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https://www.readbyqxmd.com/read/28446350/the-first-aid-and-hospital-treatment-of-gunshot-and-blast-injuries
#1
Axel Franke, Dan Bieler, Benedikt Friemert, Robert Schwab, Erwin Kollig, Christoph Güsgen
BACKGROUND: When gunshot and blast injuries affect only a single person, first aid can always be delivered in conformity with the relevant guidelines. In contrast, when there is a dynamic casualty situation affecting many persons, such as after a terrorist attack, treatment may need to be focused on immediately life-threatening complications. METHODS: This review is based on pertinent publications retrieved by a selective search in Medline and on the authors' clinical experience...
April 7, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28445317/timing-of-tourniquet-release-in-total-knee-arthroplasty-a-meta-analysis
#2
Pei Zhang, Yuan Liang, Jinshan He, Yongchao Fang, Pengtao Chen, Jingcheng Wang
BACKGROUND: For total knee arthroplasty (TKA), the tourniquet is routinely employed for better visualization, less blood loss, and easier cementation. However, the time to release tourniquet remains controversial. Therefore, we performed current meta-analysis to assess whether releasing tourniquet before wound closure is more effective in reducing blood loss than releasing tourniquet after wound closure in TKA without an increased risk of complications. METHODS: To conduct this meta-analysis, we searched Medline, Embase, Web of science, and the Cochrane library up to November 2016, for randomized controlled trials comparing tourniquet releasing before and after wound closure in TKA...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28433364/belts-evaluated-as-limb-tourniquets-belt-study-comparing-trouser-supporters-used-as-medical-devices-in-a-manikin-model-of-wound-bleeding
#3
Blake W Bequette, John F Kragh, James K Aden, Michael A Dubick
OBJECTIVE: The purpose of the present study is to compare several models of commercially designed belts as used as a tourniquet. METHODS: In the Belts Evaluated as Limb Tourniquets (BELT) study, an experiment was designed to test the effectiveness of pants belts as nonimprovised medical devices to control hemorrhage in a manikin. Models of belts included Tourni-belt, Tourniquet Belt, ParaBelt, and Battle Buddy. Data collected included effectiveness, time to stop bleeding, total time of application, pressure, blood loss, and composite results (score count of good results; composite outcome good if every component was good)...
April 19, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28428919/tibial-bone-grafting-for-wrist-reconstruction
#4
Schneider K Rancy, Stephanie D Malliaris, Scott W Wolfe
Background Iliac crest bone graft harvesting is routinely performed for upper extremity orthopedic procedures despite high complication rates associated with sensory nerve injury, hematoma, chronic pain, and fracture. Description of Technique Cancellous bone graft is harvested from the proximal tibia using a medial approach, minimizing donor site morbidity. Patients and Methods A retrospective review was undertaken of 14 patients who underwent cancellous proximal tibia bone graft harvesting to augment healing of wrist reconstruction, with 2 months minimum follow-up...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428759/morphological-regeneration-and-functional-recovery-of-neuromuscular-junctions-after-tourniquet-induced-injuries-in-mouse-hindlimb
#5
Huiyin Tu, Dongze Zhang, Ryan M Corrick, Robert L Muelleman, Michael C Wadman, Yu-Long Li
Tourniquet application and its subsequent release cause serious injuries to the skeletal muscle, nerve, and neuromuscular junction (NMJ) due to mechanical compression and ischemia-reperfusion (IR). Monitoring structural and functional repair of the NMJ, nerve, and skeletal muscle after tourniquet-induced injuries is beneficial in exploring potential cellular and molecular mechanisms responsible for tourniquet-induced injuries, and for establishing effective therapeutic interventions. Here, we observed long-term morphological and functional changes of the NMJ in a murine model of tourniquet-induced hindlimb injuries...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28417223/dorsal-metacarpal-veins-anatomic-variation-and-potential-clinical-implications
#6
Sara S Elmegarhi, Justin Z Amarin, Maher T Hadidi, Darwish H Badran, Islam M Massad, Amjad M Bani-Hani, Amjad T Shatarat
The dorsal metacarpal veins are frequently cannulated. Cannulation success is determined by several variable anatomic features. The objective of this study is to classify, for the first time, the anatomic variants of the dorsal metacarpal veins. In this cross-sectional study, 520 university students and staff were conveniently recruited. The dorsal metacarpal veins in 1040 hands were studied. Venous visibility was enhanced by either tourniquet application or near-infrared illumination. Variant patterns of the dorsal metacarpal veins were classified...
April 17, 2017: Anatomical Science International
https://www.readbyqxmd.com/read/28413903/digital-revascularization-and-replantation-using-the-wide-awake-hand-surgery-technique
#7
Jkf Wong, C H Lin, N J Chang, H C Chen, Y T Lin, C C Hsu
The use of local anaesthesia and adrenaline for hand surgery is gaining popularity; however, where vascularity is impaired, wide-awake surgery is considered a contraindication. We present our case series of five digital devascularizations and eight amputations that underwent surgery using the 'wide-awake' anaesthetic technique. A temporary digital tourniquet (< 20 min) was used in three cases to identify structures quickly. The anastomoses were performed under local anaesthesia without a tourniquet. All cases had successful re-establishment of blood flow with good perfusion to the digital tips; no cases were re-explored because of vascular crisis...
April 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28411931/north-american-snake-envenomation
#8
REVIEW
Bryan Corbett, Richard F Clark
Native US snakes that produce clinically significant envenomation can be divided into 2 groups, crotalids and elapids. The crotalids include rattlesnakes, cottonmouths, and copperheads. Crotalid envenomation can result in significant local tissue damage as well as thrombocytopenia and coagulopathy. Rarely are bites fatal. Native US elapids are all coral snakes that possess neurotoxic venom that can cause weakness, respiratory paralysis, and rarely death. Treatment of both types of envenomation revolves around general supportive care and antivenom administration when indicated...
May 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/28410510/tourniquet-application-after-local-forearm-warming-to-improve-venodilation-for-peripheral-intravenous-cannulation-in-young-and-middle-aged-adults-a-single-blind-prospective-randomized-controlled-trial
#9
Yuki Yamagami, Kohei Tomita, Tomomi Tsujimoto, Tomoko Inoue
BACKGROUND: Local forearm warming before tourniquet application is often used to promote venodilation for peripheral intravenous cannulation; however, few studies have compared the effect of tourniquet application with and without local warming on vein size. OBJECTIVE: To evaluate the effectiveness of tourniquet application after local forearm warming with that of tourniquet application alone in young and middle-aged adults. DESIGN: A single-blind, prospective, parallel group, randomized controlled trial...
March 27, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28405534/improving-the-standard-of-orthopaedic-operation-documentation-using-typed-proforma-operation-notes-a-completed-audit-loop
#10
Fionn Coughlan, Prasad Ellanti, Andrew Moriarty, Nuala McAuley, Niall Hogan
INTRODUCTION: The Royal College of Surgeons (RCS) published Good Surgical Practice guidelines in 2008 and revised them in 2014. They outline the basic standard that all surgical operation notes should meet. OBJECTIVES: To retrospectively audit 57 typed orthopaedic operation notes from St. James's Hospital in Dublin (from August to November 2015) against the RCS Good Surgical Practice guidelines published in 2014. They were then compared with the department's previous audit of handwritten notes to complete the audit loop...
March 7, 2017: Curēus
https://www.readbyqxmd.com/read/28399633/value-of-tourniquet-use-in-anterior-ankle-arthroscopy-a-randomized-controlled-trial
#11
Damjan Dimnjaković, Pero Hrabač, Ivan Bojanić
BACKGROUND: A tourniquet is usually used during anterior ankle arthroscopy to allow for improved visibility and reduced operation time. However, this has not been demonstrated to be true in clinical studies on knee arthroscopy, while limited tourniquet time has been described as a possible factor to lower the complication rate of ankle arthroscopy. The purpose of this randomized controlled trial was to examine the effect of tourniquet use on arthroscopic visualization, operative time, postoperative intra-articular bleeding, postoperative pain scores, and outcome of anterior ankle arthroscopy...
April 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28399253/using-tourniquets-to-stop-bleeding
#12
Joseph M Galante
No abstract text is available yet for this article.
April 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28392736/preanalytical-external-quality-assessment-of-the-croatian-society-of-medical-biochemistry-and-laboratory-medicine-and-croqalm-finding-undetected-weak-spots
#13
Nora Nikolac, Jasna Lenicek Krleza, Ana-Maria Simundic
INTRODUCTION: The aim of this paper is to present results of first two years of preanalytical external quality assessment (EQA) in Croatia. MATERIALS AND METHODS: This paper summarizes results from 6 rounds of preanalytical EQA during 2014-2016 in 161-175 Croatian laboratories (number ranged between cycles). EQA was designed as an online survey of the compliance with National recommendations for phlebotomy (NRP). Forty-seven questions in 5 categories are analyzed (materials and equipment, patient identification, patient preparation, sampling and storage)...
February 15, 2017: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
https://www.readbyqxmd.com/read/28390890/impact-of-soft-tissue-imbalance-on-knee-flexion-angle-after-posterior-stabilized-total-knee-arthroplasty
#14
Sachiyuki Tsukada, Tomoko Fujii, Motohiro Wakui
BACKGROUND: This study was performed to assess the impact of soft tissue imbalance on the knee flexion angle 2 years after posterior stabilized total knee arthroplasty (TKA). METHODS: A total of 329 consecutive varus knees were included to assess the association of knee flexion angle 2 years after TKA with preoperative, intraoperative, and postoperative variables. All intraoperative soft tissue measurements were performed by a single surgeon under spinal anesthesia in a standardized manner including the subvastus approach, reduced patella, and without use of a pneumonic tourniquet...
March 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28380474/a-randomized-trial-comparing-triple-versus-single-uterine-tourniquet-in-open-myomectomy
#15
Ragip Atakan Al, Omer E Yapca, Neset Gumusburun
BACKGROUND: Single and triple uterine tourniquet significantly reduces blood loss during myomectomy and both are highly effective. Triple tourniquet, however, blocks ovarian circulation and there is doubt that it causes ischemic damage to ovaries. These 2 methods have not been compared by a randomised controlled study yet. The purpose of this study was to compare triple uterine tourniquet with single tourniquet in terms of blood loss during open myomectomy. MATERIAL AND METHODS: Women were randomized to triple (n = 24) or to single tourniquet (n = 24) at open myomectomy...
April 6, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28378211/intra-articular-versus-intravenous-tranexamic-acid-application-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#16
Bobin Mi, Guohui Liu, Wu Zhou, Huijuan Lv, Yi Liu, Kun Zha, Qipeng Wu, Jing Liu
BACKGROUND: The purpose of this meta-analysis was to compare the blood loss and complications of intra-articular (IA) with intravenous (IV) tranexamic acid (TXA) for total knee arthroplasty (TKA). METHODS: A comprehensive search of studies was conducted to identify related articles in Pubmed, Embase, Cochrane central Register of Controlled Trials, springerLink, OVID and the Research published from January 1980 to September 2016. All studies that compared IA TXA with IV TXA application on TKA were included...
April 4, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28367692/operative-wound-complications-following-total-ankle-arthroplasty
#17
Christopher E Gross, Kamran S Hamid, Cynthia Green, Mark E Easley, James K DeOrio, James A Nunley
BACKGROUND: Wound complications following total ankle replacement (TAR) potentially lead to devastating consequences. The aim of this study was to compare the operative and demographic differences in patients with and without major wound problems which required operative management. We hypothesized that increased tourniquet and operative time would negatively influence wound healing. METHODS: We identified a consecutive series of 762 primary TARs performed between December 1999 and April 2014 whose data were prospectively collected...
April 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28365664/complications-of-peripheral-venous-access-devices-prevention-detection-and-recovery-strategies
#18
Elizabeth A Mattox
Most hospitalized patients have placement of a peripheral venous access device, either a short peripheral catheter or a peripherally inserted central catheter. Compared with central venous catheters that are not peripherally inserted, the other 2 types are generally perceived by health care providers as safer and less complicated to manage, and less emphasis is placed on the prevention and management of complications. Expertise of nurses in inserting, managing, and removing these devices may reduce the likelihood of complications, and increased recognition of complications associated with use of the devices is important to ensure continued improvements in the safety, quality, and efficiency of health care...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28360498/arthroscopic-assisted-ankle-arthrodesis-a-retrospective-study-of-32-cases
#19
Raju Vaishya, Ahmad Tariq Azizi, Amit Kumar Agarwal, Vipul Vijay
PURPOSE: The arthroscopic assisted ankle arthrodesis (AAAA) is a minimally invasive procedure for end-stage ankle arthritis with numerous benefits like faster time of union, insignificant blood loss, less morbidity, less infection rate, and less soft tissue complications. A shorter hospital stay decreases the cost and results in early mobilization compared to open methods. We present a retrospective series of 32 patients, who underwent AAAA during a period of 8 years. METHODS: Thirty-two patients were reviewed retrospectively from 2008 to 2015...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28359491/tricuspid-valve-repair-with-artificial-chorda-after-previous-ventricular-septal-defect-repair
#20
Toshiharu Sassa, Ken Okamoto, Hirokazu Tazume, Ryo Noguchi, Ayumi Koga, Toshihiro Fukui
We evaluated a 49-year-old man with severe tricuspid valve regurgitation and coronary artery disease who had undergone congenital ventricular septal defect repair four decades previously. We found an enlarged, prolapsed commissure between the anterior and septal leaflets and a ruptured septal leaflet chorda. Two mattress sutures closed the commissure, with the leaflets' height matched by inverting the prolapsed site ventricularly. After implanting the annuloplasty band, we undertook chordal replacement using expanded polytetrafluoroethylene sutures...
April 2017: Annals of Thoracic Surgery
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