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Biomedical subjects

M Mousavi

Publications and source records attributed to M Mousavi.

At least 19 recordsLinked to original sources

Minimally invasive ilioinguinal approach to the acetabulum.

The classic ilioinguinal approach is a gold standard in acetabular surgery. We developed a modification, a minimally invasive method that entails a median lower abdominal approach with extraperitoneal dissection and exposure of the pubic symphysis. The second incision is lateral, next to the iliac crest. This allows an easy, safe and quick exposure of the anterior iliac ring as well as easy access to the posterior column and wall towards the sacroiliac joint. The iliac vessels and nerves are thereby protected, and no preparation of neurovascular structures is required. The technique was applied in 23 clinical cases and compared with the classic ilioinguinal approach in 9 similar cases over the same period.

Acetabulum↗

Knowledge, attitudes and sources of information regarding HIV/AIDS in Iranian adolescents.

The World Health Organization recently reported an 'alarming trend' of increasing Human Deficiency Virus (HIV) infection in the Islamic Republic of Iran. Adolescents form a particularly important target group for primary prevention. An anonymous questionnaire, derived from standard surveys such as the Safer Choices questionnaire and the 2001 Youth Risk Behavior Survey, was distributed to 1227 Iranian students attending 19 randomly selected high schools in Hashtgerd in 2002. Students reported that television (84%) and school teachers (66%) were the best sources of HIV/AIDS information, while parents (27%) and school books (15%) were least informative. Most students knew that heterosexual intercourse (90%) and shared intravenous needles (94%) can cause HIV infection; however, salient misconceptions were revealed. Only 53% were aware that condoms protect against infection through sexual intercourse. More effective school-based HIV/AIDS education is needed in Iran.

Adolescent↗

A new simplified technique for producing platelet-rich plasma: a short technical note.

A possible strategy to promote the wound-healing cascade in both soft and hard tissues is the preparation of an autologous platelet-rich plasma (PRP) to encourage the release of growth factors from activated platelets. In this process, PRP combines the advantage of an autologous fibrin clot that will aid in hemostasis as well as provide growth factors in high concentrations to the site of a tissue defect. The PRP preparation can be used as a biological enhancer in the healing of fractures and lumbar fusions. The local application of growth factors seems to promote initiation and early maturation of bone formation. Autologous bone or bone substitutes can be added to this mixture to increase the volume of grafting material. A simplified technique utilizing a commercially available separation system (GPS-Gravitational Platelet Separation System) is described. This system provides a less costly alternative to other previously described augmentation techniques and also presents a patient-friendly and operator-safe alternative. Further experimental studies of the actual concentrations of the growth factors in the PRP samples are necessary in order to validate the platelet concentration and growth-factor activation by laboratory evidence. In further prospective clinical trials, the safety and efficacy of PRP, in combination with autologous bone or bone graft substitutes, must be evaluated.

Blood Loss, Surgical↗

Prediction of relative response factors of electron-capture detection for some polychlorinated biphenyls using chemometrics.

The relative response factor (RRF) of an electron-capture detection (ECD) system is predicted for a set of 118 polychlorinated biphenyls (PCBs). Due to the wide range of relative retention times of PCB congeners, the RRFs of these compounds were calculated based on two different internal standards. Therefore, the compounds were divided into two molecular subsets. As a first step, multiple linear regression (MLR) was employed to find informative descriptors that can predict the RRFs of these compounds. Two descriptors of molecular ion ionization potential (MIIP) and ionization potential of the molecule (IP) that are related to affinity of the compounds for the electrons show the highest mean effects in subsets 1 and 2. respectively. The descriptors appearing in the MLR models were considered as inputs for developing the back-propagation artificial neural networks (BP-ANN). Two networks with the architectures of 5-5-1 and 7-6-1 were generated for the prediction of RRFs of molecules of subsets 1 and 2, respectively. Comparison of the results indicates the superiority of neural networks over that of the MLR method indicating the nonlinear behaviors of the ECD system. Inspection of the models reveals that the surface of the molecules play different roles in response factors of two subsets due to rotation of one phenyl group with respect to the other for the subset consisting of larger number of chlorine atoms.

Chemistry Techniques, Analytical↗

Reduced levels of Abeta 40 and Abeta 42 in brains of smoking controls and Alzheimer's patients.

The effects of nicotine on levels of Abeta 40 and Abeta 42 and nicotinic receptor binding sites were studied in brains from nonsmoking and smoking patients with Alzheimer's disease (AD) and aged-matched controls. The levels of soluble and insoluble Abeta 40 and Abeta 42 in frontal cortex and Abeta 40 in temporal cortex and hippocampus were significantly decreased in smoking AD patients compared to nonsmokers with AD. In smoking controls the levels of soluble and insoluble Abeta 40 and Abeta 42 in the frontal and temporal cortex were significantly lower than in nonsmoking controls. The binding of [(3)H]cytisine in temporal cortex was significantly increased in smokers with AD compared to nonsmokers with AD. In smoking controls [(3)H]cytisine and [(3)H]epibatidine binding were significantly increased from 1.5- to 2-fold compared to nonsmoking controls whereas binding sites for [(125)I]alpha-bungarotoxin was less up-regulated. These results indicate that selective nicotinic receptor agonists may be a novel protective therapy in AD by reducing Abeta levels as well as the loss of nicotinic receptors in AD brain.

Aged↗

Borderline ovarian tumours: clinical analysis of 38 cases.

Thirty-eight patients with ovarian tumours of low malignant potential (borderline) were diagnosed and treated in Tehran University Gynecology Oncology Department from 1991 to 2002, and have been reviewed. In this study age, clinical behavior, symptoms, surgical stage, type of tumour, surgery, adjuvant treatment, survival and recurrences were evaluated. A retrospective chart review was performed on these 38 patients who were treated for histopathologically confirmed tumours of low malignant potential between 1991-2002. The mean age was 34.4 years, range (14-83) (SD: 18.33). Post surgical FIGO staging was: Stage I=93.75%, stage III 6.25%. Histologic subtypes were: Serous 76.31% (29 patients), Mucinous 21.05% (8 patients), Mixed types 2.63% (1 patient). Mean pre-operative CA125 value was 114.90 (SD: +/- 90.30). Thirty-three percent of patients had only a simple cyst in ultrasonography. Conservative surgery was performed in 76.32% (29 patients). More radical surgery (TAH + BSO) was performed in 9 patients (23.68%). There were 6 recurrences. Three patients with recurrence and invasive implants received chemotherapy and secondary surgery was performed. Survival rate was 100% at 3 years for all stages and 89% at 5 years. One patient died of recurrent disease at 48 months after initial diagnosis. Our data suggest that LMP tumours are most frequently diagnosed in stage I. Most common histological type was serous, and 5 of the recurrences of (6 patients) were initially diagnosed at stage I, and had been treated with conservative surgery with no adjuvant therapy.

Adolescent↗

Protein and mRNA levels of nicotinic receptors in brain of tobacco using controls and patients with Alzheimer's disease.

The neuronal nicotinic receptors (nAChRs) are involved in several processes in brain including nicotine dependence and cognitive disorders. While the number of nAChRs in the brain of tobacco smokers is up-regulated, the receptors are reduced in the brain of patients with Alzheimer's disease (AD). The aim of this study was to investigate nAChR mRNA and protein levels in brain of smoking and non-smoking controls and AD patients. Western blotting and RT-PCR techniques were used to quantify different nAChR subunits in autopsy brain. The alpha4 and alpha7 but not the alpha3 nAChR protein levels were significantly increased in the temporal cortex of smoking (SC) compared with non-smoking controls (NSC). The alpha4-protein level was significantly higher in the temporal cortex of smoking AD (SAD) patients compared with non-smoking AD (NSAD). No changes in the alpha3, alpha4 or alpha7 subunits protein level were found in the hippocampus in any of the smoking groups. For both SADs and NSADs the protein levels for the alpha3 and alpha4 in temporal cortex and hippocampus and alpha7 in the hippocampus were significantly lower compared with non-smoking controls. No significant differences in alpha4 and alpha7 mRNA levels were detected in the hippocampus or temporal cortex of smokers compared with non-smokers. In conclusion this study showed an increased level of alpha4 and alpha7 nAChRs subunits in the temporal cortex of SC compared with NSC. This up-regulation was also seen in SAD although the protein levels of nAChR subunits were still lower in smoking AD brain compared with the NSC. The up-regulation of nAChRs in smoking groups and the loss of these receptors in AD patients were not correlated to any changes at the mRNA level suggesting that these changes may reflect post-transcriptional events.

Aged↗

Expression of nicotinic acetylcholine receptors in human and rat adrenal medulla.

Neuronal nicotinic receptors (nAChRs) are expressed in the brain but also in the peripheral tissues including the adrenal medulla. However, it is unclear which nAChRs are present in the human adrenal medulla. In the study, receptor binding assay, Western blot and RT-PCR have been performed to investigate the expression of nAChRs in adrenal medulla from human, rat and mouse. The results showed that in human adult adrenal medulla, mRNAs for nAChR alpha3, alpha4, alpha5, alpha7, beta2, beta3, and beta4 subunits but not beta2 in the fetal human adrenal medulla were expressed. Saturation binding of [3H]epibatidine showed two binding sites in human aged adrenal medulla. The specific binding of [3H]epibatidine (0.1 nM) was significantly higher in human fetal compared to human aged adrenal medulla. mRNAs for the alpha3, alpha4, alpha5, alpha7, beta2, and beta4 subunits but not the beta3 were detectable in adult rat and mouse adrenal medulla. No differences in gene-expression of the nAChRs were observed between new born, adult and aged rat adrenal medulla. Saturation binding of [3H]epibatidine showed only one binding site in rat adrenal medulla. Lower protein levels for the nAChR subunits were observed in the rat adrenal medulla compared to rat brain. There was lower protein levels of the nAChRs in aged rat adrenal medulla compared to the young rats. Sub-chronic treatment of nicotine to rats did not influence level of the nAChRs in the adrenal medulla. In conclusion, the expression of nAChRs in adrenal medulla is age- related and species dependent.

Adrenal Medulla↗

Reduced expression of neuronal nicotinic acetylcholine receptors during the early stages of damage by oxidative stress in PC12 cells.

The mechanism for a large loss of neuronal nicotinic acetylcholine receptors (nAChRs) in brains with neurodegenerative diseases remains unclear. Based on our previous results of [(3)H]epibatidine binding influenced by lipid peroxidation, we suggest that nAChR deficit in neurodegenerative diseases might be related to the neurons attacked by free radicals. To further understand how free radicals influence the expression of nAChRs, we detected [(125)I]alpha-bungarotoxin binding, nAChR subunit protein and mRNA during the early stage of damage by oxidative stress in PC12 cells in the present study. The results showed that free radical insult (FeSO(4)) within the concentration range (1 -100 microM) used in the study induced dose-dependent increases in lipid peroxidation and toxicity to PC12 cells, but did not result in apoptosis or necrosis. Significant reductions in [(125)I]alpha-bungarotoxin binding site, protein level for the alpha3 and alpha7 subunits, and mRNA level for the alpha7 subunit were observed in PC12 cells treated by FeSO(4) at the concentrations without inducing cell death compared to control. Pretreatment of cultural cells with antioxidant such as Vitamin E and reduced glutathione prevented the inhibiting effect of free radicals on [(125)I]alpha-bungarotoxin and [(3)H]epibatidine bindings. The present results further demonstrate that oxidative stress might reduce the number of [(125)I]alpha-bungarotoxin binding site and selectively suppress the expression of the nAChR subunits at protein and mRNA levels during the early stages of damage in PC12 cells.

Animals↗

[Intramedullary fixation of humerus shaft fractures. An analysis of complications of 2 implants with special reference to outcome after management with the unreamed humerus interlocking nail].

INTRODUCTION: Operative treatment of humeral shaft fractures has gained a new impetus with the development of intramedullary interlocking systems for the humerus. Because of the anatomical structure of the humeral marrow cavity, a regular jamming of nail into bone is not to be expected, so that the stability of these systems needs to be achieved through an interlocking mechanism. Among the commercially available interlocking nailing systems the unreamed humeral nail (UHN) and the Seidel-nail (SHN) can be regarded as the standard implants. DESIGN: In a retrospective study comparing two groups of patients, each treated with one of the two systems, problems and advantages, as well as disadvantages were analyzed, and the complications inherent in the systems examined. PATIENTS: Between 1988-1992, 47 patients with humeral shaft fractures were treated with a Seidel interlocking nail: 25 acute and 18 pathological fractures as well as 4 non-unions (Group 1). Between 1997-1999, 34 patients with humeral shaft fractures were treated with the unreamed humeral nail (UHN). A total of thirty-five (n = 35) nailings (30 acute and 4 pathological fractures, as well as one re-osteosynthesis after emergence of a non-union) were carried out. Three primary palsies of the radial nerve ensued: two with loss of sensitivity, and one complete paralysis (Group 2). METHODS: Based on pre- and postoperative X-rays and follow-up examinations, the healing process and complications inherent in each of the systems were evaluated. RESULTS: Intra-operative complications of Seidel-nailing (Group 1) were seen in 5 cases: failure of the proximal target device in 2 (4.2%) cases; the breaking of the long screwdriver during the distal locking in 1 (2.1%) case; blockade of nail-insertion due to the spreading distal lamellas in 1 (2.1%) case; in 1 (2.1%) case it was impossible to find the imbus of the distal locking screw with the screwdriver. Incorrect surgical technique resulting in further fragmentation of the shaft required revisions in 2 (4.2%) cases. In 3 cases (6.4%), the insertion of the nail was insufficient, so that an impingement resulted. In 12 cases, postoperative complications after Seidel-nailing resulted: 3 (6.4%) radial nerve palsies, of which 2 (4.2%) were transitory; 3 (6.4%) infections; in 3 (6.4%) cases, loosening of the locking bolt inserted in the frontal plane; in 1 (2.1%) case, loosening of the distal spreading screw. The system failed in treating 2 (of 4) non-unions, whereas successful ossification and repair occurred in all acute fractures. In Group 2 (UHN) the acute fractures of 33 cases healed without complications. Intra-operative complications of the unreamed nail: in 2 cases (5.6%), failure of the target devices resulted in malpositoning of interlocking screws. The following intra-operative complications of the retrograde technique were observed: burst of a fragment at the insertion site in 1 case (2.8%); intra-articular positioning of the most proximal interlocking screw in another case (2.8%). Postoperative complications of the unreamed nail: breaking of a proximal and a distal interlocking screw in 1 case (2.8%), which had no influence on the healing progress. In 1 case (2.8%) both proximal interlocking screws came loose and a non-union ensued. After re-osteosynthesis with the same technique, bony repair was achieved. CONCLUSION: The possibilities of operative methods in treatment of humeral shaft fractures are enhanced by intramedullary interlocking systems. Comparing with the Seidel nail, the unreamed humeral nail (UHN) has two advantages: it can be inserted anterogradely as well as retrogradely, and it provides the possibility of compressing the fracture, resulting in a high rotational stability. Due to these results, the application of the UHN is recommended.

Adult↗

The diagnostic dilemma of traumatic rupture of the diaphragm.

BACKGROUND: Traumatic rupture of diaphragm is caused by blunt or penetrating trauma. Early diagnosis is difficult, and complications such as visceral herniation may arise. A 10-year evaluation of all diagnostic procedures used in patients with surgically proved traumatic rupture of the diaphragm is presented. METHODS: A review of all patients with surgically proved diaphragmatic injury from 1988 to 1998 was conducted. All diagnostic methods were analyzed in terms of their ability to identify diaphragmatic rupture. RESULTS: During the study period, 31 patients with a mean age of 34 years were treated. Of these patients, 20 sustained blunt trauma and 11 experienced penetrating trauma. The initial chest x-ray was diagnostic for 6 of the 31 patients, nonspecific for 15 of the patients, and normal for 10 of the patients. In no case was sonography diagnostic. Thoracoabdominal computed tomography (CT), performed in 22 of the patients, led to diagnosis for 5 patients and unspecific findings for 17 patients. Statistical analyses showed no significant difference between initial chest x-ray and thoracoabdominal CT. No significant difference between blunt or penetrating trauma or between left-side and right-side ruptures could be recognized with any diagnostic tool. CONCLUSIONS: All the diagnostic methods investigated in this study showed unsatisfying results, and traumatic rupture of the diaphragm seems to remain a diagnostic dilemma. Endoscopic techniques not tested in this study and discussed controversially may offer a good chance for early diagnosis and repair of the injured diaphragm.

Abdominal Injuries↗

[Change in procedure and re-osteosynthesis of the femur. Definition and retrospective analysis].

The change of treatment modality in osteosynthesis is based on two principles. On one hand, one can exchange the implant as part of a two step procedure to reduce side effects of stabilizing fractures. On the other hand, a reosteosynthesis may be required for treatment of complications. A retrospective analysis was undertaken to differentiate the situation of indication, technique and results of patients with fractures of the femur. Indications for two step procedure of therapy at the femur are limited to fractures of polytraumatized patients and fractures with severe soft tissue damage. External fixator devices have been used for stabilization of long bone fractures with severe soft tissue damage using the two step procedure in the past decades; nowadays unreamed nailing is commonly preferred. Reosteosynthesis may be appropriate for the treatment of failing of osteosynthesis; they can also be used due to delayed union or nonunion of fractures, osseous deficiency or infection. In the case of failing osteosynthesis, the reasons for failing have to be studied thoroughly and a variety of subsequent procedures has to be taken into consideration for successful treatment.

Adolescent↗

Intracranial pressure-alterations during controlled intramedullary reaming of femoral fractures: an animal study.

Reaming during intramedullary nailing increases the intramedullary pressure (IMP) and can cause fat intravasation and subsequently lead to pulmonary dysfunction, especially in polytraumatized patients with lung contusion as well as increases in intracranial pressure (ICP).ICP changes were measured in two groups consisting of 12 sheep each with either a fractured or intact femur. The animals were exposed to haemorrhagic shock and were resuscitated by autoinfusion. Transverse midshaft fractures were created bilaterally in one group before reaming of both femoral shafts. Controlled reaming was performed at 15 and 50 mm/s driving speed (DS) and at 150 and 450 revolutions per minute (RPM) with a reaming control system using AO-Reamers. Fat intravasation was measured by transoesophageal sonography (TES) and Gurd test. ICP monitoring was performed with a piezo-electric epidural catheter. Haemodynamic and respiratory parameters, ICP, and cerebral perfusion pressure were measured continuously. High DS and low RPM caused higher IMP and ICP increases in both groups. Significantly higher microemboli were observed in TES in the fractured group as compared to the unfractured group with the same reaming parameters (P=0.021). However, the existence of a femoral fracture did not show a significant influence on changes in ICP (P-value=0.057). Reaming should be performed at a low DS and high RPM to minimize the risk of fat intravasation and the subsequent ICP increase.

Animals↗

[Penetrating injuries of the neck, injury pattern and diagnostic algorithm].

Penetrating neck injuries are potentially life-threatening injuries. Management is controversial despite decades of discussion in the literature. An algorithm for diagnosis and therapy is needed because of the potential risk of mortality. In the Department of Trauma Surgery of Vienna Medical School, mandatory surgical exploration after noninvasive investigations is practiced. Thirty-one patients with this kind of injury were treated between August 1992 and September 1999. Injuries were caused in seven cases by gunshots, in eight cases by broken glass, in one case by an iron rod, in one case by a spear, in one case by a branch and in 13 cases the penetrating injuries were stab wounds caused by knives. Complications like pseudoaneurysms and fistulas were not seen. No patient came to death.

Adolescent↗

Pressure changes during reaming with different parameters and reamer designs.

Reaming increases intramedullary pressure and can cause fat intravasation. This study investigated the influence of reaming parameters on pressure changes using the AO, Gray, and Howmedica reamers. Silicone cylindrical shells with 10-, 11-, 16-, 19-, and 20-mm inner diameters were filled with a 1:2 ratio of paraffin and petroleum jelly. The 10- and 11-mm shells were reamed using a 9-mm reamer, the 16-mm shells with a 14-mm reamer, and the 19- and 20-mm shells with an 18-mm reamer. Each experiment was performed seven times while singularly varying driving speeds of 15, 30, and 50 mm per second, with a revolution rate of 150, 250, and 500 revolutions per minute. Using stepwise linear regression analysis, driving speed was the most significant parameter. The lowest pressure increases occurred at the lowest driving speed and the highest revolution rate in all cylinders. The model used for this study did not take into consideration the interaction between the cortical shell and reamer head. The results of this study suggest that reaming should be done at a low driving speed and a high revolution rate using a small cored reamer head, especially during the first reaming steps.

Embolism, Fat↗

Regional distribution of nicotinic receptor subunit mRNAs in human brain: comparison between Alzheimer and normal brain.

The regional expression of mRNA for the nicotinic acetylcholine receptor (nAChR) subunits alpha3, alpha4 and alpha7 was examined in postmortem brain tissues from controls and patients with Alzheimer's disease (AD) by using quantitative RT-PCR. In parallel, the numbers of nAChRs were measured by receptor binding. Relative quantification of the nAChR gene transcripts in control brains showed that expression of alpha3 was highest in the parietal cortex, frontal cortex and hippocampus, and lower in the temporal cortex and cerebellum. The highest level of alpha4 mRNA was found in the temporal cortex and cerebellum, while alpha7 mRNA was equally distributed in all brain regions except for hippocampus where it was less abundant. In comparison with AD brains, no differences in the expression of alpha3 and alpha4 in the temporal cortex, hippocampus and cerebellum were found. The level of alpha7 mRNA was significantly higher in the hippocampus of AD brains compared to controls. The binding sites for [3H] epibatidine and [3H] nicotine in the temporal cortex and [125I] alpha-bungarotoxin in hippocampus were significantly decreased in AD patients compared to controls. Saturation analysis of [3H] epibatidine binding revealed two classes of binding sites, with a significant reduction of the higher affinity epibatidine binding sites in the temporal cortex of AD brain. The results show that there is a regional distribution of the expression of the different nAChRs subunits in human brain. The findings that the alpha3 and alpha4 mRNA levels were not changed in AD brains suggest that the loss of higher affinity epibatidine binding sites observed in AD patients cannot be attributed to alternations at the transcriptional level of the alpha3 and alpha4 genes and that causes have to be searched for at the translational and/or posttranslational level. The increased mRNA level of alpha7 previously found in lymphocytes, and now also in the hippocampus of AD patients, indicate that subunit specific changes in gene expression of nAChRs is associated with AD.

Aged↗

Acetabular fractures: operative management and long term results.

INTRODUCTION: While the undisplaced acetabular fractures have a good prognosis after conservative treatment, the management of the displaced fractures has been a controversial issue over the last decades with variable results in their treatment and prognosis. Anatomical reduction can be only achieved operatively. The long term outcome of 209 patients with displaced acetabular fractures treated by open reduction and internal fixation was presented. MATERIAL AND METHODS: Between 1972 and 1996, 209 patients with a mean age of 38 years (15-62a) were treated for displaced acetabular fractures operatively. 161 patients could be followed up over a period of 2 to 20 years. The function of the hip joint in correlation with radiological results was evaluated according to the scheme of Merle d'Aubinge. RESULTS: Patients with single column fractures showed 90% good or excellent results followed by 55% good or excellent results in patients with transverse fractures. The highest rates of complication (20% osteoarthritis, 6% femoral head necrosis, 9% heterotopic ossification) were observed in both column fractures and in transverse and posterior wall fractures. Deep infection was observed in 6 cases (4%), superficial wound infection in 8 cases (5%). Primary sciatic nerve palsy was seen in 10 cases (6%) and postoperative peroneal nerve palsy in 6 cases (4%), all of which improved during the rehabilitation period. CONCLUSION: Displaced acetabular fractures of the weight bearing part of the dome, i.e. transtectal fractures, should be treated operatively. The operation should preferably be performed within one week after the injury.

Acetabulum↗

[Concomitant intra-abdominal injuries in pelvic trauma].

A pelvic fracture combined with abdominal injury and soft tissue damage, defined as complex pelvic trauma, is an expression of severe trauma and requires specific procedures in terms of diagnosis and treatment. The clinical course and outcome of 75 patients (56 males and 19 females) with complex pelvic injuries from 1985 to 1996 are presented in this follow-up study. There were 33 (44%) Type A (stable pelvic ring fracture), 10 (13%) Type B (rotationally unstable pelvic ring fracture) and 32 (43%) Type C (rotationally and vertically unstable pelvic ring fracture). Concomitant abdominal injuries included: 14 liver lacerations (19%), 28 splenic lesions (37%), 7 ruptures of the kidney (9%), 18 ruptures of the bladder (24%), 13 urethra lesions (17%), 13 intestinal lesions (17%) and 16 ruptures of the diaphragm (21%). The mean Hannover polytrauma score was 22 points. Twelve patients (16%) died within 6 hours after associated head and/or chest injury with hemorrhage, and 3 patients (4%) died in the intensive care unit from sepsis and multiorgan failure within 2 weeks after injury. The priority of the steps taken is of utmost importance in the diagnosis and treatment of such injuries. Immediate control of hemorrhage by surgical or minimally invasive radiological techniques, stabilization of pelvic fractures and inter-disciplinary cooperation are important requirements for management and successful treatment.

Abdominal Injuries↗