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  • 1
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Les résultats d'une étude comparative sur les types d'accidents concernant les motocyclistes et vélocyclistes dans la province de Victoria ont été utilisés par le Royal Australasian College of Surgeons pour faire une campagne nationale en faveur du port de caseque pour tout cycliste et obtenir des instances légales que le port du casque soit obligatoire. Les lésions crâniennes liés à un accident de vélo étaient bien plus fréquentes que celles liées à un accident de moto. Par contre, les accidents de moto provoquaient d'avantage d'accidents corporels sévères. Avant l'introduction en Juillet 1990 de l'obligation du port de casque dans la province de Victoria par les vélocyclistes, il y avait eu une augmentation du port volontaire du casque et par conséquent, une réduction des dépenses dans ce domaine. Parmi une population de plus de 1,700 cyclistes de la province de Victoria, 64 casques ont été choisis au hasard afin d'évaluer leur résistance à un choc et les possibles rapports avec la survenue d'accidents. On a trouvé que 16/64 casques avaient subi plus d'un choc pendant l'accident. Toutes les lésions crâniennes orrespendant à un score AIS de 4 ou plus étaient survenues lors d'un accident entre un cycliste et un véhicule motorisé. De plus, dans cette catégorie, la tête et le casque avaient reçu plus d'un choc et/ou le casque avait été perdu pendant le choc de l'accident. La plupart des chocs étaient inférieurs à la moyenne pour l'Australie et les Etats-Unis. Dix pourcent des chocs, cependant, étaient plus importants. Des recommandations sont proposées pour améliorer les normes des casques.
    Abstract: Resumen Los resultados de un estudio comparativo de los perfiles de trauma de motociclistas del estado de Victoria (Australia) y de muertes de accidentes de bicicleta fueron utilizados por el royal Australasian College of Surgeons para iniciar una campaña estatal destinada a promover el uso de cascos de seguridad aprobados por los ciclistas victorianos y a lograr de la legislación necesaria para que su uso fuera obligatorio. Los muertos por accidentes de bicicleta habían sufrido más frecuentes y más severas lesiones craneoencefálicas que los muertos por accidentes de motocicleta, aunque los últimos habían sufrido, en general, más graves lesiones corporales. Se registraron incrementos en la frecuencia del uso voluntario de cascos y reducciones en los costos con anterioridad a la introducción en Victoria, en julio de 1990, de la obligatoriedad del uso de cascos por los ciclistas. Sesenta y cuatro cascos obtenidos en el curso del estudio sobre más de 1700 ciclistas victorianos que usaban y no usaban casco fueron evaluados en cuanto a la eficacia frente al impacto, y los hallazgos se correlacionaron con la incidencia del trauma craneano. Dieciseis cascos sufrieron más de un impacto en el accidente. Todos los muertos que sufrieron trauma craneano severo (AIS ≥ 4) estuvieron involucrados en una colisión con un vehículo automotor y sufrieron más de un impacto sobre la cabeza/casco y/o el casco se había soltado durante el accidente. La mayoría de los impactos se produjeron por debajo de los estándares de seguridad establecidos en Australia y en los E.U.A. Diez por ciento de los impactos fueron de mayor severidad que los requeridos en los estándares de referencia. Se hacen recomendaciones para mejorar los estándares actuales.
    Notes: Abstract The results of a comparative study of the injury profiles of Victorian motorcyclist and bicyclist casualties were used by the Royal Australasian College of Surgeons in initiating a state-wide campaign to promote the wearing of approved safety helmets by Victorian bicyclists and to obtain the necessary legislation whereby such wearing would become compulsory. Bicyclist casualties had sustained more frequent and severe head injuries than motorcyclist casualties although the latter had sustained overall more severe body injuries. Increases in voluntary helmet wearing rates and reductions in costs preceded the introduction in July, 1990 in Victoria of compulsory safety helmet wearing by bicyclists. Sixty-four helmets obtained during a study of more than 1,700 Victorian bicyclists wearing and not wearing helmets were evaluated for performance by impact severity testing and findings related to head injury occurrence. Sixteen helmets sustained more than one impact during the accident. All casualties who sustained a severe head injury (Abbreviated Injury Scale ≥ 4) were involved in a collision with a motor vehicle and subjected to more than one impact to the head/helmet and/or the helmet had come off during the accident. Most impacts occurred below the current test lines of Australian and United States standards. Ten percent of impacts were more severe than required in performance standards. Recommendations are made for improvements in the current standard.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 6 (1982), S. 160-165 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé La guérison du cancer colique nécessite que l'intervention chirurgicale surmonte deux obstacles: les complications post opératoires et la récidive du processus tumoral. La récidive survient généralement au cours des cinq années qui suivent l'opération. Les complications opératoires, elles, sont le fait de l'infection. Il est rare que l'infection entraîne la mort; plus souvent en altérant l'endothélium vasculaire elle favorise la thrombose artérielle et veineuse. Elle est la source d'une morbidité très importante qu'elle se développe au sein de la cavité abdominale ou au niveau de la paroi abdominale. Plusieurs méthodes permettent de l'éviter: 1) La réduction du nombre des germes dans l'intestin (préparation pré-opératoire). 2) La diminution du nombre des germes susceptibles en cours d'intervention de contaminer le champ opératoire (technique aseptique). 3) La destruction des agents bactériens contaminant la paroi.
    Notes: Abstract A patient undergoing surgery for carcinoma of the large bowel has 2 hurdles to negotiate before claiming a cure. The first is postoperative complications and the second, recurrence of the tumor. Recurrence of the tumor will occur almost always within the first 5 years. Postoperative complications are mainly related to infection. Infection on its own is rarely responsible for the death of the patient, but by damaging the vascular endothelium may predispose to arterial or venous thrombosis. More commonly, sublethal sepsis is the cause of considerable morbidity whether within the abdominal wound or the intraperitoneal cavity. One or more of 3 basically different methods are employed to control infection in large bowel surgery: (1) reduction in the number of microorganisms in the large bowel; (2) reduction in the number of microorganisms contaminating the wound, whether within or without the peritoneal cavity; and (3) destruction of microorganisms contaminating the wound. The authors have relied on reducing the number of microorganisms contaminating the wound by strict attention to wound protection and aseptic surgery, and the destruction of microorganisms that actually reach the wound. To this end, excellent results with antibiotics have been obtained by combining meticulous aseptic surgery with the use of cefazolin and metronidazole administered a short time prior to surgery.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    World journal of surgery 9 (1985), S. 794-797 
    ISSN: 1432-2323
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Trente-deux observations d'accidentés présentant des lésions intestinales dues au port de la ceinture de sécurité sont rapportées. Elles se classent en trois groupes en fonction de la nature et du mécanisme des lésions. Le groupe I concerne 4 accidentés qui présentaient une section complète du jéjunum proximal provoquée par la décélération. Des lésions associées comprenaient la rupture de la rate, la perforation du colon transverse et de l'angle splénique. Le groupe II répond à 6 blessés qui présentaient un infarcissement iléal provoqué par l'écrasement. Les lésions associées répondaient à des déchirures du coecum, de l'aorte et de la veine cave inférieure. Le groupe III intéresse 22 accidentés qui présentaient des perforations du jéjunum et de l'iléon par brusque distension due elle-même à la force de la contusion, ce type de lésions par rupture ne s'accompagnant pas de lésion spécifique associée.
    Abstract: Resumen Se revisaron treinta y dos casos de lesiones del yeyuno y del íleon por cinturones de seguridad (automotrices). Los pacientes fueron clasificados en tres grupos de acuerdo a la naturaleza y mecanismo de la lesión. El grupo I consistió de 4 pacientes con transección completa del yeyuno proximal causada por fuerzas de desaceleración. Como lesiones frecuentemente asociadas aparecieron la ruptura del bazo y la perforación del colon transverso y del ángulo esplénico. El grupo II consistió de 6 pacientes con infarto del íleon causado por fuerzas de machacamiento. Como lesiones asociadas se encontraron desgarros del ciego, de la aorta y de la vena cava inferior. El grupo III consistió de 22 pacientes con perforación por estallido del yeyuno y del íleon. Estas lesiones son causadas por fuerzas transmitidas a partir de la pared anterior del abdomen, los cuales causan una elevación repentina en la presión intraluminal del intestino delgado. No se encontraron lesiones específicas asociadas en este grupo de pacientes. La mortalidad por lesiones del intestino delgado causadas por trauma abdominal cerrado ha sido principalmente atribuida a diagnóstico tardío. Los síntomas iniciales pueden ser mínimos. El neumoperitoneo puede aparecer radiográficamente sólo en el 50% de los casos; la determinación de la amilasa sérica generalmente ha demostrado ser poco confiable. En nuestra serie la mortalidad reflejómás bien la presencia de lesiones asociadas que diagnóstico tardío. Creemos que el examen e historia clínicos cuidadosos y un buen conocimiento de los mecanismos de lesión del intestino delgado pueden alertar al cirujano para lograr un diagnóstico correcto en la mayoría de los casos.
    Notes: Abstract Thirty-two patients with seat belt-induced injuries to the jejunum and ileum are reviewed. These patients are classified into 3 groups according to the nature and mechanism of injury. Group I consists of 4 patients with complete transection of the proximal jejunum caused by deceleration forces. Injuries commonly associated include spleen rupture and perforation of the transverse colon and splenic flexure. Group II consists of 6 patients with infarcted ileum caused by crushing forces. Associated injuries include tears to the cecum, aorta, and inferior vena cava. Group III consists of 22 patients with “blowout” perforations of the jejunum and ileum. These injuries are caused by transmitted forces. There are no associated specific injuries related to this group.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 22 (1977), S. 637-640 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Adaptation in the small bowel after resection is associated with increases in crypt cell proliferation and villus height. This paper gives the results of an autoradiographic investigation with [3H]thymidine of epithelial cell migration 60 days after 40% small-bowel resection in the rat. The mean number of cell positions between the crypt-villus junction and the leading labeled cell 30 hr after injection was increased by 19.4% in the resected group (P〈0.02). The mean total number of cells per villus column was increased by 27.8% (P〈0.002). Migration rate estimated in cell positions per hour was accelerated by 18.9% (P〈0.001) after resection. The 8.1% lengthened life span of villus cells was not statistically significant. The increased number of cells per villus column and unaltered life span of villus cells would facilitate functional adaptation. The causal relationship between the larger villus cell population and accelerated migration after resection and increased crypt cell proliferation is unknown.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Digestive diseases and sciences 18 (1973), S. 881-886 
    ISSN: 1573-2568
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effects of single and repeated doses of aspirin on the gastric mucosa of the rat were compared to determine whether the mucosal response alters after repeated aspirin. Aspirin (120 mg/kg) was administered by esophageal intubation either as a single dose or daily for 3, 14, 28 and 56 days. Mucosal damage was present in all treated rats but, on histologic quantitation, there was a highly significant reduction in the numbers of acute erosions in the groups receiving repeated daily aspirin. This apparent adaptation did not persist when aspirin administration was interrupted for 3 days. Repeated aspirin administration was not associated with any reduction in aspirin absorption or excretion, nor was there any significant change in hydrochloric acid or pepsin secretion. The investigation has shown an adaptation to repeated aspirin in the rat which appears to result from an alteration in the gastric mucosa. The precise mechanism of the adaptation remains uncertain.
    Type of Medium: Electronic Resource
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