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thePinoy » Blog Archive » Kidney failure plagues thousands of Pinoys

Abila has stage 5 chronic kidney disease which started from a urinary tract infection left untreated. This resulted into complications when she had hypertension when she became pregnant. And since she preferred to eat fatty foods and did not have enough water intake, ... Health experts have embarked on a campaign to promote kidney donation from deceased individuals or those patients who have been declared brain dead or have become victims of trauma, such as an accident. ...

Vertebral Osteomyelitis — NEJM

8 In a study involving 253 patients with vertebral osteomyelitis, the primary focus of infection, identified in 51% of the patients, was the urinary tract, skin, or soft tissue; a site of vascular access; or endocarditis, bursitis, ...

Female Feline Urinary Tract Infection | CAT LOVE

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Lower Urinary Tract Injury & Pelvic Trauma

July 8, 2009 · Posted in TRAUMA · Comment 

31 LOWER URINARY TRACT INJURY AND PELVIC TRAUMA
Fernando J. Kim M.D., Siam Oottamasathien M.D.

1. What are the causes of bladder injury?

Show answer
Iatrogenic manipulation and penetrating or blunt trauma. Because of the rich detrusor blood supply, bladder injury is usually accompanied by hematuria. Other signs may include suprapubic pain, inability to void, or incomplete recovery of catheter irrigation.
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Urinary Calculus Disease. Bonus Questions

July 14, 2009 · Posted in UROLOGY · 1 Comment 

BONUS QUESTIONS

11. Is there any type of stone that cannot be seen on helical CT scan?

Show answer
Patients taking indinavir sulfate (Crixivan) for HIV infection can form stones from the crystals of the medication; these stones are not seen on CT scan.
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Hepatic & Biliary Trauma. Biliary Tract Injury

July 7, 2009 · Posted in TRAUMA · Comment 

BILIARY TRACT INJURY

22. Why are complications associated with bile duct leaks?

Show answer
Bilomas (i.e., collections of bile) frequently become infected and may result in lethal peritonitis. Biliopleural fistula, a communication between the biliary system and pleural cavity, persists because of the relative negative pressure in the thorax and may result in a bile empyema.

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Penetrating Abdominal Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

24 PENETRATING ABDOMINAL TRAUMA
Clay Cothren M.D., Ernest E. Moore M.D.

1. Why is there a different approach to stab and gunshot wounds?

Show answer
Whereas one third of stab wounds to the anterior abdomen do not penetrate the peritoneum, 80% of gunshot wounds violate the peritoneum. Furthermore, penetration of the peritoneum by a bullet is associated with visceral or vascular injuries in > 95% of cases, whereas only one third of stab wounds violating the peritoneal cavity produce significant injury. (See Figure 24-1.)
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Upper Urinary Tract Injuries

July 8, 2009 · Posted in TRAUMA · Comment 

30 UPPER URINARY TRACT INJURIES
Fernando J. Kim M.D., Siam Oottamasathien M.D.

1. What is the most common type of renal trauma in the United States, blunt or penetrating?

Show answer
Blunt, by far.

2. Do most kidney injuries require surgery?

Show answer
No. Fewer than 2% of blunt injuries require surgery, and many penetrating injuries can also be treated nonoperatively.
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Urinary Calculus Disease

July 14, 2009 · Posted in UROLOGY · Comment 

94 URINARY CALCULUS DISEASE
Bretat B. Abernathy M.D.

1. What are the most common types of urinary stones found in North America?

Show answer

* Calcium stones (calcium oxalate, calcium phosphate, or mixed calcium stones): 70%.
* Struvite or magnesium ammonium phosphate stones, often associated with infection: 20%.
* Uric acid stones (radiolucent): 5%
* Cystine stones, often with a genetic association: 5% Read more

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Penetrating Abdominal Trauma. Controversy

July 7, 2009 · Posted in TRAUMA · Comment 

CONTROVERSY

14. What is the role of laparoscopy and thoracoscopy after penetrating abdominal trauma?

Show answer
Although an intriguing diagnostic modality with additional therapeutic capabilities, laparoscopy thus far appears to have limited application after trauma. With the exception of suspected diaphragmatic injury, an isolated solid organ injury, or evaluation for peritoneal penetration, laparoscopy has yet to demonstrate advantages over the algorithm delineated above. The potential for missed injuries, poor evaluation of the retroperitoneum, and expense are major drawbacks. In patients with wounds to the lower chest with pneumothorax (and, thus, an indication for chest tube placement), thoracoscopy is reasonable to exclude diaphragmatic injury.

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Hepatic & Biliary Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

25 HEPATIC AND BILIARY TRAUMA
Reginald J. Franciose M.D., Ernest E. Moore M.D.

1. How often is the liver injured in trauma?

Show answer
The liver is both big and central, so it is an easy target.

2. Do the liver and spleen respond similarly to injury?

Show answer
No. The liver has a unique ability to establish spontaneous hemostasis even with extensive injuries. For this reason, the majority of liver injuries in hemodynamically stable patients can be managed nonoperatively. In contrast, many splenic fractures continue to bleed; therefore, a greater percentage require operative intervention.

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Trauma To The Colon & Rectum. Rectal Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

RECTAL TRAUMA

9. How do rectal injuries occur?

Show answer
Similar to colon injuries, most rectal injuries result from penetrating trauma. Blunt pelvic fractures should be assessed with a strong suspicion for rectal (and urethral) injury.

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Trauma To The Colon & Rectum. Colon Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

28 TRAUMA TO THE COLON AND RECTUM
W. Andrew Lawrence M.D., Jon M. Burch M.D.

COLON TRAUMA

1. How do most colon injuries occur?

Show answer
Nearly all (> 95%) colon injuries are caused by penetrating trauma from gunshot, stab, iatrogenic, or sexual injury. Blunt colonic trauma is rare and usually results from seat belts during motor vehicle accidents.
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Blunt Abdominal Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

23 BLUNT ABDOMINAL TRAUMA
David J. Ciesla M.D., Ernest E. Moore M.D.

1. What elements of the history are important in evaluating a patient with suspected blunt abdominal trauma (BAT)?

Show answer
First, the mechanism of injury (e.g., motor vehicle collision, automobile-pedestrian accident, fall) is important. In motor vehicle accidents, note the position of the victim in the car, velocity of impact (high, moderate, low), type of accident (front, lateral, or rear impact; side swipe; rollover), and type of restraint used (shoulder restraint, air-bag, lap belt). Information about damage to the vehicle, such as a broken windshield or bent steering wheel, may raise suspicion of cervical and chest injuries. In a fall, it is important to note the distance fallen and the site of anatomic impact. Vertical landing on the feet or in a sitting position causes a different pattern of injury than lateral landing on the side. Serial vital signs and mental status are always important.
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Pediatric Trauma

July 8, 2009 · Posted in TRAUMA · Comment 

36 PEDIATRIC TRAUMA
David A. Partrick M.D., Denis D. Bensard M.D.

1. What is the leading cause of death in children in the United States?

Show answer
Injuries cause more death and disability in children from ages 1 to 18 years than all other causes combined. Unintentional injury deaths account for 65% of all injury deaths in children under 19 years of age. Each year, approximately 20,000 children and teenagers die as a result of injury and 50,000 children suffer permanent disabilities. Each year, nearly one child in four receives medical treatment for an injury. The estimated annual cost is $15 billion.
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Penetrating Neck Trauma

July 7, 2009 · Posted in TRAUMA · Comment 

20 PENETRATING NECK TRAUMA
Clay Cothren M.D., Ernest E. Moore M.D.

1. Why are penetrating neck wounds unique?

Show answer
Although comprising only a small percentage of body surface area, the neck contains a heavy concentration of vital structures.
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Traumatic Brain Injury

July 7, 2009 · Posted in TRAUMA · Comment 

18 TRAUMATIC BRAIN INJURY
J. Paul Elliott M.D., Sanjay Misra M.D.

1. Is traumatic brain injury (TBI) a common problem?

Show answer
Yes. In the United States, 1 in 12 deaths is due to injury. One third of traumatic deaths are associated with TBI. Of deaths resulting from motor vehicle accidents, 60% are due to brain injury. Even more common is minor TBI, which accounts for 75% of admissions for head trauma.

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Hepatic & Biliary Trauma. Operative Management Of Liver Injury

July 7, 2009 · Posted in TRAUMA · Comment 

OPERATIVE MANAGEMENT OF LIVER INJURY

11. How are acute liver injuries classified?

Show answer
Liver wounds are generally graded on a scale of I to VI according the depth of parenchymal laceration and involvement of the hepatic veins or retrohepatic portion of the inferior vena cava. Optimal methods of obtaining hemostasis vary with the severity of the injury.
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