AIM To retrospectively review patients with chronic pancreatitis(CP) treated with Frey's procedures between January 2009 and January 2014.METHODS A retrospective review was performed of patients with CP treated wi...AIM To retrospectively review patients with chronic pancreatitis(CP) treated with Frey's procedures between January 2009 and January 2014.METHODS A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life(Qo L), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016. Qo L of patients was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30) version 3.0. The patients were requested to fill in the questionnaires by themselves via correspondence or clinical interview.RESULTS A total of 80 patients were enrolled for analysis, including 44 who underwent the original Frey's procedure and 36 who underwent a modified Frey's procedure. The mean age was 46 years in the original group and 48 years in the modified group. Thirtyfive male patients(80%) were in the original group and 33(92%) in the modified group. There were no differences in the operating time, blood loss, and postoperative morbidity and mortality between the two groups. The mean follow-up was 50.3 mo in the original group and 48.7 mo in the modified group. There were no differences in endocrine and exocrine function preservation between the two groups. The original Frey's procedure resulted in significantly betterpain relief, as shown by 5-year follow-up(P = 0.032), better emotional status(P = 0.047) and fewer fatigue symptoms(P = 0.028). When stratifying these patients by the M-ANNHEIM severity index, no impact was found on pain relief after the two types of surgery.CONCLUSION The original Frey's procedure is as safe as the modified procedure, but the former yields better pain relief. The severity of CP does not affect postoperative pain relief.展开更多
Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Ass...Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.展开更多
Purpose： To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center. Methods： Patients with multiple traumas referring to the emergency department of Hashe...Purpose： To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center. Methods： Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, lran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score （ISS） 〉 9 were included in this study. Data analysis was performed by SPSS software （Version 11.5） and P values less than 0.05 were considered as significant differences. Results： Among the 6306 hospitalized trauma patients during this period, 148 had ISS〉9. The male fe- male ratio was 80%. The mean age of the patients was （33.5 m 19.3） years. And 71% of the patients were younger than 44 years old. There were 19 （13%） deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was （55 e 26） minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases （75%）. Conclusion： Motorcycle crashes have high frequency in lran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.展开更多
Purpose： Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergen...Purpose： Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score （ISS）, new injury severity score （NISS） and revised trauma score （RTS） on children＇s mortality, hospitalization and need for surgery. Methods： In this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included. Statistical analysis was applied to determine the ISS, NISS and RTS ability in predicting the outcomes of interest. Results： There were 588 records in hospital registry system. The mean age of the patients was （7.3 ± 3.8） years, and 62.1% （n = 365） of patients were male. RTS was the more ability score to predict mortality with an area under curve （AUC） of 0.99 （95% CI, 0.99-1）. In the hospital length of stay （LOS）, ISS was best predictor for both the hospital LOS with AUC of 0.72 （95% CI, 0.67-0.76） and need for surgical surgery with AUC of 0.94 （95% CI, 0.90-0,98）. Conclusion： RTS as a physiological scoring system has a higher predicting AUC value in predicting mortality. The anatomic scoring systems of ISS and NISS have good performance in predicting of hospital LOS and need for surgery outcomes.展开更多
Purpose： Lately there is an increasing tendency of using Patient Reported Outcome Measures （PROMs） as a final indicator of the outcome of many surgical treatments in orthopaedics and in other medical specialties. C...Purpose： Lately there is an increasing tendency of using Patient Reported Outcome Measures （PROMs） as a final indicator of the outcome of many surgical treatments in orthopaedics and in other medical specialties. Currently there are many outcome scores in orthopaedics and most of them are site specific. In the contrary there is a lack of trauma specific outcome scores. Methods： We have designed a new PROM especially for orthopaedic trauma patients, in order to measure in what extent the patients manage to return to their pre-injury state. This score uses as baseline the preinjury status of the patient and has the aim to determine the percentage of rehabilitation after treatment for any injury. Results： A total of 60 Chertsey Outcome Score for Trauma （COST） questionnaires were gathered in our outpatients department. The participants were 57% male （aged 46.81 years ± 18.5 years） and the questionnaires collected at mean 10 months post-injury. A Cronbach＇s Alpha value of 0.89 was identified for the whole construct. The three dimensions of the scale had good internal consistency as well （Cronbach＇s Alpha test values 0.74, 0.84 and 0.81 for symptoms, function and mental status respectively）. Strong/moderate correlation （Spearman＇s Rho test 0.43-0.65） was observed between the respective physical/mental dimensions of the COST and SF-12v2 questionnaires. Conclusion： There is a need among the orthopaedic trauma society for a specific PROM of trauma. COST is a useful and easy to use tool for every trauma surgeon.展开更多
文摘AIM To retrospectively review patients with chronic pancreatitis(CP) treated with Frey's procedures between January 2009 and January 2014.METHODS A retrospective review was performed of patients with CP treated with Frey's procedures between January 2009 and January 2014 in the Department of Pancreatic Surgery. A cross-sectional study of postoperative pain relief, quality of life(Qo L), and alcohol and nicotine abuse was performed by clinical interview, letters and telephone interview in January 2016. Qo L of patients was evaluated with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire(EORTC QLQ-C30) version 3.0. The patients were requested to fill in the questionnaires by themselves via correspondence or clinical interview.RESULTS A total of 80 patients were enrolled for analysis, including 44 who underwent the original Frey's procedure and 36 who underwent a modified Frey's procedure. The mean age was 46 years in the original group and 48 years in the modified group. Thirtyfive male patients(80%) were in the original group and 33(92%) in the modified group. There were no differences in the operating time, blood loss, and postoperative morbidity and mortality between the two groups. The mean follow-up was 50.3 mo in the original group and 48.7 mo in the modified group. There were no differences in endocrine and exocrine function preservation between the two groups. The original Frey's procedure resulted in significantly betterpain relief, as shown by 5-year follow-up(P = 0.032), better emotional status(P = 0.047) and fewer fatigue symptoms(P = 0.028). When stratifying these patients by the M-ANNHEIM severity index, no impact was found on pain relief after the two types of surgery.CONCLUSION The original Frey's procedure is as safe as the modified procedure, but the former yields better pain relief. The severity of CP does not affect postoperative pain relief.
文摘Thirty cases of cervical spondylotic myelopathy (CSM) were treated by a maneuver-dominated non-surgical therapy. Eighteen cases were recovered to grade E according to the criteria set by the American Spinal Injury Association. The effect was definite. Indications and contraindications of the maneuver were proposed on the basis of the pathogenesis of CSM and the principles of this manual method.
文摘Purpose： To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center. Methods： Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, lran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score （ISS） 〉 9 were included in this study. Data analysis was performed by SPSS software （Version 11.5） and P values less than 0.05 were considered as significant differences. Results： Among the 6306 hospitalized trauma patients during this period, 148 had ISS〉9. The male fe- male ratio was 80%. The mean age of the patients was （33.5 m 19.3） years. And 71% of the patients were younger than 44 years old. There were 19 （13%） deaths from which 68.5% were older than 44 years old. The mean transfer time from the injury scene to hospital was （55 e 26） minutes. The most frequent mechanisms of injury were motorcycle crashes and falling from height, which together included 66.2% of all the injuries. A total of 84% of hospital deaths occurred after the first 24 h of hospitalization. Head and neck were the most common body injured areas with a prevalence of 111 cases （75%）. Conclusion： Motorcycle crashes have high frequency in lran. Since most victims are young males, injury prevention strategies should be considered to reduce the burden of injuries.
文摘Purpose： Pediatric trauma is one of the major health problems around the world which threats the life of children. The survival of injured children depends upon appropriate care, accurate triage and effective emergent surgery. The objective of this study was to determine the predictive values of injury severity score （ISS）, new injury severity score （NISS） and revised trauma score （RTS） on children＇s mortality, hospitalization and need for surgery. Methods： In this study, records of trauma patients under 15 years old transported from a trauma scene to emergency department of Poursina hospital from 2010 to 2011 were included. Statistical analysis was applied to determine the ISS, NISS and RTS ability in predicting the outcomes of interest. Results： There were 588 records in hospital registry system. The mean age of the patients was （7.3 ± 3.8） years, and 62.1% （n = 365） of patients were male. RTS was the more ability score to predict mortality with an area under curve （AUC） of 0.99 （95% CI, 0.99-1）. In the hospital length of stay （LOS）, ISS was best predictor for both the hospital LOS with AUC of 0.72 （95% CI, 0.67-0.76） and need for surgical surgery with AUC of 0.94 （95% CI, 0.90-0,98）. Conclusion： RTS as a physiological scoring system has a higher predicting AUC value in predicting mortality. The anatomic scoring systems of ISS and NISS have good performance in predicting of hospital LOS and need for surgery outcomes.
文摘Purpose： Lately there is an increasing tendency of using Patient Reported Outcome Measures （PROMs） as a final indicator of the outcome of many surgical treatments in orthopaedics and in other medical specialties. Currently there are many outcome scores in orthopaedics and most of them are site specific. In the contrary there is a lack of trauma specific outcome scores. Methods： We have designed a new PROM especially for orthopaedic trauma patients, in order to measure in what extent the patients manage to return to their pre-injury state. This score uses as baseline the preinjury status of the patient and has the aim to determine the percentage of rehabilitation after treatment for any injury. Results： A total of 60 Chertsey Outcome Score for Trauma （COST） questionnaires were gathered in our outpatients department. The participants were 57% male （aged 46.81 years ± 18.5 years） and the questionnaires collected at mean 10 months post-injury. A Cronbach＇s Alpha value of 0.89 was identified for the whole construct. The three dimensions of the scale had good internal consistency as well （Cronbach＇s Alpha test values 0.74, 0.84 and 0.81 for symptoms, function and mental status respectively）. Strong/moderate correlation （Spearman＇s Rho test 0.43-0.65） was observed between the respective physical/mental dimensions of the COST and SF-12v2 questionnaires. Conclusion： There is a need among the orthopaedic trauma society for a specific PROM of trauma. COST is a useful and easy to use tool for every trauma surgeon.
