β level was seen among trauma patients compared to control (
-value < 0.001). Although there was no significant association between IL-1β level with trauma severity or death; IL-1β level was higher in severe brain injures compared with moderate and mild one, and the mean concentration of IL-1β was high (18.75 pg/mL) among patient developed poor outcome compared to survivals (15.17 pg/mL). T recessive allele of
gene was detected in 13.3% of participant. #link# The highest circulatory level of IL-1β (17.8 pg/mL) was observed among patients with TT homozygous alleles.
gene polymorphism was not associated with trauma severity and death.
IL-1β circulatory level was varied according to trauma severity and highly levels were seen among patients developed unfavorable outcome.
511C/T gene was not associated with trauma severity and outcome.
IL-1β circulatory level was varied according to trauma severity and highly levels were seen among patients developed unfavorable outcome. IL-1β-511C/T gene was not associated with trauma severity and outcome.
Up-to-date technology has been increasingly useful for learning resuscitation skills in the emergency and resuscitation settings. It improves the learning curve of the learners and helps them to avoid making mistakes on real patients. This study aimed to evaluate the educational efficiency for tracheal intubation by comparing Macintosh (direct) laryngoscope (DL) and video laryngoscope (VL) learning in novices.
This prospective randomized controlled study was conducted in an emergency department between 2013 and 2014. Fifth- and sixth-year medical students were enrolled and assigned to normal airway and difficult airway groups, respectively. They were then further randomized into using a VL or DL for tracheal intubation learning. Participants had three practices before proceeding to the post-course assessment. Our primary outcome was post-course assessment performance, which included intubation success rate, total intubation time and best glottic view. The secondary outcome was the sum of total intubation learning times during the three practices.
We recruited 177 undergraduate students. Of these, 97 were assigned to the normal airway group (49 VL and 48 DL) and 80 were placed in the difficult airway group (40 each for VL and DL). VL significantly quickened the intubation learning time in both the normal airway and difficult airway groups (140 s vs. 158 s, 141 s vs. 221.5 s; both
< 0.05). The learning curve was much improved with VL when compared using time-to-event analysis (
< 0.001). VL also improved the glottic view performance during post-course assessments.
VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
VL improves the learning curve in acquiring intubation skills compared with traditional DL. It shortens the time undergraduate students take to develop such skills and increased their first attempt success rates.
To investigate the association of clinical and hematological parameters with return of spontaneous circulation (ROSC) in out-of-hospital cardiac arrest (OHCA).
Clinical data of successive non-traumatic adult OHCA patients with available laboratory data of complete blood count and peripheral blood smear at emergency department (ED) arrival were requested. Hematological parameters were collected and calculated, and logistic regression and survival analysis were performed for association of ROSC with the parameters.
From December 2015 to December 2016, a total of 188 OHCA patients transported to our ED were enrolled. In ROSC group, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were signifi cantly higher and smudge cell count was signifi cantly lower when compared with non-ROSC group. In the univariate regression, NLR more than 2.0 (odds ratio [OR] 2.40, 95% confi dence interval [CI] 1.31-4.41;
= 0.004) and smudge cell count less than 0.45 °- 109/L (OR 0.33, 95% CI 0.15-0.71;
= 0.004) were signifi cantly associated with ROSC in OHCA. In logistic regression, bystander witnessed (OR 3.15, 95% CI 1.59-6.27;
= 0.001) and prehospital epinephrine use (OR 2.15, 95% CI 1.10-4.23;
= 0.026) were signifi cantly associated with ROSC in OHCA. NLR and smudge cell count were also seemingly related to ROSC in OHCA, but without statistical signifi cance. In survival analysis, neither NLR nor smudge cell count was associated with patient survival to discharge in OHCA.
NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.
NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.Atrial fibrillation (Af) is frequently seen in the emergency department (ED), and the main concern of which is the potential to lead to blockage of blood flow. link2 Cardiac tumors can also present with Af, which are often overlooked due to the rarity but clinically significant. A 70-year-old woman presented at our ED with intermittent palpitation and dizziness for several weeks. She has an underlying disease of right thyroid follicular carcinoma status-post surgery many years ago, but no history of heart disease. Her electrocardiogram (ECG) showed Af, and the transthoracic echocardiography showed a huge mass occupying the left atrium. The patient underwent an open-heart surgery with tumor excision. The pathology revealed metastatic thyroid follicular carcinoma. The patient recovered smoothly, and her ECG showed normal sinus rhythm after the operation. Most cardiac secondary tumors remain clinically silent and are often diagnosed postmortem. These conditions are rare but clinically significant; therefore, the physician should always raise suspicion of metastatic cardiac tumor as the differential diagnosis when patient presents with an unexplained Af.About 1-5 % of cases of tuberculosis (TB) have uncommon abdominal conditions, and affect primarily young adults. The clinical diagnosis is challenging and often delayed due to the symptoms being non-specific and may be confused with other bowel diseases, therefore resulting in significant morbidity and mortality. A 27-year-old man was brought to our emergency department with the complaints a fever and abdominal pain. According to the chest X-ray findings taken 24 hours previously, pulmonary TB was suspected. ML141 nmr associated intestinal obstruction, ascites and lymphadenopathy were found by computed tomography and exploratory laparotomy. link3 He was treated surgically by segmental resection, however passed away due to severe bleeding caused by the recurrence of perforation of the small intestine and sepsis. This case of systemic TB highlights the difficulties in diagnosis and treatment in time. The early diagnosis and timely treatment are both necessary to manage the disease successfully.
Epistaxis is the most common cause of otorhinolaryngologic emergencies. There is a longstanding controversy regarding the relationship between epistaxis and hypertension (HTN), in terms of blood pressure (BP) control in the emergency department (ED) setting. The objective of this study is to evaluate the association between HTN, BP control, and recurrent epistaxis among patients initially admitted to the ED for epistaxis.
This retrospective cohort study was conducted in the EDs of three different hospitals in Taiwan and included a total of 739 patients admitted for epistaxis.
Among ED patients with epistaxis, older age was significantly associated with a history of HTN, and a statistically significant difference in age was noted between groups classified according to the systolic BP/diastolic BP (SBP/DBP) at triage. Patients with a history of HTN had higher BP values at triage than did patients without a history of HTN (SBP 175.68 ± 32.30 mmHg vs. 148.00 ± 26.26 mmHg, DBP 95.04 ± 20.98 mmHg vs. 83.30 ± 16.