OBJECTIVES: To recommend appropriate immobilization after the initial reduction of acetabular displaced fractures in order to minimize the risk of heterotopic ossification formation. DESIGN: Retrospective study of patients treated in our surgical department during the years 2005-2018. MATERIALS AND METHODS: There were 94 patients included in statistical analysis. The factors of injury severity, course of surgery and hospitalization and incidence of complications were recorded. The functional and X-ray results were evaluated at least one year after surgery. RESULTS: The patients were divided into the two groups according to the type of fixation after closed reduction, the external fixation (EF) and the skeletal traction (ST) group. According to the type of fracture there were 33 patients with central displacement and 61 patients with posterior displacement. Ossification grade III. And IV. Occur in 20% of our sample. There was greater incidence of Brooker grade III. And IV. Ossification in the ST group, but statistically insignificant, p = 0.57. There was no statistically significant difference in the occurrence of ossifications regarding the severity of the head injury, p = 0.11, or to the severity of the injury p = 0.54. The combination of posterior displacement and ST results in higher risk for ossifications, specifically in our group at 11.48% compared to the combination of posterior displacement and EF where it is 8.2%. CONCLUSION: Skeletal traction for posterior displaced acetabular fracture appears to be a more risky procedure for the development of ossifications than external fixation.
- MeSH
- acetabulum zranění chirurgie MeSH
- externí fixátory * škodlivé účinky MeSH
- fixace fraktur škodlivé účinky MeSH
- heterotopická osifikace * epidemiologie etiologie prevence a kontrola MeSH
- lidé MeSH
- retrospektivní studie MeSH
- výsledek terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: This retrospective study aimed to analyze the trend of mortality due to thoracic aortic ruptures caused by deceleration injuries that occurred within the catchment area of Hradec Kralove University Hospital. MATERIALS AND METHODS: The study sample comprised 175 patients who had sustained thoracic aortic ruptures caused by deceleration injuries and were transported to Hradec Kralove University Hospital in 2009-2014. The small proportion of patients enrolled in this retrospective study were diagnosed and treated at the emergency department (ED). However, the overwhelming majority of the sample comprised of patients who died at the accident scene and later underwent an autopsy at the Institute of Forensic Medicine in our hospital. RESULTS: Of 175 patients, 150 underwent an autopsy. Of these, 139 individuals (79%) died at the incident scene, and 11 (6%) were transported to the ED and later died of their injuries. A total of 36 patients were admitted to the hospital; 29 were admitted primary (11 later died), and 7 were transferred. No deaths occurred in the group of secondary admissions. Thus, 31% of all patients hospitalized died following transport to the hospital. Of 175 patients, 15% (or 69% of all hospitalized patients) survived their injuries. Among patients who died as a result of thoracic aortic injury, no unexpected deaths were recorded (i.e., no deaths among patients with survival probability more than 50% = PS > 0.5). CONCLUSION: Our results suggested that the lethality of thoracic aortic injuries might be minimized by transporting triage-positive patients directly to trauma centers. Accurate diagnoses and treatments were supported by admission chest X-rays, a massive transfusion protocol, and particularly, CT angiography, which is not routinely included in primary surveys. An additional prognostic parameter was clinical collaboration between an experienced trauma surgeon, an interventional radiologist, and a vascular or thoracic surgeon.
- MeSH
- aorta thoracica diagnostické zobrazování zranění MeSH
- dopravní nehody mortalita statistika a číselné údaje MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- rentgendiagnostika MeSH
- retrospektivní studie MeSH
- ruptura aorty diagnostické zobrazování epidemiologie etiologie mortalita MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- traumatologická centra statistika a číselné údaje MeSH
- zpomalení škodlivé účinky MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Hongkong MeSH
Úvod: Poranění bránice je poměrně málo často se vyskytující poranění, většinou jako součást sdruženého poranění či polytraumatu. Cílem naší práce bylo vyhodnotit incidenci tohoto poranění a jeho dopad na morbiditu a letalitu. Materiál a metodika: Do souboru byli zahrnuti všichni pacienti z databáze Traumacentra FN Hradec Králové, kteří byli přivezeni zdravotnickou záchrannou službou a u nichž byla diagnostikována ruptura bránice v šestiletém období (1. 1. 2008 – 31. 12. 2013). Výsledky: Během uvedeného období bylo do FN Hradec Králové přijato celkem 3309 pacientů, u 18 z nich byla diagnostikována ruptura bránice. Jasně převažoval tupý mechanizmus úrazu (n=14), nejčastěji zaklínění ve vozidle (n=9). Celkem zemřelo šest pacientů (33 %). Závěr: Diagnostika poranění bránice je při její nízké incidenci nadále velmi problematická. Ani negativní vstupní CT vyšetření jasně nevyloučí jeho pozdní manifestaci. Proto při náhle vzniklé dušnosti či kolapsu a anamnéze závažného úrazu je nutné na toto poranění myslet jako na jednu z možných příčin.
Introduction: Rupture of the diaphragm is an uncommon injury, seen in patients with multiple injury or polytrauma. The aim of our study was to evaluate the incidence of this type of injury and it´s influence on morbidity and mortality. Material and methods: All patients from the University Hospital of Hradec Králové Traumacentre's database brought by ambulance and in whom a rupture diaphragm was diagnosed in a six-year period (1. 1. 2008 – 31. 12. 2013), were included in this study. Results: In the above mentioned period 3309 patients were brought by ambulance to the University Hospital of Hradec Králové and in 18 of them was rupture of the diaphragm diagnosed. Blunt injury was clearly the leading trauma mechanism (n=14), the patients were most commonly stuck in a vehicle (n=9). 6 patients died in total (33 %). Conclusions: Diagnostics of diaphragm rupture is because of it´s low incidence, still very challenging. Despite of a negative primary CT-exam later manifestation cannot be excluded. Therefore it is inevitable, in case of sudden dyspnea or collapse and adequate trauma history to bear in mind the option of this rare injury.
Treponema pallidum strains are closely related at the genome level but cause distinct diseases. Subspecies pallidum (TPA) is the causative agent of syphilis, subspecies pertenue (TPE) causes yaws while subspecies endemicum (TEN) causes bejel (endemic syphilis). Compared to the majority of treponemal genomic regions, several chromosomal loci were found to be more diverse. To assess genetic variability in diverse genomic positions, we have selected (based on published genomic data) and sequenced five variable loci, TP0304, TP0346, TP0488, TP0515 and TP0558, in 19 reference Treponema pallidum strains including all T. pallidum subspecies (TPA, TPE and TEN). Results of this multilocus analysis divided syphilitic isolates into two groups: SS14-like and Nichols-like. The SS14-like group is comprised of SS14, Grady, Mexico A and Philadelphia 1 strains. The Nichols-like group consisted of strains Nichols, Bal 73-1, DAL-1, MN-3, Philadelphia 2, Haiti B and Madras. The TP0558 locus was selected for further studies because it clearly distinguished between the SS14- and Nichols-like groups and because the phylogenetic tree derived from the TP0558 locus showed the same clustering pattern as the tree constructed from whole genome sequences. In addition, TP0558 was shown as the only tested locus that evolved under negative selection within TPA strains. Sequencing of a short fragment (573bp) of the TP0558 locus in a set of 25 clinical isolates from 22 patients collected in the Czech Republic during 2012-2013 revealed that clinical isolates follow the SS14- and Nichols-like distribution.
- MeSH
- dospělí MeSH
- genotyp MeSH
- lidé středního věku MeSH
- lidé MeSH
- molekulární epidemiologie MeSH
- multilokusová sekvenční typizace MeSH
- novorozenec MeSH
- shluková analýza MeSH
- syfilis epidemiologie mikrobiologie MeSH
- Treponema pallidum klasifikace genetika izolace a purifikace MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- novorozenec MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Karcinom prsu je v České republice nejčastěji se vyskytujícím zhoubným nádorem u žen. Počet nově hlášených nádorů v posledních desetiletích postupně narůstá. Změnila se však i diagnostika a léčba karcinomu prsu. Materiál a metodika: Retrospektivní studie na Chirurgické klinice v Pardubicích. Jsou porovnány roky 1991 a 2006 v počtu výkonů, stran diagnostických metod, typu výkonů, velikosti nádoru, postižení lymfatických uzlin, metastáz předoperačního času a věku. Výsledky a závěr: Počet výkonů se zdvojnásobil, velikost nádoru se zmenšila z 3,05 cm na 2,01 cm, zlepšila se diagnostika metastáz v uzlinách a v plicích, je patrný posun k prs zachovávajícím výkonům, zkrátil se předoperační čas.
The breast carcinoma is the most frequent malignancy in the women in the Czech Republic. The incidence of the breast carcinoma is still increasing. But the diagnostics and treatment of this disease was also changed. MATERIAL AND A METHODS: Retrospective study on the Department of Surgery Pardubice General Hospital. There are compared two periods--the years 1991 and 2006. Particularly there are followed numbers of procedures, diagnostics methods, types of procedures, size of the tumor, lymph node and systemic metastases, preoperative time and age of the patients. RESULTS AND CONCLUSION: The number of procedures doubled, the size of the tumor decreased from 3.05 to 2.01 cm, detection of lymph node metastases and lung metastases improved, there is trend to breast conservative treatment, preoperative time shortened.
- MeSH
- lidé MeSH
- nádory prsu diagnóza chirurgie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- časná detekce nádoru * MeSH
- lidé MeSH
- nádory prsu * diagnóza terapie MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
