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23 results

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Orthopedic Emergencies
  • Expert Management for the Emergency Physician
  • Edited by Michael C. Bond
  • Edited in association with Andrew D. Perron, Michael K. Abraham
  • Published online: 05 November 2013
  • Print publication: 31 October 2013
  • Acute care physicians are frequently faced with diagnosing and treating orthopedic emergencies with limited resources and without immediate specialist availability. Orthopedic Emergencies focuses on the acute management and stabilization of orthopedic injuries with specific recommendations on procedures and the stabilization of fractures and dislocation. The topics are organized anatomically with additional chapters on Procedures, Reduction Techniques, and Immobilization and Splinting. The information needed for a rapid diagnosis is available instantly through the bullet-point-style text, diagrams, images, pearls and pitfalls. There are specific recommendations on which splint to apply and how to position the affected limb, as well as advice on when to arrange follow up with an orthopedist or sports medicine physician. The spiral binding allows the book to lay flat for easy use at the bedside, making Orthopedic Emergencies the ideal companion for all emergency medicine providers including emergency department physicians, sports clinics, family medicine practitioners and mid-level providers.

  • Chapter 10 - Immobilization and splinting

  • Edited by Michael C. Bond
  • Edited in association with Andrew D. Perron, Michael K. Abraham
  • Book: Orthopedic Emergencies
  • Published online: 05 November 2013
  • Print publication: 31 October 2013, pp 248-269

  • Summary

    This chapter presents the key facts, mechanism, anatomy, symptoms, diagnosis, and treatment of pelvic fractures e.g. avulsion fractures, and non-displaced pelvic fractures such as pubic ramis fractures, ischial body fractures, ilium fractures, sacral fractures, coccyx fractures, displaced pelvic fractures, acetabular fractures and hip fractures. Pelvic fractures represent 3% of all fractures, and are associated with significant morbidity and mortality. The mortality rate for high-energy pelvic fractures is between 10% and 20%. The pelvis consists of the ilium and pubis, and the ilium on each side forming the innominate bones that are then joined at the pubis symphysis anteriorly and the sacrum posteriorly. Fractures involving a single pubic ramis are usually caused by a fall in the elderly, though in the young it is often the result of persistent tension/stress on the adductors or hamstrings resulting in a fracture at their site of origination.

  • Chapter 8 - Orthopedic infections and other complications

  • Edited by Michael C. Bond
  • Edited in association with Andrew D. Perron, Michael K. Abraham
  • Book: Orthopedic Emergencies
  • Published online: 05 November 2013
  • Print publication: 31 October 2013, pp 178-190

  • Summary

    This chapter presents the key facts, diagnostic testing, treatments, and prognosis of various types of hand and wrist fractures such as distal radius fracture, distal radioulnar joint disruption (DRUJ), carpal bone fractures, metacarpal bone fractures, phalangeal bone fractures, and distal phalanx fracture. Distal radius and ulnar injuries are often associated with median and ulnar neuropathies. A transverse fracture of the distal radial metaphysis with dorsal displacement and angulation, often caused by a fall on an outstretched hand. The lateral radiograph is the best view for revealing an intra-articular fracture of the radius and any associated carpal displacement in Barton fractures. A posteroanterior (PA) radiograph often shows a comminuted fracture of the distal radius. Barton fractures require emergency orthopedic/hand-specialist consultation for early operative management. Non-displaced Hutchinson fractures can be managed with a short-arm splint and routine orthopedic/hand-specialist follow-up.

  • High sodium:potassium intake ratio increases the risk for all-cause mortality: the REasons for Geographic And Racial Differences in Stroke (REGARDS) study

  • Suzanne E. Judd, Kristal J. Aaron, Abraham J. Letter, Paul Muntner, Nancy S. Jenny, Ruth C. Campbell, Edmond K. Kabagambe, Emily B. Levitan, Deborah A. Levine, James M. Shikany, Monika Safford, Daniel T. Lackland
  • Journal: Journal of Nutritional Science / Volume 2 / 2013
  • Published online by Cambridge University Press: 23 April 2013, e13
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  • Increased dietary Na intake and decreased dietary K intake are associated with higher blood pressure. It is not known whether the dietary Na:K ratio is associated with all-cause mortality or stroke incidence and whether this relationship varies according to race. Between 2003 and 2007, the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort enrolled 30 239 black and white Americans aged 45 years or older. Diet was assessed using the Block 98 FFQ and was available on 21 374 participants. The Na:K ratio was modelled in race- and sex-specific quintiles for all analyses, with the lowest quintile (Q1) as the reference group. Data on other covariates were collected using both an in-home assessment and telephone interviews. We identified 1779 deaths and 363 strokes over a mean of 4·9 years. We used Cox proportional hazards models to obtain multivariable-adjusted hazard ratios (HR). In the highest quintile (Q5), a high Na:K ratio was associated with all-cause mortality (Q5 v. Q1 for whites: HR 1·22; 95 % CI 1·00, 1·47, P for trend = 0·084; for blacks: HR 1·36; 95 % CI 1·04, 1·77, P for trend = 0·028). A high Na:K ratio was not significantly associated with stroke in whites (HR 1·29; 95 % CI 0·88, 1·90) or blacks (HR 1·39; 95 % CI 0·78, 2·48), partly because of the low number of stroke events. In the REGARDS study, a high Na:K ratio was associated with all-cause mortality and there was a suggestive association between the Na:K ratio and stroke. These data support the policies targeted at reduction of Na from the food supply and recommendations to increase K intake.

  • 4 - The Hudson Bay Lowland

  • Edited by Lauchlan H. Fraser, University of Akron, Ohio, Paul A. Keddy, Southeastern Louisiana University
  • Book: The World's Largest Wetlands
  • Published online: 10 August 2009
  • Print publication: 10 June 2005, pp 118-148

  • Summary

    Introduction

    At the center of North America, lying south of Hudson Bay and west and south of James Bay (50° to 59° N, 76° to 96° W) is the world's third-largest wetland – the Hudson Bay Lowland (Zoltai 1973). This area is the size of Japan, larger than the United Kingdom or Germany but smaller than Zimbabwe, France, or Iraq.

    The Lowland is located near the center of the former Laurentide Ice Sheet which formed during the late Wisconsin glaciation (Fig. 4.1) and is a legacy of that age (Zoltai 1973, Riley 2003). As the glacier receded, the depression left behind was inundated by melt waters which became the Tyrrell Sea (and later the modern Hudson Bay and James Bay). The Lowland has emerged over the last 7000 to 8000 years due to one of the continent's most-rapid rates of isostatic rebound (0.7 to 1.2 cm per year; Webber et al. 1970). At this rate, the Hudson Bay shoreline is moving northward 4 m per year. The maximum elevation, currently about 120 m above sea level, occurs at the Lowland's southern limit (Gray et al. 2001).

    Stretching from Churchill to the Eastmain River (Fig. 4.2), the Hudson Bay Lowland covers 373 700 km2, or 3.7% of Canada (ESWG 1995). Over 80% of the Lowland lies in northern Ontario. It is bounded inland by exposed bedrock of the Precambrian Shield (Hustich 1957).

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