A major challenge facing the developers of intelligent decision-support systems is how to present pertinent information to physicians in such a way that it will be effective in influencing their behavior. The successful integration of medical decision-support systems into clinical environments has been a widely reported problem ever since such systems began to appear. While recognizing these sy...

Reprints available directly from the publisher Photocopying permitted by license only Significant trends in the treatment of hepatic trauma. Annals of Surgery; 215: 492-502. Several significant advances in the treatment of hepatic injuries have evolved over the past decade. These trends have been incorporated into the overall treatment strategy of hepatic injuries and are reflected in experienc...

Sir In reference to the article on teaching trauma management in the accident and emergency department (Williams et al., 1991), we are concerned that it may perpetuate the myth that junior staff can and indeed should continue to manage critically injured patients. Many studies have shown that preventable trauma deaths can be reduced from 20-30% to less than 5% with appropriate organizational an...

The adult liver weighs around 1500 g and lies mainly in the right upper quadrant of the abdomen, immediately beneath the diaphragm [1]. The liver is the most commonly injured intra-abdominal organ and is found to be damaged in 30% of patients undergoing laparotomy for penetrating injuries and in 15–20% of laparotomies for blunt injuries [2]. An appreciation of basic liver anatomy is essential i...

MANAGEMENT OF UPPER EXTREMITY TRAUMA by NIRU PRASAD, M.D., F.A.A.P., F.A.C.E.P. DEPARTMENT OF EMERGENCY MEDICINE HENRY FORD HOSPITAL WEST BLOOMFIELD CENTER DEPARTMENT OF AMBULATORY PEDIATRICS ST. JOSEPH MERCY HOSPITAL PONTIAC, MICHIGAN INTRODUCTION General Principles Anatomy and Physiologic differences between Musculoskeletal System of Children and Adult Physeal Injuries Terminology and Classif...

Bleeding is a common problem in major trauma. Coagulopathy could be detected in approximately 25% of all trauma patients on arrival in the emergency room. The reasons for that are blood loss, dilution of the remaining coagulation factors by fluids not containing coagulation factors, consumption of coagulation factors and hyperfibrinolysis. Hypothermia and acidosis are also well described contri...

With increased awareness and liberal screening of trauma patients with identified risk factors, recent case series demonstrate improved early diagnosis of carotid artery trauma before they become problematio. There remains a need for unified screening criteria for both intracranial and extracranial carotid trauma. In the absence of contraindications, antithrombotic agents should be considered i...

After the adventure endoscopic surgery and usage for the management of lung based pathologies, it is carried to the endoscopic approaches of thoracal spine pathologies (1,2). The major advantages of endoscopic surgery is the elimination of thoracotomy. For this reason, the patient does not cause to the thoracotomy pain which is one of the main source of the pain after surgery. The surgical appr...