Comparison of modified Kampala trauma score with trauma mortality prediction model and trauma-injury severity score: A National Trauma Data Bank Study.

BACKGROUND: Mortality prediction of trauma patients relies on anatomical, physiological or combined scores. The purpose of this study is to compare the diagnostic accuracy of the modified Kampala Trauma Score (M-KTS) with the Trauma Mortality Prediction Model (TMPM), and Trauma-Injury Severity Score (TRISS) using data from a large dataset from a developed registry, the National Trauma Data Bank (NTDB). METHODS: Using 2011 and 2012 data from NTDB, patient based trauma scores (M-KTS, TMPM, and TRISS) were calculated and predictive ability of M-KTS for mortality was compared with other trauma scores using receiver operating characteristics (ROC) curves. RESULTS: A total of 841089 patients were included in the study. TRISS outperformed other scores (AUC=0.922, %95 CI 0.920-0.924) with M-KTS as the second best score (AUC=0.901, %95 CI 0.899-0.903) followed by TMPM (AUC=0.887, 95% CI 0.844-0.889). For blunt trauma, TRISS (AUC=0.917, 95% CI 0.915-0.919) performed better than M-KTS (AUC=0.891, %95 CI 0.889-0.893) and TMPM (AUC=0.874, 95% CI 0.871-0.877). For penetrating trauma, M-KTS (AUC=0.956, 95% CI 0.954-0.959) and TMPM (AUC=0.955, 95% CI 0.951-0.958) had similar performance after TRISS (AUC=0.969, 95% CI 0.967-0.971). CONCLUSION: M-KTS performed worse than TRISS although its' main advantage is simple use in resource-limited settings.

Gastric duplication cyst in adult: Challenge for surgeons.

Gastric duplication cysts (GDCs) are uncommon developmental anomalies found primarily in children, being rarely seen in adults. Duplications can occur anywhere in the intestinal tract from the mouth to the anus. Accurate diagnosis of cysts before resection is difficult even using the most advanced imaging techniques. In this report, we present and discuss a case of GDC in a 25-year-old man treated laparoscopically. Patient admitted to our department with complaints of epigastric pain and swelling. Magnetic resonance imaging performed for accurate characterisation showed a 4 cm × 4.5 cm cystic lesion, with heterogeneous signal intensity on T2-weighted images, located in the posterior wall of the stomach. Pre-operative differential diagnosis including gastrointestinal stromal tumour (GIST) was made according to radiological findings. Patient underwent surgery and cyst resected laparoscopically. Histopathological examination suggesting duplication cyst. GDC can easily be mistaken for a GIST, and the clinician as well as radiologist must maintain a high degree of suspicion.

Negative-pressure Wound Therapy in Chronic Inflammatory Breast Diseases.

Mastitis is inflammation of breast tissue that may or may not originate from an infection. Two different forms of mastitis have been described, lactational and non-lactational. Lactational mastitis is the most common type and generally conservative therapy that includes milk removal and physical therapy provides symptomatic relief, but antibiotic therapy is also needed. Common types of non-lactational mastitis are periductal mastitis and idiopathic granulomatous mastitis. Treatment includes antibiotics, drainage, and surgery, but usually this is a chronic process and a therapeutic management algorithm for chronic breast inflammation is unclear and has no consensus. Negative-pressure wound therapy is commonly used for various types of wounds but is limited for breast wounds. In this report, we present and discuss two patients with chronic breast inflammation who underwent surgery and were successfully treated using negative-pressure wound therapy to minimize wide tissue defects and cosmetic problems after surgery. Use of negative-pressure wound therapy for breast wounds might be benefical as it is with other wounds but there is scarce information in the literature.