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Biomedical subjects

Y Kluger

Publications and source records attributed to Y Kluger.

At least 91 records · Page 5Linked to original sources
PubMed1997

[Patterns of injuries and preventive measures for motorcycle accidents].

Retrospective analysis of a series of 32 motorcyclists admitted after road accidents was performed. 62% were injured on scooters with 50 cc engine capacity and most of the combined injuries occurred in this group. Most crashes occurred at road junctions. Riders of scooters with larger engine capacities tended to wear protective garments as opposed to riders with smaller engines. There was no correlation between engine capacity and severity of injury. We conclude that motorcyclists should receive special education, especially as to behavior on entering road junctions. We recommend that taxes on protective garments should be lowered in order to encourage motorcyclists to use them.

Accidents, Traffic↗
PubMed1997

[Whipple operation in trauma].

Pancreato-duodenectomy is a formidable operation for the critically injured patient. We describe a patient who sustained a stab wound to the stomach and duodenum. At operation this injury could not be reconstructed. A Whipple operation was performed in which the pancreatic stump was stapled and recovery was uneventful, although there was a low output fistula from the pancreatic stump. Limited indications for the Whipple procedure in trauma patients are suggested.

Adult↗
PubMed1997

[Blunt perineal injuries].

Blunt perineal and anal injuries are rare. We describe 2 patients who suffered injury to the perineum and anal canal due to blunt force. New surgical techniques for the reconstruction of the sphincteric mechanism are promising and should be used by the initial treating surgeon as minimal procedures in the perineal region. Anal tagging, minimal debridement, approximation of the edges of perineal laceration, repeated irrigation and loop-colostomy for fecal diversion should be the only initial surgical procedures.

Adult↗
PubMed1997

[Kapoera--popular dance or martial art?].

Kapoera, a combination of acrobatics and coordinated athletic movement, is believed to have been introduced to South America during the 19th century by transported African slaves. The dance does not involve intentional physical contact, but during 6 months, 3 patients were admitted here for injuries induced by the forceful movements of this dance. 2 underwent exploratory laparotomy that revealed bowel perforations and 1 suffered a comminuted nasal bone fracture. Medical personnel should be familiar with the potential hazards of this dance and martial art.

Adult↗
PubMed1997

Gastric serosal patch in distal pancreatectomy for injury: a neglected technique.

Distal pancreatectomy to manage disruption of the body and tail of the pancreas is a well-established surgical procedure. Fistula formation after distal pancreatectomy for injury may be as high as 24 per cent, and its treatment, although non-operative, prolongs hospitalization and increases the patient's discomfort. We describe the gastric serosal patch technique designed to cover the pancreatic stump after distal pancreatectomy in injured patients. Although this procedure has been previously described, it did not receive appropriate acclaim. Our experience suggests that this technique may eliminate fistula formation and other complications, thereby reducing patient discomfort, morbidity and hospital stay.

Adolescent↗
PubMed1997

Diarrheal epidemics among Rwandan refugees in 1994. Management and outcome in a field hospital.

We describe the clinical course and outcome of Rwandan refugees with cholera-like illness (n = 567) and clinical dysentery (n = 1,062) treated at the Israeli Army field hospital in the disaster region of Goma, Zaire, during the summer of 1994. Vigorous fluid administration was the primary therapy, complemented with antibiotics for patients with presumed Shigella infection. Recovery rates were 94% and 96% for patients with cholera and dysentery, respectively. Mortality was substantially affected by comorbid conditions such as pneumonia and meningitis, which occurred in one-quarter of these patients. Infective, metabolic, and surgical complications (including three cases of intussusception) may have contributed to the deaths. The outcome of patients during diarrheal epidemics of cholera or bacillary dysentery may be favorable, even in disaster settings, if patients are evacuated promptly to medical facilities and appropriate therapy is instituted. We close with general observations on procedures to be followed in future epidemics of diarrheal diseases.

Adolescent↗
PubMed1997

Direct induction of acute lung and myocardial dysfunction by liver ischemia and reperfusion.

OBJECTIVES: To investigate whether liver ischemia and reperfusion (IR) directly affect functions of remote organs. BACKGROUND: Cardiovascular and respiratory dysfunction follows hemorrhage, spinal shock, or trauma as a result of no-flow-reflow phenomena. Hepatic IR induces remote organ damage probably by xanthine oxidase and oxygen species. MATERIALS AND METHODS: Isolated rat livers, lungs, and hearts were perfused with Krebs-Henseleit solutions. After stabilization, livers were either perfused or made ischemic. Then, livers and hearts or livers and lungs were reperfused in series, and the liver was disconnected and the second organ continued to perfuse with the accumulated effluents. MEASUREMENTS AND MAIN RESULTS: Ischemic and reperfused liver effluent contained high lactate dehydrogenase and uric acid concentrations compared with controls; xanthine oxidase increased 60 to 100 times. Ischemic and reperfused lung peak inspiratory pressure almost doubled; airway static compliance halved; myocardial contractility decreased to 70% of baseline; wet weight-to-dry weight ratios of lungs and livers increased. CONCLUSION: Ischemic and reperfused liver can directly induce myocardial and pulmonary dysfunction, presumably by oxidant-induced injury.

Acute Disease↗
PubMed1997

The use of hemorrhage occluder pins for controlling paravertebral intercostal artery bleeding: case report.

OBJECTIVE: To describe a technique for arresting traumatic bleeding uncontrollable by conventional means. METHODS AND RESULTS: Major intrathoracic bleeding was stopped in a 17-year-old boy who had been stabbed in his right chest by using a Hemorrhage Occluder Pin (Surgical Instruments Inc., Placetia, Calif). CONCLUSIONS: The use of occluder pins to stop bleeding from intercostal arteries may be life-saving.

Adolescent↗
PubMed1997

Methylene blue--a promising treatment modality in sepsis induced by bowel perforation.

In this study, we compared the effects of methylene blue (MB) and an L-arginine analogue on host outcome, blood pressure, lung injury, and nitric oxide (NO) production in rats following fecal peritonitis induced by cecal ligation and puncture (CLP). Sepsis syndrome was induced in 90 rats: 30 were treated with MB, 30 with an NO synthase inhibitor, and 30 with normal saline. We found significantly less alveolar damage, higher blood pressure, better respiratory function, and delayed mortality among animals treated with MB compared to the control group. We conclude that the ability of MB to reduce alveolar damage and therefore to delay mortality in this animal septic shock model may give this harmless substance a role among the treatment modalities of septic shock syndrome induced by fecal peritonitis.

Animals↗
PubMed1997

The impact of advanced trauma life support course on graduates with a non-surgical medical background.

The aim of this study was to assess advanced trauma life support (ATLS) and combat trauma life support (CTLS) skills implementation among general practising physicians, its perceived utility in their routine daily practice as well as in their potential army combat assignments. One hundred and ten physicians, graduates of ATLS and CTLS courses, from the subspecialties of geriatrics, psychiatry and family medicine, were surveyed by telephone, to answer a specially designed questionnaire. The response rate was 82%. Professional distribution was: 6.6% geriatrics; 46.7% family physicians; and 46.7% psychaitrists. The number of trauma events treated by these physicians in their post-course practise was: geriatrics-three; family physicians-30; psychiatrists-18. We believe that a properly designed ATLS course, executed and applied to general practitioners, can be highly beneficial to trauma victims.

Adult↗
PubMed1997

Combat trauma life support training versus the original advanced trauma life support course: the impact of enhanced curriculum on final student scores.

BACKGROUND: Within a military framework, the trauma course student, a young medical officer, is trained to become a trauma team leader and the first provider of medical aid. By adding battlefield medicine-related subjects to the basic Advanced Trauma Life Support (ATLS) course, as well as exercises tailored to the distinctive demands of military medicine, we could develop a special teaching unit: Combat Trauma Life Support (CTLS). The curriculum is basically the complete unchanged ATLS course of the American College of Surgeons enriched with lectures and practicums to fill the gap between the essentially civilian emergency department character of the ATLS course and the military tasks of the medical officer. PURPOSE OF STUDY: To compare the cognitive knowledge achievements of trauma course participants in the Israel Defence Force Medical Corps and to delineate the impact of the course type on students' written test results. DESIGN: A retrospective comparison analysis of pre- and post-course written test scores of 2,614 physicians who had participated in the ATLS and CTLS courses in the Israel Defence Force School of Military Medicine between 1990 and 1993. RESULTS: The analysis indicated that students who undertook the CTLS course achieved statistically better results in written tests (87.9 +/- 8.7 vs. 79.6 +/- 11.4, R2 = 0.33). CONCLUSIONS: We conclude that the CTLS comprehensive curriculum provides an improved training basis for the complex task of army battlefield trauma care support.

Curriculum↗
PubMed1997

[Penetrating gluteal injuries management--the need for management protocols].

Gunshot wounds are the most common cause of penetrating injuries in the gluteal region (PIGR), while only 17.5% result from stabbing. Complications and even death have been described as resulting from stab injury in this area, which is thus a hazard that demands an algorithm for proper management. Recently, DiGiacomo et al. recommended that transpelvic bullet trajectory warrants surgery. Mercer et al., in a study of 81 patients with PIGR, recommended an algorithm based on anatomical gluteal zones and concluded that angiography is not mandatory in such injuries. We describe 9 cases of PIGR, 4 of which were from stab wound and 1 a gunshot wound, which bled from rami of the gluteal arteries. In 2 there was no apparent bleeding, and they were hemodynamically stable. Thus in this type of injury significant damage may be obscured. Our results suggest that angiography is important in the evaluation of such injuries an should be part of the protocol for management of PIGR.

Algorithms↗
PubMed1996

[Packing and abbreviated laparotomy in the injured--a life-saving procedure].

Packing of abdominal viscera and abbreviated laparotomy are gaining favor among surgeons for cases with multiple injuries. During a 2-year period, 10 patients required abbreviated exploratory laparotomy for abdominal trauma. The 6 records which were complete form the basis of this study. 3 patients were hypotensive at the scene of injury and in the emergency department. Major vascular injury was encountered in 4. The only procedures attempted at the initial operation were packing bleeding solid viscera and controlling bleeding and fecal spillage. Hypothermia, acidosis and need for massive blood transfusion were indications for terminating exploration without attempting definitive surgery.

Abdominal Injuries↗