4 research outputs found
Hepatic Trauma: A 21-year Experience [trauma Hepático: Uma Experiência De 21 Anos]
Objective: To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma. Methods: We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM). Results: 748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%. Conclusion: trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.404318322Talving, P., Beckman, M., Häggmark, T., Iselius, L., Epidemiology of liver injuries (2003) Scand J Surg., 92 (3), pp. 192-194Diorio, A.C., Fraga, G.P., Dutra Jr., I., Joaquim, J.L., Mantovani, M., Predictive factors of morbidity and mortality in hepatic trauma (2008) Rev Col Bras Cir., 35 (6), pp. 397-405Smaniotto, B., von Bahten, L.C., Nogueira Filho, D.C., Tano, A.L., Thomaz Júnior, L., Fayad, O., Hepatic trauma: Analysis of the treatment with intrahepatic balloon in a university hospital of Curitiba (2009) Rev Col Bras Cir., 36 (3), pp. 217-222Croce, M.A., Fabian, T.C., Menke, P.G., Waddle-Smith, L., Minard, G., Kudsk, K.A., Nonoperative management of blunt hepatic trauma is the treatment of choice for hemodynamically stable patients. Results of a prospective trial (1995) Ann Surg., 221 (6), pp. 744-753Sriussadaporn, S., Pak-art, R., Tharavej, C., Sirichindakul, B., Chiamananthapong, S., A multidisciplinary approach in the management of hepatic injuries (2002) Injury., 33 (4), pp. 309-315Champion, H.R., Sacco, W.J., Copes, W.S., Gann, D.S., Gennarelli, T.A., Flanagan, M.E., A revision of the Trauma Score (1989) J Trauma., 29 (5), pp. 623-629Baker, S.P., O'Neill, B., Haddon Jr., W., Long, W.B., The injury severity score: A method for describing patients with multiple injuries and evaluating emergency care (1974) J Trauma., 14 (3), pp. 187-196Boyd, C.R., Tolson, M.A., Copes, W.S., Evaluating trauma care: The TRISS method. Trauma Score and the Injury Severity Score (1987) J Trauma., 27 (4), pp. 370-378Moore, E.E., Cogbill, T.H., Jurkovich, G.J., Shackford, S.R., Malangoni, M.A., Champion, H.R., Organ injury scaling: Spleen and liver (1994 revision) (1995) J Trauma., 38 (3), pp. 323-324Stalhschmidt, C.M., Formighieri, B., Marcon, D.M., Takejima, A.L., Soares, L.G.S., Hepatic trauma: Five years of epidemiology in an emergency service (2008) Rev Col Bras Cir., 35 (4), pp. 225-228Malhotra, A.K., Fabian, T.C., Croce, M.A., Gavin, T.J., Kudsk, K.A., Minard, G., Blunt hepatic injury: A paradigm shift from operative to nonoperative management in the 1990s (2000) Ann Surg., 231 (6), pp. 804-813Matthes, G., Stengel, D., Seifert, J., Rademacher, G., Mutze, S., Ekkernkamp, A., Blunt liver injuries in polytrauma: Results from a cohort study with the regular use of whole-body helical computed tomography (2003) World J Surg., 27 (10), pp. 1124-1130Krige, J.E., Bornman, P.C., Terblanche, J., Liver trauma in 446 patients (1997) S Afr J Surg., 35 (1), pp. 10-15Scollay, J.M., Beard, D., Smith, R., McKeown, D., Garden, O.J., Parks, R., Eleven years of liver trauma: The Scottish experience (2005) World J Surg., 29 (6), pp. 744-749Pachter, H.L., Knudson, M.M., Esrig, B., Ross, S., Hoyt, D., Cogbill, T., Status of nonoperative management of blunt hepatic injuries in 1995: A multicenter experience with 404 patients (1996) J Trauma., 40 (1), pp. 31-38Asensio, J.A., Demetriades, D., Chahwan, S., Gomez, H., Hanpeter, D., Velmahos, G., Approach to the management of complex hepatic injuries (2000) J Trauma, 48 (1), pp. 66-69Kozar, R.A., Moore, J.B., Niles, S.E., Holcomb, J.B., Moore, E.E., Cothren, C.C., Complications of nonoperative management of high-grade blunt hepatic injuries (2005) J Trauma., 59 (5), pp. 1066-1071Sikhondze, W.L., Madiba, T.E., Naidoo, N.M., Muckart, D.J., Predictors of outcome in patients requiring surgery for liver trauma (2007) Injury., 38 (1), pp. 65-70Fraga, G.P., Zago, T.M., Pereira, B.M., Calderan, T.R., Silveira, H.J., Use of Sengstaken-Blakemore intrahepatic balloon: An alternative for liver-penetrating injuries (2012) World J Surg., 36 (9), pp. 2119-2124Meredith, J.W., Young, J.S., Bowling, J., Roboussin, D., Nonoperative management of blunt hepatic trauma: The exception or the rule? (1994) J Trauma., 36 (4), pp. 529-534Bynoe, R.P., Bell, R.M., Miles, W.S., Close, T.P., Ross, M.A., Fine, J.G., Complications of nonoperative management of blunt hepatic injuries (1992) J Trauma., 32 (3), pp. 308-314Sherman, H.F., Savage, B.A., Jones, L.M., Barrette, R.R., Latenser, B.A., Varcelotti, J.R., Nonoperative management of blunt hepatic injuries: Safe at any grade? (1994) J Trauma., 37 (4), pp. 616-621Coimbra, R., Hoyt, D.B., Engelhart, S., Fortlage, D., Nonoperative management reduces the overall mortality of grades 3 and 4 blunt liver injuries (2006) Int Surg., 91 (5), pp. 251-257Norrman, G., Tingstedt, B., Ekelund, M., Andersson, R., Non-operative management of blunt liver trauma: Feasible and safe also in centres with a low trauma incidence (2009) HPB., 11 (1), pp. 50-56Zago, T.M., Pereira, B.M., Calderan, T.R., Hirano, E.S., Rizoli, S., Fraga, G.P., Blunt hepatic trauma: Comparison between surgical and nonoperative treatment (2012) Rev Col Bras Cir., 39 (4), pp. 307-313Zago, T.M., Tavares Pereira, B.M., Araujo Calderan, T.R., Godinho, M., Nascimento, B., Fraga, G.P., Nonoperative management for patients with grade IV blunt hepatic trauma (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S8Pereira, B.M., Non-operative management of hepatic trauma and the interventional radiology: An update review (2012) Indian J Surg., , [on line]Carrasco, C.E., Godinho, M., de Azevedo Barros Berti, M., Rizoli, S., Fraga, G.P., Fatal motorcycle crashes: A serious public health problem in Brazil (2012) World J Emerg Surg., 7 (SUPPL. 1), pp. S
Cryptococcosis: a review of the brazilian experience for the disease Criptococose: revisão sobre a experiência brasileira sobre a doença
Cryptococcosis is a systemic mycosis caused by Cryptococcus neoformans. The disease occurs in patients with cellular immunodeficiency. The incidence of cryptococcosis arises with aids, and mycosis is one of the opportunistic infections that defines AIDS. After the HAART era the occurrence of cryptococcosis decreased all over the world, but it still continues to be a prevalent disease in Brazil. Thus, we consider this paper to be very important as a result of our reviewing of Brazilian literature regarding some relevant aspects of that disease.<br>Criptococose é micose sistêmica causada por Cryptococcus neoformans. A doença ocorre em pacientes com deficiência da imunidade celular. Com o aparecimento da doença AIDS, a incidência de criptococose aumentou, e a micose é uma das infecções oportunistas que definem um caso de AIDS. Após a era HAART, criptococose parece estar diminuindo no mundo todo, mas continua sendo uma doença prevalente no Brasil. Este artigo visa a análise da contribuição dos autores brasileiros sobre vários aspectos da doença