Objective This study aims to determine the topographic localization of the stylomastoid foramen (SF) and its morphometric relationship with the surrounding bony landmarks. Design A descriptive anatomical study. Setting Anatomy Laboratory of the Faculty of Medicine. Participants Measurements were performed on 53 dry temporal bones. Main Outcome Measures On the inferior and lateral aspects of photographic images, lines and angles were defined. The most lateral end of the SF (SF1) and the transverse medial–lateral line that passes through the upper end of the anterior border of mastoid process (line 1) were used as reference points for topographic evaluation. The upper end of the anterior border of mastoid process (A) and the tip of mastoid process (B) were considered in defining angles. The dates about SF were evaluated using the ImageJ 1.46r software and digital caliper. Results SF1 was classified into three different types based on its topographical localization, stated as Type 1, Type 2, and Type 3. In Type 1, SF1 was located anterior to line 1 (54.7%). SF1 was located posterior to line 1 in Type 2 (34.0%). SF1 was located just over line 1 in Type 3 (11.3%). We also detected angular variations between these types in the inferior and lateral aspects. Conclusions The recommended angles of application are 30 degrees on the horizontal plane and 55 degrees on the sagittal plane for Type 1 when point B is considered. A needle length below 10 mm is more suitable to minimize the potential complications of the nerve block.
A venous air embolism can occur as a result of circumstances that include blunt head or chest trauma, thoracentesis, arterial catheterization, neurosurgery, cardiac surgery, and Caisson disease. The formation of a venous air embolism requires an air source, interaction between the air source and the vessel, and a pressure gradient supporting air migration into the vessel. Air enters through the impaired venous structure and travels to the right side of the heart and the pulmonary arteries, and depending on the amount of air, may occasionally be fatal. This report is the description of the case of a 3-year-old child who developed a fatal venous and cerebral embolism during neurosurgery for the treatment of skull fractures with epidural and subdural bleeding due to blunt head and chest trauma resulting from a television falling on her. The pathophysiology of death and notes regarding the medico-legal autopsy procedure in such cases are discussed. Meticulous autopsy techniques must be used to determine the presence of an air embolism in cases of blunt trauma, especially in patients with blunt trauma to the head who die during neurosurgery, and possible future malpractice claims should be kept in mind.
BACKGROUND: Turkey is an experienced country for both military and civilian mass casualties that arise from explosions and shootings by various terrorist groups. In this study, we aimed to investigate the characteristics of patient flow admitted to our hospital caused by primarily gunshot wounds during the coup attempts on the 15 th of July. METHODS: This descriptive, retrospective study included a total of 50 patients who were injured during a coup attempt on the date of July 15, 2016, and admitted to our emergency department (ED). Demographic characteristics, anatomical injury sites, postoperative clinical outcomes, and hospitalization settings were recorded. The Glasgow Coma Scale (GCS), Trauma and Injury Severity Score (TRISS), Abbreviated Injury Scale (AIS), Revised Trauma Score (RTS) and Injury Severity Score (ISS) were used to measure the severity of injuries. RESULTS: A total of 63 medical personnel voluntarily reached the ED within two hours. Extremity injuries were the most common injuries. The mean RTS, GCS, and TRISS scores did not differ significantly between the patients discharged from the ED and the patients who were hospitalized (p>0.05). However, there was a statistically significant difference in the ISS scores (p<0.001, independent t-test). There was no statistically significant difference in the GCS and RTS scores between the discharged and hospitalized patients, although the ISS scores were higher in hospitalized patients (p>0.05 and p<0.001, respectively). A total of 33 patients (66%) were admitted to the hospital for follow-up and/or surgical intervention. Five (10%) of the patients were hospitalized for more than 14 days. CONCLUSION: The management of each disaster is unique. Armed conflicts result in gunshot wounds, and preparations must be focused on surge capacity and a prolonged hospital stay of the patients. In our study, the length of stay in the hospital decreased after the arrival of volunteer staff to the ED, but we should note that the ISS increased. Hospital disaster plans should be reorganized not only for ED but also for the whole hospital.
ÖZET Gelişen teknolojiler doğrultusunda estetik ve kozmetik girişimlerde yeni teknikler gelişmesi sebebiyle, girişim miktarında ve talebinde artış izlenmektedir. Buna bağlı olarak son yıllarda tıbbi uygulama hatası iddialarında belirgin artış izlenmektedir. Çalışmada Adli Tıp Kurumu 3. İhtisas Kurulu’nca 2007-2011 yılları arasında görüş bildirilen estetik ve kozmetik girişimler ile ilgili tıbbi uygulama hatası iddiası bulunan 134 olgu incelenmiştir. Olguların 38’i erkek, 96’sı kadın, yaş ortalaması ise 39,5±1,2 idi. Olguların büyük çoğunluğuna Özel Hastanelerde girişim uygulanmıştı. (47%). Olguların 29’una (%21,6) kusur verilmiş olup, 17’si (%12) hakkında çeşitli sebeplerle görüş bildirilememişti. Kusur bulunan gruptaki girişim bölgesi çoklu olanlar kusur bulunmayan gruptan istatistiksel olarak anlamlı şekilde yüksek saptanmıştır (p
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