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Showing papers by "Lincoln Hospital published in 1988"


Journal ArticleDOI
TL;DR: A case of fracture of the hyoid bone is described and the diagnosis and treatment of the condition are discussed.

22 citations


Journal Article
TL;DR: It is concluded that splenic injuries after blunt trauma in adults are treated best by early laparotomy in order to achieve maximal splenic preservation.
Abstract: Forty-eight adult patients with isolated splenic trauma from blunt injury were analyzed during a six year period (1980 to 1986). Early laparotomy was performed upon 38 patients and splenic preservation was accomplished in 18. The remaining ten patients who were hemodynamically stable were managed nonoperatively with close monitoring. Splenic injuries were confirmed by one of the imaging methods, such as computed tomography, radionuclide scan or ultrasound. One patient with known hepatic cirrhosis underwent embolization of the splenic artery and recovered. Nonoperative treatment failed in seven of the remaining nine patients, mandating an exploratory laparotomy between the third and tenth day of admission. In six of the seven patients, splenic preservation was unsuccessful, necessitating a splenectomy. The length of hospital stay was longer for this latter group (a mean of 15.8 days) than for patients who had splenorrhaphy (a mean of 7.5 days), or splenectomy (a mean of 8.7 days, p less than 0.001). Patients managed nonoperatively required more units of blood compared with those undergoing splenorrhaphy (4.1 units versus 1.7 units, p less than 0.01). A review of the literature reveals that splenic preservation is possible in less than 25 per cent of the patients who fail to respond to nonoperative management. We conclude that splenic injuries after blunt trauma in adults are treated best by early laparotomy in order to achieve maximal splenic preservation.

21 citations


Journal ArticleDOI
TL;DR: Four cases of gunshot fragments involving the anterior elements of C1 and C2 are presented and the fragments were removed via a transoral approach without neurological complications or mechanical instability.
Abstract: Low velocity firearm damage to the upper cervical spine without neurological deficit occurs infrequently. Four cases of gunshot fragments involving the anterior elements of C1 and C2 are presented. In all four cases, the fragments were removed via a transoral approach without neurological complications or mechanical instability.

20 citations


Journal ArticleDOI
TL;DR: The use of conventional radiography, complex motion tomography, and computed tomography for evaluation of eight patients with orbital floor fractures indicates that CT scans in an axial plane with coronal and sagittal reformations offer the best radiographic evaluation of the orbit.

15 citations


Journal ArticleDOI
TL;DR: A prospective study was undertaken in a section of New York City to determine factors that may have resulted in failure of prevention of CS in the first week of life, and identified risk factors for developing CS.
Abstract: Congenital syphilis (CS) continues to occur despite widespread serologic testing of pregnant women.' The incidence of CS generally reflects the prevalence of untreated primary and secondary syphilis in women of childbearing age? Reported cases of CS in the United States increased from 115 to 268 during the period 1978-1985: Metropolitan New York and three states-Texas, California, and Florida-accounted for 80% of the reported cases of CS in 1985. Mascola et al., after a retrospective review of 50 cases under 1 year of age, identified risk factors for developing CS.' A prospective study was undertaken in a section of New York City to determine factors that may have resulted in failure of prevention of CS in the first week of life.

2 citations