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A Dirlić

Publications and source records attributed to A Dirlić.

4 recordsLinked to original sources

War head injury score: an outcome prediction model in War casualties with acute penetrating head injury.

OBJECTIVE: To evaluate in war casualties with acute penetrating head injury whether the summed War Head Injury Score (WHIS) is a better predictor of mortality than either the Glasgow Coma Scale (GCS) score or the Injury Severity Score (ISS) alone and to establish its specific applicability. METHODS: Sensitivity, specificity, correct outcome prediction, and discrimination were assessed in 43 patients in the war group (ballistic injuries) and 41 patients in the civil group (nonballistic injuries) during the period 1991 to 1995. The new model was generated using the sum of GCS scores and ISS, to which a coded value was applied for summation. RESULTS: In the war group, the mortality rate was 23%; the sensitivity and specificity of WHIS were 100% and 79%, the sensitivity and specificity of GCS score were 90% and 85%, and the sensitivity and specificity of ISS were 100% and 49%, respectively. In the civil group, the mortality rate was 39%; the sensitivity and specificity of WHIS were 87% and 76%, the sensitivity and specificity of GCS score were 63% and 90%, and the sensitivity and specificity of ISS were 100% and 56%, respectively. CONCLUSION: With regard to civilians, war casualties with acute penetrating head injury more often have multiple injuries. WHIS represents a new scoring system that incorporates both GCS score and ISS.

Adult↗

Accidental plant poisoning with Colchicum autumnale: report of two cases.

Colchicine poisoning is a rare but serious and potentially fatal event, which results from food poisoning or overdose with drugs containing colchicine, with no currently available antidote. We report two cases of plant poisoning with Colchicum autumnale, in which the patients had identical initial symptoms but developed extremely different clinical courses. One patient recovered after only moderate gastroenteritis and liver injury, whereas the other died of rapid progressive multiple organ failure 52 h after the plant ingestion. We recommend that all patients suspected of colchicine intoxication due to its unpredictable outcome should be managed according to the principles of intensive care, irrespective of the actual degree of poisoning.

Colchicum↗

Ultrasonographically guided percutaneous dilatational tracheostomy after anterior cervical spine fixation.

Patients with anterior cervical spine fixation (ACSF) after acute spinal cord injury often require tracheostomy for prolonged ventilatory support and upper respiratory tract clearance. The authors report two patients with ACSF who underwent a successful ultrasonographically guided percutaneous tracheostomy with dilatation forceps technique. Possible advantages of the ultrasonographically guided method with dilatation forceps in patients with ACSF are discussed.

Adult↗

[Percutaneous tracheostomy].

In the last few years numerous reports from intensive care units confirm that a nonsurgical percutaneous tracheostomy has successfully replaced elective conventional (surgical) tracheostomy. The majority of authors point out the advantages over surgical technique such as: the speed of procedure, the possibility of doing it at bedside thus excluding transport and the need for operating theatre, less infections around stoma, minor cosmetic defects and finally, more economical price. The article describes three, according to pertinent literature most often utilized techniques, i.e. percutaneous dilatation tracheostomy with dilators, percutaneous dilatation tracheostomy with forceps, and translaryngeal tracheostomy. Main differences, advantages and defects of each method are presented. Contraindications and eventual complications are discussed, as well as the utility of supporting methods for safer placement of tracheostomy tubes, such as endoscopy and ultrasonography.

Humans↗