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severe trauma

Xiaojing Qin, Lingzhi Li, Qi Lv, Qingming Shu, Yongliang Zhang, Yaping Wang
Traumatic brain injury (TBI) is associated with trauma-related death. In this study, we evaluated differences in the expression of plasma microRNAs (miRNAs) in patients with different degrees of TBI, and explored the potential of miRNAs for use as diagnostic TBI biomarkers. The miRNA microarray results showed upregulation of 65, 33, and 16 miRNAs and downregulation of 29, 27, and 6 miRNAs in patients with mild, moderate, and severe TBI, respectively, compared with healthy controls. Thirteen miRNAs (seven upregulated and six downregulated) were found to be present in all TBI groups...
2018: PloS One
H Trentzsch, M Maegele, U Nienaber, T Paffrath, R Lefering
BACKGROUND: Since the publication in 1993, the dataset and documentation form of the TraumaRegister DGU® (TR-DGU) have continuously evolved. On the occasion of the 25th anniversary the authors have analyzed this evolution in order to reflect it in the light of medical progress in the treatment of the severely injured. MATERIAL AND METHODS: Enrolled in the study were 5 reference data entry sheets from the years 1993, 1996, 2002, 2009 and 2016. Every piece of information (item) queried therein was entered into the study database, was categorized by topic and counted for further analysis...
September 17, 2018: Der Unfallchirurg
Tyler J Loftus, Megan L Morrow, Lawrence Lottenberg, Martin D Rosenthal, Chasen A Croft, R Stephen Smith, Frederick A Moore, Scott C Brakenridge, Robert Borrego, Philip A Efron, Alicia M Mohr
BACKGROUND: Early recognition of bowel and mesenteric injury following blunt abdominal trauma remains difficult. We hypothesized that patients with intra-abdominal adhesions from prior laparotomy would be subjected to visceral sheering deceleration forces and increased risk for bowel and mesenteric injury following blunt abdominal trauma. METHODS: We performed a multicenter retrospective cohort analysis of 267 consecutive adult trauma patients who underwent operative exploration following moderate-critical (abdominal injury score 2-5) blunt abdominal trauma, comparing patients with prior laparotomy (n = 31) to patients with no prior laparotomy (n = 236)...
September 17, 2018: World Journal of Surgery
Mikko Heinänen, Tuomas Brinck, Rolf Lefering, Lauri Handolin, Tim Söderlund
PURPOSE: Serious thoracic injuries are associated with high mortality, morbidity, and costs. We compared patient populations, treatment, and survival of serious thoracic injuries in southern Finland and Germany. METHODS: Mortality, patient characteristics and treatment modalities were compared over time (2006-2015) in all patients with Abbreviated Injury Scale (AIS) thorax ≥ 3, Injury Severity Score (ISS) > 15, age > 15 years, blunt trauma mechanism, and treatment in Intensive Care Unit (ICU) in Level 1 hospitals included in the Helsinki Trauma Registry (HTR) and the TraumaRegister DGU® (TR-DGU)...
September 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Jessica L Ryan, Etienne E Pracht, Barbara Langland-Orban
Objective: The purpose was to analyze the association of trauma volume and hospital trauma center (TC) ownership type with trauma alert (TA) response charges, which are billed for activation of the trauma team to the emergency department (ED). Methods: All Florida ED and inpatients who were billed a TA charge from 2012 to 2014 were included (62 974 observations). Multiple linear regression, controlling for patient and hospital factors, was used to identify associations between TA charges and trauma volume and hospital ownership type...
January 2018: Health Services Research and Managerial Epidemiology
Melinda A Stanley, Nancy L Wilson, Srijana Shrestha, Amber B Amspoker, Paula Wagener, Jane Bavineau, Marla Turner, Terri L Fletcher, Jessica Freshour, Cynthia Kraus-Schuman, Mark E Kunik
OBJECTIVE: To determine whether Calmer Life (CL) improved worry, generalized anxiety disorder-related (GAD-related) symptoms, anxiety, depression, sleep, trauma-related symptoms, functional status, and quality of life better than Enhanced Community Care with Resource Counseling (ECC-RC) at 6 months and 9 months. METHODS: A randomized, controlled, comparative-effectiveness study involving underserved, low-income, mostly minority neighborhoods in Houston, Texas, looked at individuals ≥50 with significant worry and interest in psychosocial treatment...
August 7, 2018: American Journal of Geriatric Psychiatry
Olga Therese Ousdal, Anne Marita Milde, Alexander R Craven, Lars Ersland, Tor Endestad, Annika Melinder, Quentin J Huys, Kenneth Hugdahl
BACKGROUND: Neurobiological models of stress and stress-related mental illness, including post-traumatic stress disorder, converge on the amygdala and the prefrontal cortex (PFC). While a surge of research has reported altered structural and functional connectivity between amygdala and the medial PFC following severe stress, few have addressed the underlying neurochemistry. METHODS: We combined resting-state functional magnetic resonance imaging measures of amygdala connectivity with in vivo MR-spectroscopy (1H-MRS) measurements of glutamate in 26 survivors from the 2011 Norwegian terror attack and 34 control subjects...
September 18, 2018: Psychological Medicine
Hiroaki Watanabe, Yoshihide Shimojo, Eiji Hira, Shunsuke Kuramoto, Tomohiro Muronoi, Kazuyuki Oka, Akihiko Kidani
The hybrid emergency room (hybrid ER) system was first established in 2011 in Japan. It is defined as an integrated system including an ER, emergency computed tomography (CT) and interventional radiology (IVR) rooms, and operating rooms. Severe trauma patients can undergo emergency CT examinations and therapies (surgeries) without being transferred. The hybrid ER system is attracting attention because trauma resuscitation using this system has been reported to potentially improve the mortality rate in severe trauma patients...
September 17, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Robert D Schweitzer, Lyn Vromans, Mark Brough, Mary Asic-Kobe, Ignacio Correa-Velez, Kate Murray, Caroline Lenette
BACKGROUND: Despite increasing numbers of refugee women-at-risk being resettled and their potential vulnerability, there exists no empirical research into the psychiatric health of this unique subgroup with which to guide policy and practice. This research aimed to investigate psychiatric symptom status of a sample of refugee women-at-risk recently resettled in Australia, as well as factors contributing to symptoms of trauma, anxiety, depression, and somatization. The level of psychiatric symptomatology is compared to reference groups of women from Sudan and Burma, who entered Australia under the Humanitarian Entry Programme, and who did not meet criteria as women-at-risk...
September 18, 2018: BMC Medicine
Abdulkadir Aydın, Ramazan Atiç
OBJECTIVE: The aim of the study was to evaluate and compare clinical and demographic characteristics, functional status and quality of life among patients who underwent amputation for the most common reason in our region. METHODS: Demographic data, level of and reasons for undergoing amputation and clinical data on the use of prostheses in 126 patients were recorded. The amputees were divided into three groups: vascular, trauma and landmine. Variables related to clinical and demographic characteristics, daily life activities and quality of life were investigated...
September 7, 2018: Journal of Back and Musculoskeletal Rehabilitation
Coralie Jacquet, Sergio Boetto, Annick Sevely, Jean-Christophe Sol, Yves Chaix, Emmanuel Cheuret
Head injury is the most common cause of child traumatology. However, there exist no treatment guidelines in children having intracranial lesions due to minor or moderate head trauma. There is little knowledge about monitoring, clinical exacerbation risk factors, or optimal duration of hospitalization. The aim of this retrospective study is to find predictive factors in the clinical course of non-severe head trauma in children, and thus to determine an optimal management strategy. Poor clinical progress was observed in only 4 out of 113 children...
September 17, 2018: Neuropediatrics
Scott J Farber, Rami S Kantar, Eduardo D Rodriguez
As the United States continues to increase its use of Special Operations Forces worldwide, treatment of craniomaxillofacial (CMF) trauma must be adapted to meet the needs of the warfighter. The remoteness of Special Operations can result in potentially longer times until definitive treatment may be reached. A significant portion of Servicemembers incur injury to the CMF region (42%). Severe CMF trauma can result in substantial hemorrhage and airway compromise. These can be immediately life threatening and must be addressed expeditiously...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Terry R Spraker, Tetiana A Kuzmina, Eugene T Lyons, Robert L DeLong, Claire Simeone, D N Rao Veeramachaneni
A field study addressing causes of mortality in freshly dead northern elephant seals ( Mirounga angustirostris, Gill, 1866) was conducted on San Miguel Island, California, in February 2015. Necropsies were performed on 18 pups ranging in age from stillbirths to approximately 7 to 8 weeks. The primary gross diagnoses in these pups included trauma, myopathy, starvation/emaciation, infections, congenital anomalies, and perinatal mortality. However, 6 (33%) had a previously unrecognized myopathy characterized by multiple white streaks that were most obvious within the inner layer of the abdominal wall and the small innermost ventral intercostal muscles...
September 16, 2018: Veterinary Pathology
Bing Wang, Hua Xu, Jian Li, Hong-Mei Gao, Ying-Hong Xing, Zhu Lin, Hong-Jie Li, Yong-Qiang Wang, Shu-Hua Cao
Increasing evidence has demonstrated that complement activation is required for ischemia‑reperfusion injury (IRI)‑induced hepatic damage, and cobra venom factor (CVF) can deplete the complement components. The aim of the current study was to investigate the effect and intrinsic mechanism of CVF pretreatment on IRI‑induced acute hepatic injury in rats. Acute hepatic injury in rats was induced by bone fracture to simulate trauma, followed by hemorrhage for 90 min, and then the rats were resuscitated for a period of 20 min of reperfusion...
September 14, 2018: Molecular Medicine Reports
Bogdan Andrei Suciu, Ioana Halmaciu, Vasile Bud, Decebal Fodor, Vlad Vunvule, Klara Brinzaniuc, Constantin Copotoiu, Calin Molnar
The tracheo-oesophageal fistula is a severe condition endangering the patients' live. The main cause of this condition is the prolonged ventilation. The purpose of this paper is to present an innovative technique in treating this affection. CASE REPORT: We present the case of a 32 years old female patient with multiple trauma due to traffic accident. The patient was hospitalized with the diagnosis of brain injury, subarachnoid hemorrhage, and fractured femur. After 11 days of mechanical ventilation and intubation via endotracheal route, the patient was diagnosed with a large (7x3 cm) tracheo-oesophageal fistula with dilaceration of the membranous wall of the trachea...
July 10, 2018: Annali Italiani di Chirurgia
O Uleberg, K Pape, T Kristiansen, P R Romundstad, P Klepstad
BACKGROUND: Functional outcome measures are important as most patients survive trauma. The aim of this study was to describe the long-term impact of trauma within a healthcare region from a social perspective. METHODS: People active in work or education and admitted to hospitals in Central Norway in the interval 1 June 2007 to 31 May 2010 after sustaining trauma were included in the study. Clinical data were linked to Norwegian national registers of cause of death, sickness and disability benefits, employment and education...
September 17, 2018: British Journal of Surgery
Maria Böttche, Thomas Ehring, Antje Krüger-Gottschalk, Heinrich Rau, Ingo Schäfer, Julia Schellong, Anne Dyer, Christine Knaevelsrud
Background : The proposed ICD-11 criteria for trauma-related disorders define posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (cPTSD) as separate disorders. Results of previous studies support the validity of this concept. However, due to limitations of existing studies (e.g. homogeneity of the samples), the present study aimed to test the construct validity and factor structure of cPTSD and its distinction from PTSD using a heterogeneous trauma-exposed sample. Method : Confirmatory factor analyses (CFAs) were conducted to explore the factor structure of the proposed ICD-11 cPTSD diagnosis in a sample of 341 trauma-exposed adults ( n  = 191 female, M  = 37...
2018: European Journal of Psychotraumatology
Phuong D Nguyen, David Y Khechoyan, John H Phillips, Christopher R Forrest
BACKGROUND: CAD-CAM patient-specific implants offer cerebral protection and improved facial balance without the disadvantages of autologous bone grafting such as donor site morbidity and unpredictable resorption. Several alloplastic materials are available, but titanium, polymethylmethacrylate (PMMA), and polyetheretherketone (PEEK) are the current popular choices. We reviewed our experience of applying different alloplastic CAD-CAM materials in the reconstruction of complex pediatric craniofacial deformities...
August 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Xingyu Wang, Tao Chen, Xiaoyuan Ma, Wenjuan Huang, Qi Huang, Kuan Liu, Huaping Liang
Sepsis is a critical complication of severe trauma, large area burns, infection, and major surgery etc., which can induce septic shock and multiple organ dysfunction syndrome (MODS), and its incidence and mortality are always high. Nuclear factor-E2 related factor 2 (Nrf2) is an important transcription factor of antioxidant stress response. It plays a key role in the treatment of sepsis by regulating the expression of antioxidant enzyme and phase II detoxification enzyme mediated by antioxidant response element (ARE)...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Xu Liu, Ying Liu, Qilong He, Yumei Cheng, Yaya Chen, Lunsheng Jiang, Jing Jiang, Demeng Yang, Zhongyi Zhan, Difen Wang
OBJECTIVE: To understand the situations of departments of intensive care units (ICUs) of different level hospitals in Guizhou Province, and to provide directions and evidences for improving quality control in critical care medicine. METHODS: A county-level hospital and a provincial-level hospital's comprehensive ICU in Guizhou Province were selected to record and analyze and compare the structural indicators, patient admission and transfer, disease distribution, ventilator associated pneumonia (VAP), intravascular catheter related blood stream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) of the two hospitals' comprehensive ICU in 2017...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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