RESUMO
Surveillance of hunting-associated injuries was performed over a 4-year period at a rural Emergency Department in central Wisconsin. Over that period of time, 125 individuals sought treatment for hunting-related injuries. The majority of injuries were related to autumn deer hunting and included both gun and bow and arrow hunting. Over half of the persons injured while hunting with a bow and arrow fell from a height. The admission rate for persons in the immediate area was 35.1%, but for those from outside the area, it was 64.8%. The effects of the referral bias result in severe injuries being seen in rural Emergency Departments during hunting seasons, necessitating such departments to be prepared for a wide range of injuries.
Assuntos
Acidentes/estatística & dados numéricos , Recreação , Serviços de Saúde Rural/estatística & dados numéricos , Ferimentos e Lesões/epidemiologia , Acidentes por Quedas/estatística & dados numéricos , Humanos , Incidência , Encaminhamento e Consulta/estatística & dados numéricos , Wisconsin/epidemiologia , Ferimentos por Arma de Fogo/epidemiologia , Ferimentos Penetrantes/epidemiologiaRESUMO
During a 10-year period, 555 cholecystectomies were performed without drainage of the gallbladder bed or subhepatic space. Six per cent of the patients had acute cholecystitis or hydrops of the gallbaldder and 11% had common duct exploration. Only in those patients with frank infection, spillage of obviously infected bile or in whom satisfactory closure of the gallbladder bed could not be accomplished was a drain used. Meticulous closure of the gallbladder bed was performed to minimize leakage of bile. The series was critically studied to evaluate complications, morbidity, mortality and hospital stay. It was concluded that drainage following cholecystectomy or choledochotomy can safely be omitted except for the indications mentioned.
Assuntos
Colecistectomia/métodos , Drenagem , Adolescente , Adulto , Idoso , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos RetrospectivosRESUMO
(1) In a six year experience with ileal loops in patients with neurogenic bladder, 49% of the patients were paralyzed, 30% had multiple sclerosis, and 91% had recurrent or persistent urinary tract infection. Reflux, incontinence, retention, and bladder calculi were additional indications for supravesical urinary diversions. (2) All loops were performed in a similar manner, most of them placed retroperitoneally, and a vigorous program of postoperative care was followed. There were no postoperative deaths, and a moderate number of complications occurred in 51.8% of the patients. (3) The participation of the enterostomal therapist is the preparation of the patient and in the immediate and long-term stomal care has been invaluable and is strongly recommended.
