BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not bee...BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not been reported.METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions(>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of f T3, free thyroxine(f T4), and thyroidstimulating hormone(TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation.RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M(1.95±0.37 pg/m L) were signifi cantly lower than those in group C(2.49±0.72 pg/m L; P<0.01) and remained low until 1 week after admission. Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week(1.99±1.64 μIU/m L) were higher than at admission(1.48±0.5 μIU/m L) in group C(P<0.05).CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.展开更多
This study aimed to identify the reasons for transferring athletes to local medical facilities during the Olympic and Paralympic Games.Data on 567 injuries and other illnesses of athletes treated at the on-site clinic...This study aimed to identify the reasons for transferring athletes to local medical facilities during the Olympic and Paralympic Games.Data on 567 injuries and other illnesses of athletes treated at the on-site clinics were collected from the Tokyo 2020 Organizing Committee.Of these,84 athletes who required outpatient care during the Games were registered for this survey.During the Olympic and Paralympic Games,66(8.3/1000)and 18(7.2/1000)athletes,respectively,consulted external medical facilities.In the Olympic Games,the reasons for these visits included 48 cases(72.7%)of injuries,13(19.7%)cases of illnesses,and 5(7.6%)cases of heat stroke illness(HSI).Of these patients,56(84.9%)were treated as outpatients and 10(15.1%)were hospitalized,while three of these patients required hospitalization for>7 days.On the other hand,in the Paralympics Games,there were 7(38.8%)cases of injuries,9(50.0%)other illnesses,1(5.6%)case of HSI,and 1(5.6%)other cases,of which 11(61.1%)were treated as outpatients and 7(38.9%)were hospitalized,but none was hospitalized for>7 days.Injuries accounted for 70%of the total cases at the 2021 Olympic Games,but only three(0.05%)were severe cases that required hospitalization for more than 1 week.In contrast,in the Paralympic Games,other illnesses accounted for approximately half of the total cases.This study provides details on the extent of injuries and other illnesses that were transferred to outside facilities,which has not been documented in previous games.展开更多
文摘BACKGROUND: Although non-thyroidal illness syndrome(NTIS) is considered a negative prognostic factor, the alterations in free triiodothyronine(f T3) levels in trauma patients requiring massive transfusion have not been reported.METHODS: A prospective observational study comparing 2 groups of trauma patients was conducted. Group M comprised trauma patients requiring massive transfusions(>10 units of packed red blood cells) within 24 hours of emergency admission. Group C comprised patients with an injury severity score >9 but not requiring massive transfusions. Levels of f T3, free thyroxine(f T4), and thyroidstimulating hormone(TSH) were evaluated on admission and on days 1, 2, and 7 after admission. The clinical backgrounds and variables measured including total transfusion amounts were compared and the inter-group prognosis was evaluated. Results are presented as mean±standard deviation.RESULTS: Nineteen patients were enrolled in each group. In both groups, 32 were men, and the mean age was 50±24 years. In group C one patient died from respiratory failure. The initial f T3 levels in group M(1.95±0.37 pg/m L) were signifi cantly lower than those in group C(2.49±0.72 pg/m L; P<0.01) and remained low until 1 week after admission. Initial inter-group f T4 and TSH levels were not significantly different. TSH levels at 1 week(1.99±1.64 μIU/m L) were higher than at admission(1.48±0.5 μIU/m L) in group C(P<0.05).CONCLUSION: Typical NTIS was observed in trauma patients requiring massive transfusions. When initial resuscitation achieved circulatory stabilization, prognosis was not strongly associated with NTIS.
文摘This study aimed to identify the reasons for transferring athletes to local medical facilities during the Olympic and Paralympic Games.Data on 567 injuries and other illnesses of athletes treated at the on-site clinics were collected from the Tokyo 2020 Organizing Committee.Of these,84 athletes who required outpatient care during the Games were registered for this survey.During the Olympic and Paralympic Games,66(8.3/1000)and 18(7.2/1000)athletes,respectively,consulted external medical facilities.In the Olympic Games,the reasons for these visits included 48 cases(72.7%)of injuries,13(19.7%)cases of illnesses,and 5(7.6%)cases of heat stroke illness(HSI).Of these patients,56(84.9%)were treated as outpatients and 10(15.1%)were hospitalized,while three of these patients required hospitalization for>7 days.On the other hand,in the Paralympics Games,there were 7(38.8%)cases of injuries,9(50.0%)other illnesses,1(5.6%)case of HSI,and 1(5.6%)other cases,of which 11(61.1%)were treated as outpatients and 7(38.9%)were hospitalized,but none was hospitalized for>7 days.Injuries accounted for 70%of the total cases at the 2021 Olympic Games,but only three(0.05%)were severe cases that required hospitalization for more than 1 week.In contrast,in the Paralympic Games,other illnesses accounted for approximately half of the total cases.This study provides details on the extent of injuries and other illnesses that were transferred to outside facilities,which has not been documented in previous games.
