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Obesity and trauma

Darnell J Brown, Kuo Jung G Lu, Kristina Chang, Jennifer Levin, John T Schulz, Jeremy Goverman
Background: Morel-Lavallee lesions (MLLs) are rare internal degloving injuries typically caused by blunt traumatic injuries and most commonly occur around the hips and in association with pelvic or acetabular fractures. MLL is often overlooked in the setting of poly-trauma; therefore, clinicians must maintain a high degree of suspicion and be familiar with the management of such injuries, especially in obese poly-trauma patients. Case presentation: We present a 30-year-old female pedestrian struck by a motor vehicle who sustained multiple long bone fractures, a mesenteric hematoma, and full-thickness abdominal skin friction burn which masked a significant underlying abdominal MLL...
2018: Burns and Trauma
Andre M Samuel, Pablo J Diaz-Collado, Raj J Gala, Matthew L Webb, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Han Jo Kim, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine the rate of venous thromboembolism event (VTE) and risk factors for their occurrence in patients with vertebral fractures. SUMMARY OF BACKGROUND DATA: Deep vein thrombosis or pulmonary embolism (VTE) events are a significant source of potentially preventable morbidity and mortality in trauma patients. In patients with traumatic vertebral fractures, a common high-energy injury sometimes resulting in spinal cord injury, there is debate about what factors may be associated with such VTEs...
March 13, 2018: Spine
Raquel Bernardelli Iamaguchi, Renan Lyuji Takemura, Gustavo Bersani Silva, Jairo Andre de Oliveira Alves, Luciano Ruiz Torres, Alvaro Baik Cho, Teng Hsiang Wei, Marcelo Rosa de Rezende, Rames Mattar
INTRODUCTION: Indication of free tissue transfer for limb reconstruction continues to grow, and despite the good results with this treatment option, complications can impair the functional results and cause a raise in health costs, with prolonged hospitalization. Therefore, peri-operative surgical information and comorbidities were described and analyzed, for identification of independent risk factors for complications of free flaps results for traumatic wounds. For our knowledge, intraoperative ischemia time of free flap was not previously studied for post-traumatic limb reconstruction, which could influence results, in these traumatic cases, with the highest rates of complications among microsurgical flap reconstructions...
March 13, 2018: International Orthopaedics
Anton A Kasatkin, Aleksandr L Urakov, Anna R Nigmatullina
INTRODUCTION: Central venous cannulation may be difficult in morbidly obese patients. We present a case of successful right internal jugular vein catheterization under real-time ultrasound guidance in an obese patient in a forced semi-sitting position. CASE REPORT: A 43-year-old male patient with body mass of 182 kg (body mass index, 52.2 kg/m2 ) was admitted to the clinic 48 h after the trauma. The patient was in a forced semi-sitting position (37° head elevation)...
March 1, 2018: Journal of Vascular Access
D L Rofey, N E El Nokali, L J Jackson Foster, E Seiler, H L McCauley, E Miller
STUDY OBJECTIVE: To examine the impact of childhood trauma and family history of psychiatric illness on weight loss trajectories of obese, adolescent females with PCOS. DESIGN: Prospective Study SETTING: PCOS and Adolescent Medicine Outpatient Clinics PATIENTS: Participants were, on average, 15.8 years, 80% Caucasian, and had a BMI of 36.8 ± 8.8 kg/m2 . INTERVENTIONS: Healthy Bodies, Healthy Minds is an evidence-based one-on-one intervention consisting of four weekly sessions, four bi-weekly sessions, and three monthly booster sessions...
March 8, 2018: Journal of Pediatric and Adolescent Gynecology
Haruo Hanyu
There is a wide range of potentially modifiable risk factors for Alzheimer's disease and dementia, including cardiovascular risk factors (e.g. hypertension, diabetes, dyslipidemia, obesity, sleep-apnea syndrome), psychosocial factors (e.g., depression), health behaviors (e.g., low level of physical or mental activity, smoking status), and head trauma. In the elderly, weight loss associated with frailty and sarcopenia is another risk factor for dementia. Recent epidemiological studies have shown that the prevalence of dementia has declined in the US and European countries during the last 20 years...
March 2018: Brain and Nerve, Shinkei Kenkyū No Shinpo
Stephen C Gale, JoAnn Peters, Jason S Murry, Jessica S Crystal, Viktor Y Dombrovskiy
Background: Late middle age (LMA), is a watershed between youth and old age, with unique physical and social changes and declines in vitality, but a desire to remain active despite increasing comorbidity. While post-injury outcomes in the elderly are well studied, little is known regarding LMA patients. We analyzed the injured LMA population admitted to a rural, regional Level 1 Trauma Center relative to outcomes for both younger and older patients. Materials and methods: Our registry was queried retrospectively for patients admitted 7/2008- 12/2015; they were divided into three cohorts: 18-54, 55-65, and >65 years...
March 2018: Annals of Medicine and Surgery
Laneita Freeman Williamson, Donald D Kautz
PURPOSE: This clinical article explores how trauma-informed care (TIC) can be used by rehabilitation nurses with patients who have experienced pervasive adverse childhood experiences (ACEs). METHOD (INTERVENTION STRATEGIES): This clinical article gives suggestions for using the five guiding principles of TIC: safety, trustworthiness, choice, collaboration, and empowerment, as the best clinical practice. CONCLUSION: Implementing TIC promotes successful rehabilitation, improves patient outcomes, and reduces costs...
March 2018: Rehabilitation Nursing: the Official Journal of the Association of Rehabilitation Nurses
Alexander Cohen, Jay Mandrekar, Erik K St Louis, Michael H Silber, Suresh Kotagal
STUDY OBJECTIVE: To assess comorbidities in a community-based cohort of narcolepsy. METHODS: A 2000-2014 community-based narcolepsy cohort was identified in Olmsted County, Minnesota. Records were reviewed by a certified sleep specialist for accuracy of diagnosis, and comorbidities were extracted and analyzed. Comorbidities in narcolepsy subjects, both at diagnosis and upon follow-up, were compared with those in unaffected and age- and sex-matched cohort using conditional logistic regression...
March 2018: Sleep Medicine
Andre M Samuel, Pablo J Diaz-Collado, Lauren K Szolomayer, Daniel H Wiznia, Wayne W Chan, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Jonathan N Grauer
Proximal tibia fractures are associated with concurrent collateral ligament injuries. Failure to recognize these injuries may lead to chronic knee instability. The purpose of this study was to identify risk factors for concurrent collateral ligament injuries with proximal tibia fractures and their association with inpatient outcomes. A total of 32,441 patients with proximal tibia fractures were identified in the 2011-2012 National Trauma Data Bank. A total of 1445 (4.5%) had collateral ligament injuries, 794 (2...
February 16, 2018: Orthopedics
Eileen M Condon, Lois S Sadler, Linda C Mayes
Exposure to stressful environments in early childhood can cause a toxic stress response and lead to poor health outcomes, including obesity, cardiac disease, diabetes, and mental illness. In animals and maltreated children, the presence of a nurturing caregiver can buffer against the physiological disruptions associated with a toxic stress response; however, the specific caregiver and parenting characteristics that best promote a protective relationship in humans remain largely unexplored, particularly in families living in high-risk environments...
February 14, 2018: Research in Nursing & Health
Thomas Irlbeck, Silke Janitza, Balázs Poros, Monika Golebiewski, Lorenz Frey, Philipp M Paprottka, Teresa da Silva, Michael Irlbeck, Wolfgang Böcker, Thomas Weig
BACKGROUND: Recent scientific work proved that knowledge about body composition beyond the body mass index is essential. Both adipose tissue and muscular status are determining risk factors of morbidity and mortality. Analysis of single cross-sectional computed tomography (CT) images, acquired during routine care only to prevent additional radiation exposure, provide a detailed insight into the body composition of chronically and critically ill patients. METHODS: This retrospective study included 490 trauma patients of whom a whole-body multiple detector CT scan was acquired at admission...
January 23, 2018: European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes
Naoki Notani, Masashi Miyazaki, Toyomi Yoshiiwa, Toshinobu Ishihara, Shozo Kanezaki, Hiroshi Tsumura
RATIONALE: Acute neurological deficits following spinal surgery commonly result from epidural hematoma, surgical trauma, vascular compromise, and graft or hardware impingement, with the cause identified by magnetic resonance imaging (MRI). We present a rare case of dynamic paraspinal muscle impingement after C1 posterior arch laminectomy, which was diagnosed by myelography, with no significant findings on MRI. PATIENT CONCERNS: An 81-year-old, severely obese male, was referred to our department for the treatment of vertebral disease of the lumbar spine...
December 2017: Medicine (Baltimore)
Qinghong Qin, Qixing Tan, Bin Lian, Qinguo Mo, Zhen Huang, Changyuan Wei
Breast reconstruction after mastectomy plays an active role in improving the quality-of-life (QoL) and alleviating the psychological trauma of breast cancer patients, and has become an indispensable part of the comprehensive treatment in breast cancer. However, compared with mastectomy alone, breast reconstruction also increase operative complications. The surgical, oncological outcomes, and cosmetic effect of breast reconstruction remains to be evaluated. Data for patients with breast cancer who underwent breast reconstruction after mastectomy from February 2009 to November 2015 in our hospital were retrospectively analyzed, with a median follow-up time of 44 months...
February 2018: Medicine (Baltimore)
Roxana Cleper
Solitary functioning kidney (SFK) occurs with unilateral renal agenesis (URA) in 1/2000 live births - or after uninephrectomy for tumor, trauma, uncontrolled infections or hypertension and post-kidney donation. URA-associated states include urological, cardiac, gastrointestinal and skeletal anomalies or it might be a component of a genetic syndrome. In 10% of cases of URA another family member is affected. In any case of SFK a compensatory process is triggered consisting of glomerular hypertension with hyperfiltration which achieves 75% of two kidneys' function...
January 2018: Harefuah
Clay A Spitler, Patrick F Bergin, George V Russell, Matthew L Graves
BACKGROUND: Morbid obesity and segmental fracture/bone loss are challenging problems in the treatment of fractures and nonunions of the distal femur. The use of an intramedullary rod as an endosteal substitute for a deficient medial cortex along with a lateral locked plate is 1-tool to combat these problems. This article describes the technique used and its results at a single Level 1 trauma center. METHODS: Retrospective chart and radiographic review of all patients treated for acute fractures and nonunions of the distal femur using endosteal substitution with an intramedullary nail and a lateral locked plate...
February 2018: Journal of Orthopaedic Trauma
Malin Öhlund, Malin Palmgren, Bodil Ström Holst
BACKGROUND: Overweight in cats is a major risk factor for diabetes mellitus and has also been associated with other disorders. Overweight and obesity are believed to be increasing problems in cats, as is currently seen in people, with important health consequences. The objectives of the present study were to determine the prevalence of overweight in cats from two different cohorts in a cross-sectional study design and to assess associations between overweight and diagnoses, and between overweight and demographic and environmental factors...
January 19, 2018: Acta Veterinaria Scandinavica
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
Eyal Klang, Nayroz Kanana, Alon Grossman, Steve Raskin, Jana Pikovsky, Miri Sklair, Lior Heller, Shelly Soffer, Edith M Marom, Eli Konen, Marianne Michal Amitai
RATIONALE AND OBJECTIVES: Gynecomastia is the benign enlargement of the male breast because of proliferation of the glandular component. To date, there is no radiological definition of gynecomastia and no quantitative evaluation of breast glandular tissues in the general male population. The aims of this study were to supply radiological-based measurements of breast glandular tissue in the general male population, to quantitatively assess the prevalence of gynecomastia according to age by decades, and to evaluate associations between gynecomastia and obesity, cirrhosis, and dialysis...
January 8, 2018: Academic Radiology
Olga Gajic-Veljanoski, Alexandra Papaioannou, Courtney Kennedy, George Ioannidis, Claudie Berger, Andy Kin On Wong, Kenneth Rockwood, Susan Kirkland, Parminder Raina, Lehana Thabane, Jonathan D Adachi
BACKGROUND: Despite knowing better how to screen older adults, understanding how frailty progression might be modified is unclear. We explored effects of modifiable and non-modifiable factors on changes in frailty in community-dwelling adults aged 50+ years who participated in the Canadian Multicentre Osteoporosis Study (CaMos). METHODS: Rates of change in frailty over 10 years were examined using the 30-item CaMos Frailty Index (CFI). Incident and prevalent low-trauma fractures were categorized by fracture site into hip, clinical vertebral and non-hip-non-vertebral fractures...
January 5, 2018: BMC Geriatrics
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