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https://www.readbyqxmd.com/read/29156107/hemodynamic-force-triggers-rapid-netosis-within-sterile-thrombotic-occlusions
#1
X Yu, J Tan, S L Diamond
BACKGROUND: Neutrophil extracellular traps (NETs) are released when neutrophils encounter infectious pathogens, especially during sepsis. Additionally, NETosis occurs during venous and arterial thrombosis, disseminated intravascular coagulation, and trauma. OBJECTIVE: We tested if hemodynamic forces trigger NETosis during sterile thrombosis. METHODS: NETs were imaged with Sytox-green during microfluidic perfusion of Factor XIIa-inhibited or thrombin-inhibited human whole blood over fibrillar collagen (± tissue factor)...
November 20, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29155530/dental-trauma-2-acute-management-of-fracture-injuries
#2
Serpil Djemal, Parmjit Singh, Nectaria Polycarpou, Rachel Tomson, Martin Kelleher
Fortunately, traumatic dental injuries are a relatively uncommon occurrence in general dental practice. However, when they do present, timely diagnosis and treatment of such injuries is essential to maximize the chance of a successful outcome. This is the second part of a two-part series on traumatic dental injuries that are commonly encountered in the clinical setting. Part one covered the management of acute luxation/displacement injuries affecting the supporting structures of the tooth, while part two will cover the management of fracture injuries associated with teeth and the alveolar bone...
December 2016: Dental Update
https://www.readbyqxmd.com/read/29155312/designing-clinical-studies-in-orthopedic-traumatology
#3
REVIEW
D M Rouleau
The design of clinical studies in orthopedic traumatology is challenging in several respects. In this era of evidence-based medicine, the pressure is high to choose our treatments solely based on randomized controlled studies. This type of study, when well-constructed, makes it possible to discern the best treatment for a specific fracture in a given group of patients and in connection with a specific outcome. Randomized controlled trials require a lot of resources and are not designed to answer all research questions...
November 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29151048/early-vasopressor-use-following-traumatic-injury-a-systematic-review
#4
Mathieu Hylands, Augustin Toma, Nicolas Beaudoin, Anne Julie Frenette, Frédérick D'Aragon, Émilie Belley-Côté, Emmanuel Charbonney, Morten Hylander Møller, Jon Henrik Laake, Per Olav Vandvik, Reed Alexander Siemieniuk, Bram Rochwerg, François Lauzier, Robert S Green, Ian Ball, Damon Scales, Srinivas Murthy, Joey S W Kwong, Gordon Guyatt, Sandro Rizoli, Pierre Asfar, François Lamontagne
OBJECTIVES: Current guidelines suggest limiting the use of vasopressors following traumatic injury; however, wide variations in practice exist. Although excessive vasoconstriction may be harmful, these agents may help reduce administration of potentially harmful resuscitation fluids. This systematic review aims to compare early vasopressor use to standard resuscitation in adults with trauma-induced shock. DESIGN: Systematic review. DATA SOURCES: We searched MEDLINE, EMBASE, ClinicalTrials...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149741/the-isolated-posterior-malleolar-fracture-and-syndesmotic-instability-a-case-report-and-review-of-the-literature
#5
Diederik P J Smeeing, Roderick M Houwert, Moyo C Kruyt, Falco Hietbrink
INTRODUCTION: Ankle fractures are among the most common type of fractures in the lower extremity. A posterior malleolar fracture is frequently part of a more complex ankle fracture and only in rare cases it occurs as isolated injury. Posterior malleolar fractures often occur with associated injuries, such as a Maisonneuve fracture or with bi- or trimalleolar ligamentous injuries. Knowledge about these associated injuries is essential to prevent missed diagnoses. The aim of this article is to describe the isolated posterior malleolar fracture, the possible associated injuries, the diagnostic work-up and therapeutic consequences...
November 13, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29144110/effect-of-stabilization-exercise-on-back-pain-disability-and-quality-of-life-in-adult-with-scoliosis-a-systematic-review
#6
Malik H Alanazi, Eric C Parent, Elizabeth Dennett
INTRODUCTION: Adult Scoliosis (AS) is the most common spine deformity in adults. Back pain is the main symptom leading patients to seek medical consultation. Stabilization exercise has been shown effective for reducing back pain. No literature review has examined the effects of such exercises in adults with scoliosis. OBJECTIVES: To systematically review the effects of stabilization exercises on back pain, disability and quality of life in adults with scoliosis...
November 16, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29143793/marrubium-vulgare-l-leave-extract-phytochemical-composition-antioxidant-and-wound-healing-properties
#7
Bédis Amri, Emanuela Martino, Francesca Vitulo, Federica Corana, Leila Bettaieb-Ben Kaâb, Marta Rui, Daniela Rossi, Michela Mori, Silvia Rossi, Simona Collina
Several factors contribute in wound generation, e.g., accidental traumas or surgery, and in certain cases, this dermal injury may have a devastating outcome. When skin damage occurs, the human body puts in place a sophisticated choreography, which involves numerous repairing processes to restore physiological conditions. Nevertheless, natural healing mechanisms are ineffective towards chronic or non-healing wounds and thus, therapeutic strategies may represent the only beneficial alternative to counteract these tissue insults...
October 28, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/29142872/isolated-tympanic-plate-fracture-detected-by-cone-beam-computed-tomography-report-of-four-cases-with-review-of-literature
#8
Ashita Ritesh Kalaskar, Ritesh Kalaskar
The tympanic plate is a small part of the temporal bone that separates the mandibular condyle from the external auditory canal. Fracture of this small plate is rare and usually associated with other bony fractures, mainly temporal and mandibular bone. There is a limited amount of literature on this subject, which increases the chance of cases being overlooked by physicians and radiologists. This is further supported by purely isolated cases of tympanic plate fracture without evidence of other bony fractures...
October 2017: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/29140953/contemporary-management-of-rectal-injuries-at-level-i-trauma-centers-the-results-of-an-american-association-for-the-surgery-of-trauma-multi-institutional-study
#9
Carlos V R Brown, Pedro G Teixeira, Elisa Furay, John P Sharpe, Tashinga Musonza, John Holcomb, Eric Bui, Brandon Bruns, H Andrew Hopper, Michael S Truitt, Clay C Burlew, Morgan Schellenberg, Jack Sava, John VanHorn, Brian Eastridge, Alicia M Cross, Richard Vasak, Gary Vercruysse, Eleanor E Curtis, James Haan, Raul Coimbra, Phillip Bohan, Stephen Gale, Peter G Bendix
INTRODUCTION: Rectal injuries have been historically treated with a combination of modalities including direct repair, resection, proximal diversion, presacral drainage, and distal rectal washout. We hypothesized that intraperitoneal rectal injuries may be selectively managed without diversion and the addition of distal rectal washout and pre-sacral drainage in the management of extraperitoneal injuries are not beneficial. METHODS: This is an American Association for the Surgery of Trauma multi-institutional retrospective study from 2004-2015 of all patients who sustained a traumatic rectal injury and were admitted to one of the 22 participating centers...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29139325/the-applicability-of-resilience-training-to-the-mitigation-of-trauma-related-mental-illness-in-military-personnel-formula-see-text
#10
Summer R Thompson, Sarah Dobbins
BACKGROUND: Ongoing participation by the United States in military operations around the world places military personnel at an increased potential for exposure to trauma, which may directly result in an increased risk for mental health issues. It is important to develop and test new approaches to prevent and mitigate the effects of trauma in military personnel. One such area of research is focused on psychological resilience to prevent the sequelae of trauma. OBJECTIVES: This article examines empirical research of resilience training in military personnel and discusses the potential applicability of such training in this population...
November 1, 2017: Journal of the American Psychiatric Nurses Association
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#11
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#12
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with pre-syncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29132583/the-evolving-science-of-trauma-resuscitation
#13
REVIEW
Tim Harris, Ross Davenport, Matthew Mak, Karim Brohi
This review summarizes the evolution of trauma resuscitation from a one-size-fits-all approach to one tailored to patient physiology. The most dramatic change is in the management of actively bleeding patients, with a balanced blood product-based resuscitation approach (avoiding crystalloids) and surgery focused on hemorrhage control, not definitive care. When hemostasis has been achieved, definitive resuscitation to restore organ perfusion is initiated. This approach is associated with decreased mortality, reduced duration of stay, improved coagulation profile, and reduced crystalloid/vasopressor use...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132581/resuscitation-resequenced-a-rational-approach-to-patients-with-trauma-in-shock
#14
REVIEW
Andrew Petrosoniak, Christopher Hicks
Trauma resuscitation is a complex and dynamic process that requires a high-performing team to optimize patient outcomes. More than 30 years ago, Advanced Trauma Life Support was developed to formalize and standardize trauma care; however, the sequential nature of the algorithm that is used can lead to ineffective prioritization. An improved understanding of shock mandates an updated approach to trauma resuscitation. This article proposes a resequenced approach that (1) addresses immediate threats to life and (2) targets strategies for the diagnosis and management of shock causes...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132580/the-kids-are-alright-pediatric-trauma-pearls
#15
REVIEW
Angelo Mikrogianakis, Vincent Grant
Pediatric patients with trauma pose unique challenges, both practical and cognitive, to front-line care providers. The combination of anatomic, physiologic, and metabolic factors leads to unique injury patterns with different approaches and responses to treatment compared with adults. A similar traumatic mechanism can lead to slightly different internal injuries with unique management and treatment strategies between the two groups. This article is intended for community, nonpediatric trauma centers, and emergency physicians who are frequently required to assess, resuscitate, and stabilize injured children before they can be safely transferred to a pediatric trauma center for ongoing definitive care and rehabilitation...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132578/major-trauma-outside-a-trauma-center-prehospital-emergency-department-and-retrieval-considerations
#16
REVIEW
Preston J Fedor, Brian Burns, Michael Lauria, Clare Richmond
Care of the critically injured begins well before the patient arrives at a large academic trauma center. It is important to understand the continuum of care from the point of injury in the prehospital environment, through the local hospital and retrieval, until arrival at a trauma center capable of definitive care. This article highlights the important aspects of trauma assessment and management outside of tertiary or quaternary care hospitals. Key elements of each phase of care are reviewed, including management pearls and institutional strategies to facilitate effective and efficient treatment of trauma patients from the point of injury forward...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132575/acute-management-of-the-traumatically-injured-pelvis
#17
REVIEW
Steven Skitch, Paul T Engels
Severe pelvic trauma is a challenging condition. The pelvis can create multifocal hemorrhage that is not easily compressible nor managed by traditional surgical methods such as tying off a blood vessel or removing an organ. Its treatment often requires reapproximation of bony structures, damage control resuscitation, assessment for associated injuries, and triage of investigations, as well as multimodality hemorrhage control (external fixation, preperitoneal packing, angioembolization, REBOA [resuscitative endovascular balloon occlusion of the aorta]) by multidisciplinary trauma specialists (general surgeons, orthopedic surgeons, endovascular surgeons/interventional radiologists)...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132573/critical-decisions-in-the-management-of-thoracic-trauma
#18
REVIEW
Morgan Schellenberg, Kenji Inaba
Traumatic injuries to the thorax are common after both blunt and penetrating trauma. Emergency medicine physicians must be able to manage the initial resuscitation and diagnostic workup of these patients. This involves familiarity with a range of radiologic investigations and invasive bedside procedures, including resuscitative thoracotomy. This knowledge is critical to allow for rapid decision making when life-threatening injuries are encountered. This article explores the initial resuscitation and assessment of patients after thoracic trauma, discusses available imaging modalities, reviews frequently performed procedures, and provides an overview of the indications for operative intervention, while emphasizing the critical decision making throughout...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29132511/resuscitation-for-hypovolemic-shock
#19
REVIEW
Kyle J Kalkwarf, Bryan A Cotton
Hemorrhage is the leading cause of preventable deaths in trauma patients. After presenting a brief history of hemorrhagic shock resuscitation, this article discusses damage control resuscitation and its adjuncts. Massively bleeding patients in hypovolemic shock should be treated with damage control resuscitation principles including limited crystalloid, whole blood or balance blood component transfusion to permissive hypotension, preventing hypothermia, and stopping bleeding as quickly as possible.
December 2017: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29132272/traumatic-brain-injury-and-posttraumatic-stress-disorder-conceptual-diagnostic-and-therapeutic-considerations-in-the-context-of-co-occurrence
#20
Jennifer J Vasterling, Shawna N Jacob, Ann Rasmusson
The events leading to traumatic brain injury (TBI) are often psychologically traumatic (e.g., motor vehicle accidents) or occur within a broader context of psychological trauma, such as military combat or recurrent interpersonal violence. In such cases, posttraumatic stress disorder (PTSD) may develop and serve to complicate TBI recovery. Likewise, brain trauma may impede emotional resolution following psychological trauma exposure. This article addresses comorbid PTSD and TBI, including the epidemiology of PTSD following TBI; the clinical presentation of the comorbidity; potential mechanisms that complicate recovery from psychological trauma and TBI when they co-occur; and considerations for the clinical management of PTSD in the context of TBI, including implications for both psychosocial and psychopharmacological PTSD treatments...
November 14, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
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