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https://www.readbyqxmd.com/read/28918481/fibrinolysis-in-trauma-a-review
#1
REVIEW
M J Madurska, K A Sachse, J O Jansen, T E Rasmussen, J J Morrison
Fibrinolytic dysregulation is an important mechanism in traumatic coagulopathy. It is an incompletely understood process that consists of a spectrum ranging from excessive breakdown (hyperfibrinolysis) and the shutdown of fibrinolysis. Both hyperfibrinolysis and shutdown are associated with excess mortality and post-traumatic organ failure. The pathophysiology appears to relate to endothelial injury and hypoperfusion, with several molecular markers identified in playing a role. Although there are no universally accepted diagnostic tests, viscoelastic studies appear to offer the greatest potential for timely identification of patients presenting with fibrinolytic dysregulation...
September 16, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28918344/accesses-for-alcohol-intoxication-to-the-emergency-department-and-the-risk-of-re-hospitalization-an-observational-retrospective-study
#2
Maurizio Baldassarre, Fabio Caputo, Raimondo Maria Pavarin, Matteo Massimo Bossi, Maria Elena Bonavita, Paolo Caraceni, Alice Grignaschi, Mimosa Balloni, Mario Cavazza, Mauro Bernardi, Marco Domenicali
BACKGROUND: Alcohol use disorders (AUD) are a frequent cause of admission to emergency departments (EDs) for acute alcohol intoxication (AAI). Patients with AUD present a higher risk of readmission to EDs for AAI than the general population, however, the distinction between sporadic AAI and AAI in the context of AUD in the ED setting is difficult. AIMS: To analyze the epidemiological characteristics of patients admitted to EDs because of AAI and to identify factors associated with repeated admissions in order to develop a risk stratification system for patients with AUD based on objective data that can be easily applied in an ED setting...
September 1, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28917584/pneumatoceles-in-pediatric-blunt-trauma-common-and-benign
#3
Lindsey B Armstrong, David P Mooney
INTRODUCTION: Traumatic pneumatoceles are reported to be rare in children and to have an uncertain clinical significance. We report a single institution series of traumatic pneumatoceles to better define their frequency and clinical significance. METHODS: After obtaining approval from the IRB, data were extracted from the trauma registry of a level 1 pediatric trauma center on children diagnosed with a pulmonary contusion (International Classification of Diseases-9th edition diagnosis codes: 861...
August 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28917394/childhood-maltreatment-severity-and-alcohol-use-in-adult-psychiatric-inpatients-the-mediating-role-of-emotion-regulation-difficulties
#4
Christina D Dutcher, Anka A Vujanovic, Daniel J Paulus, Brooke A Bartlett
OBJECTIVE: Emotion regulation difficulties are a potentially key mechanism underlying the association between childhood maltreatment and alcohol use in adulthood. The current study examined the mediating role of emotion regulation difficulties in the association between childhood maltreatment severity (i.e., Childhood Trauma Questionnaire total score) and past-month alcohol use severity, including alcohol consumption frequency and alcohol-related problems (i.e., number of days of alcohol problems, ratings of "bother" caused by alcohol problems, ratings of treatment importance for alcohol problems)...
September 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28917187/trajectories-of-post-traumatic-stress-and-externalizing-psychopathology-among-maltreated-foster-care-youth-a-parallel-process-latent-growth-curve-model
#5
Gia Elise Barboza, Silvia Dominguez, Jyda Pinder
Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999-2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000...
September 13, 2017: Child Abuse & Neglect
https://www.readbyqxmd.com/read/28915647/necroptosis-as-a-potential-therapeutic-target-in-multiple-organ-dysfunction-syndrome
#6
Yao-Li Cui, Li-Hua Qiu, Shi-Yong Zhou, Lan-Fang Li, Zheng-Zi Qian, Xian-Ming Liu, Hui-Lai Zhang, Xiu-Bao Ren, Yong-Qiang Wang
PURPOSE: To investigate how necroptosisis, i.e. programmed necrosis, is involved in MODS, and to examine whether Nec-1, a specific necroptosis inhibitor, ameliorates multiorgan injury in MODS. EXPERIMENTAL DESIGN: A model of MODS was established in six-week old SD rats using fracture trauma followed by hemorrhage. Control animals received sham surgery. Cell death form and necrosome formation were measured by fluorescence-activated cell sorting and western blotting...
August 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/28915305/trauma-epidemiology-of-women-in-puerto-rico-2002-2011
#7
Sofía Muns-Aponte, Omar García-Rodríguez, Ediel O Ramos-Meléndez, Pablo Rodríguez-Ortiz
OBJECTIVE: Recent literature has suggested that trauma is heterogenic and that physiological response to it differs between sexes. The study represented in this manuscript aimed to describe gender differences in the mortality rates of trauma patients at the Puerto Rico Trauma Hospital (PRTH). MATERIALS AND METHODS: This was a cross-sectional study performed at PRTH. A total of 14,874 injured patients admitted to the hospital from 2002 to 2011 were included in the sample and divided into 2 groups, based on sex...
September 2017: Puerto Rico Health Sciences Journal
https://www.readbyqxmd.com/read/28915155/social-support-and-pain-outcomes-after-trauma-exposure-among-older-adults-a-multicenter-longitudinal-study
#8
Natalie L Richmond, Michelle L Meyer, Allison G Hollowell, Erin E Isenberg, Robert M Domeier, Robert A Swor, Phyllis L Hendry, David A Peak, Niels K Rathlev, Jeffrey S Jones, David C Lee, Christopher W Jones, Timothy F Platts-Mills
OBJECTIVES: Certain forms of social support have been shown to improve pain coping behaviors and pain outcomes in older adults with chronic pain, but little is known about the effect of social support on pain outcomes in older adults following trauma exposure. METHODS: We analyzed data from a prospective longitudinal study of adults aged 65 years and older presenting to an emergency department (ED) after a motor vehicle collision (MVC) to characterize the relationship between perceived social support and MVC-related pain after trauma overall and by subgroups based on gender, depressive symptoms, and marital status...
September 14, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28915145/posttraumatic-stress-disorder-symptoms-among-trauma-exposed-inpatient-adolescents-the-role-of-emotional-nonacceptance-and-anxiety-symptom-severity
#9
Andres G Viana, Abigail E Hanna, Elizabeth M Raines, Emma C Woodward, Daniel J Paulus, Erin C Berenz, Michael J Zvolensky
The present investigation examined the role of anxiety symptom severity in the relation between emotional nonacceptance and posttraumatic stress disorder (PTSD) symptoms in a diverse sample of trauma-exposed adolescents admitted for acute psychiatric care at an inpatient state hospital (N = 50; 52.0% women; 44% white; mean [SD] age, 15.1 [0.51] years; range, 12-17 years). Anxiety symptom severity partially accounted for the association between emotional nonacceptance and PTSD total symptoms, and fully accounted for the association between emotional nonacceptance and PTSD symptom cluster severity, even after controlling for covariates...
September 14, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28914713/the-hyperfibrinolytic-phenotype-is-the-most-lethal-and-resource-intense-presentation-of-fibrinolysis-in-massive-transfusion-patients
#10
John R Taylor, Erin E Fox, John B Holcomb, Sandro Rizoli, Kenji Inaba, Martin A Schreiber, Karen Brasel, Thomas M Scalea, Charles E Wade, Eileen Bulger, Bryan A Cotton
BACKGROUND: Among bleeding patients, we hypothesized that the hyperfibrinolytic (HF) phenotype would be associated with the highest mortality, while shutdown (SD) patients would have the greatest complication burden. METHODS: Severely injured patients predicted to receive a massive transfusion at 12 level-1 trauma centers were randomized to one of two transfusion ratios as described in the PROPPR trial. Fibrinolysis phenotypes were determined based on admission clot lysis at 30 minutes (LY30): SD ≤0...
September 13, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28914355/nasal-injury-and-comfort-with-jet-versus-bubble-continuous-positive-airway-pressure-delivery-systems-in-preterm-infants-with-respiratory-distress
#11
Jafar Khan, Venkataseshan Sundaram, Srinivas Murki, Anuj Bhatti, Shiv Sajan Saini, Praveen Kumar
Nasal injuries with use of nasal continuous positive airway pressure (CPAP) range from blanching of nasal tip to septal necrosis and septal drop. This analysis was done in preterm neonates of < 34-week gestation, who received nasal CPAP as primary support as part of a randomized trial comparing Jet device with Bubble device for delivery of CPAP, both through nasal prongs of different structure, make and fixation methods. Nasal injury was assessed using a validated nasal injury score. Out of 170 neonates enrolled, 103 (61%) had nasal injuries; moderate and severe injuries were observed in 18 (11%) and 8 (5%) infants, respectively...
September 15, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28913856/multiplate-and-teg-platelet-mapping-in-a-population-of-severely-injured-trauma-patients
#12
M J George, J Burchfield, B MacFarlane, Y-W W Wang, J C Cardenas, N J White, B S Gill, C E Wade
OBJECTIVES: The objectives of this study were to compare thromboelastography platelet mapping (TEG PM) with impedance aggregometry (Multiplate, MP) in a single trauma population and relate their results clinically. BACKGROUND: Platelet function as measured by thromboelastography and impedance aggregometry demonstrates significant reductions that persist for days following traumatic injury. However, no study compares these devices and the correlation between them is not known...
September 15, 2017: Transfusion Medicine
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#13
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913489/cerebral-salt-wasting-syndrome-in-patients-with-minor-head-trauma-two-case-reports
#14
Gabriela Csipak, Natalia Hagau
We describe two polytrauma patients without severe head trauma who developed Cerebral Salt Wasting Syndrome (CSWS) during their stay in our ICU with natriuresis, hyponatremia and hypovolemia. Hyponatremia encountered in CSWS and the syndrome of inadequate antidiuretic hormone secretion (SIADH) is a common electrolyte finding in patients with severe head trauma, subarachnoid hemorrhage, malignancy and infections of the central nervous system. CSWS was an unexpected electrolyte finding in our patients with minor head trauma without neurological or neurosurgical problems...
October 2016: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913385/closed-internal-degloving-of-the-flank
#15
Lindsay F Remy, Jacob Azurdia, Ashraf Fansa, Nabil A Ebraheim
Originally described in 1853 by Dr. Morel-Lavellee, closed internal degloving injuries represent an important, although uncommon, source of morbidity in trauma patients. These injuries are typically the result of a shearing or crushing force that traumatically separates the skin and subcutaneous tissue from the underlying fat. This results in disruption of perforating blood vessels and lymphatics, leading to hematoma/seroma formation. We describe two cases in which industrial crush injuries resulted in lumbar transverse process fracture...
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28913381/is-it-fractured-or-broken-a-patient-survey-study-to-assess-injury-comprehension-after-orthopaedic-trauma
#16
Mohammad Ghorbanhoseini, Matthew D Riedel, Tyler Gonzalez, Poopak Hafezi, John Y Kwon
BACKGROUND: Patients who sustain orthopaedic trauma in the form of fractures commonly ask treating providers whether the bone is "fractured" or "broken". While orthopaedic surgeons consider these terms synonymous, patients appear to comprehend the terms as having different meanings. Given the commonality of this frequently posed question, it may be important for providers to assess patients' level of understanding in order to provide optimal care. The purpose of this study is to evaluate patients' comprehension and understanding regarding the use of the terms fractured and broken...
July 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28913144/effect-of-pigtail-catheter-application-on-obstetric-outcomes-in-in-vitro-fertilization-intracytoplasmic-sperm-injection-pregnancies-following-hyperstimulation-syndrome
#17
Pınar Çağlar Aytaç, Hakan Kalaycı, Selçuk Yetkinel, Didem Alkaş, Seda Yüksel Şimşek, Bülent Haydardedeoğlu, Esra Bulgan Kılıçdağ
OBJECTIVE: To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). MATERIALS AND METHODS: This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment...
June 2017: Turk J Obstet Gynecol
https://www.readbyqxmd.com/read/28912029/inclusion-of-highest-glasgow-coma-scale-motor-score-in-mortality-risk-adjustment-for-benchmarking-of-trauma-center-performance
#18
David Gomez, James P Byrne, Aziz S Alali, Wei Xiong, Chris Hoeft, Melanie Neal, Harris Subacius, Avery B Nathens
BACKGROUND: The Glasgow Coma Scale (GCS) score is the most widely utilized measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor score (mGCS) is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including highest mGCS on the performance of risk-adjustment models and subsequent external benchmarking results...
September 11, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28912021/association-between-spinal-immobilization-and-survival-at-discharge-for-on-scene-blunt-traumatic-cardiac-arrest-a-nationwide-retrospective-cohort-study
#19
Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi, Shunichi Fukuhara
INTRODUCTION: Spinal immobilization has been indicated for all blunt trauma patients suspected of having cervical spine injury. However, for traumatic cardiac arrest (TCA) patients, rapid transportation without compromising potentially reversible causes is necessary. Our objective was to investigate the temporal trend of spinal immobilization for TCA patients and to examine the association between spinal immobilization and survival. METHODS: We conducted a retrospective cohort study using the Japan Trauma Data Bank 2004-2015 registry data...
September 6, 2017: Injury
https://www.readbyqxmd.com/read/28911289/incidence-of-elevated-procalcitonin-and-presepsin-levels-after-severe-trauma-a-pilot-cohort-study
#20
K Hoshino, Y Irie, M Mizunuma, K Kawano, T Kitamura, H Ishikura
Procalcitonin (PCT) and presepsin (PSEP) are useful biomarkers for diagnosing sepsis; however, elevated PCT and PSEP levels may be observed in conditions other than sepsis. We hypothesised that PCT and PSEP levels could increase after severe traumatic injuries. Trauma patients with an Injury Severity Score of ≥16 from October 2013 to September 2015 were enrolled in our study. We examined PCT and PSEP levels and their positive rates on days 0 and 1. PCT and PSEP levels on days 0 and 1 were compared. Risk factors for increasing sepsis biomarker levels were identified by multivariate logistic regression analyses...
September 2017: Anaesthesia and Intensive Care
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