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severe trauma

Ahmed M El-Angbawi, Yassir A Yassir, Grant T McIntyre, Gavin F Revie, David R Bearn
Objective: To compare orthodontically induced inflammatory root resorption (OIIRR) and patient perception of pain during orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems. Subjects and methods: Eligible participants aged 12 years or above were allocated to treatment with the 0.018-inch or 0.022-inch slot MBT appliance (3M Unitek, Monrovia, California, USA) using block randomization in groups of 10. OIIRR was assessed radiographically using standardized periapical radiographs before and after 9 months from the start of treatment...
July 11, 2018: European Journal of Orthodontics
Rachel Sayko Adams, Cindy Parks Thomas, Grant A Ritter, Sue Lee, Mayada Saadoun, Thomas V Williams, Mary Jo Larson
Introduction: Little is known about long-term prescription opioid utilization in the Military Health System. The objectives of this study were to examine predictors of any prescription opioid receipt, and predictors of long-term opioid utilization among active duty soldiers in the year following deployment. Materials and Methods: The analytic sample consisted of Army active duty soldiers returning from deployment to Operation Enduring Freedom, Operation Iraqi Freedom, or Operation New Dawn in fiscal years 2008-2014 (N = 540,738)...
July 11, 2018: Military Medicine
Ying Zhang, Xiangbo An, Qiuyue Lin, Jie Bai, Feng Wang, Jiawei Liao
BACKGROUND: For a long time, our major understanding of the spleen is to function as a blood filter for the removal of aged erythrocytes and circulating microorganisms. Splenectomy, therefore, has been widely performed in case of trauma and a variety of hematologic disorders. Although some studies have indicated an increased rate of developing hyperlipidemia and atherosclerotic cardiovascular diseases in splenectomized patients, our recognition of the splenic regulation on lipid metabolism and atherogenesis is still lacking...
June 23, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Kjetil Søreide, Thomas G Weiser, Rowan W Parks
BACKGROUND: Pancreatic injury is rare and optimal diagnosis and management is still debated. The aim of this study was to review the existing data and consensus on management of pancreatic trauma. METHODS: Systematic literature review until May 2018. RESULTS: Pancreas injury is reported in 0.2-0.3% of all trauma patients. Severity is scored by the organ injury scale (OIS), with new scores including physiology needing validation. Diagnosis is difficult, clinical signs subtle, and imaging by ultrasound (US) and computed tomography (CT) non-specific with <60% sensitivity for pancreatic duct injury...
July 11, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Laura Loucks, Carly Yasinski, Seth D Norrholm, Jessica Maples-Keller, Loren Post, Liza Zwiebach, Devika Fiorillo, Megan Goodlin, Tanja Jovanovic, Albert A Rizzo, Barbara O Rothbaum
This initial feasibility study examined the use of virtual reality exposure therapy (VRE) in the treatment of MST-related PTSD, with newly developed content tailored to MST. Participants included 15 veterans (26% male) with MST-related PTSD. Assessment of PTSD, depression, and psychophysiological indicators of distress occurred at pre-treatment, post-treatment, and 3-month follow-up. Treatment included 6-12 VRE sessions. There were significant reductions in pre- to post-treatment PTSD (CAPS severity: t(10) = 3...
June 18, 2018: Journal of Anxiety Disorders
Antonette A Ajayi, Stephanie V Commins, David E Clarke
INTRODUCTION: Angiosarcomas are rare, malignant vascular tumors that affect endothelial cells of blood vessels. Angiosarcomas most commonly occur on the scalp or face of elderly individuals and are highly aggressive, with a 5-year survival rate below 15%. Cutaneous angiosarcomas often metastasize to the lung, where they can present with cystic lesions, solid lesions, pneumothorax, and/or hemothorax. CASE PRESENTATION: We report the case of an 83-year-old woman who presented with a scalp lesion, which was initially thought to be caused by scalp trauma but was later found to be an angiosarcoma...
July 5, 2018: Permanente Journal
Janett Kreutziger, Stefan Schmid, Nikolaus Umlauf, Hanno Ulmer, Maarten W Nijsten, Daniel Werner, Thomas Schlechtriemen, Wolfgang Lederer
BACKGROUND: Deranged glucose metabolism is frequently observed in trauma patients after moderate to severe traumatic injury, but little data is available about pre-hospital blood glucose and its association with various cardiac rhythms and cardiac arrest following trauma. METHODS: We retrospectively investigated adult trauma patients treated by a nationwide helicopter emergency medical service (34 bases) between 2005 and 2013. All patients with recorded initial cardiac rhythms and blood glucose levels were enrolled...
July 13, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Miltiadis Fiorentzis, Berthold Seitz, Arne Viestenz
The traumatic macular hole (TMH) is a rare complication of a blunt or an open injury of the globe and can lead to permanent loss of vision. The pathomechanism of TMH differs from that of the idiopathic macular hole (IMH). A sudden compression and expansion of the globe leads to vitreous traction, which can result in a TMH. The final visual acuity depends on the severity of the disruption of the photoreceptors and the retinal pigment epithelial cells. The posttraumatic approach is discussed controversially. A spontaneous closure and, therefore, a conservative approach should be considered in young patients with minor defects and good visual acuity without detachment of the posterior vitreous body...
July 13, 2018: Klinische Monatsblätter Für Augenheilkunde
Jacob E Sunshine, Andrew T Humbert, Benjamin Booth, Steven M Bowman, Eileen M Bulger, Sam R Sharar
BACKGROUND: Virtually all anesthesiologists care for patients who sustain traumatic injuries; however, the frequency with which operative anesthesia care is provided to this specific patient population is unclear. We sought to better understand the degree to which anesthesia providers participate in operative trauma care and how this differs by trauma center designation (levels I-V), using data from a comprehensive, regional database-the Washington State Trauma Registry (WSTR). We also sought to specifically assess operative anesthesia care frequency vis a vis the American College of Surgeons guidelines for continuous anesthesiology coverage for Level II trauma center accreditation...
July 11, 2018: Anesthesia and Analgesia
Cheryl K Zogg, Kevin M Schuster, Adrian A Maung, Kimberly A Davis
OBJECTIVE: To identify the association between insurance status and the probability of emergency department admission versus transfer for patients with major injuries (Injury Severity Score >15) and other complex trauma likely to require higher-level trauma center (TC) care across the spectrum of TC care. BACKGROUND: Trauma systems were developed to facilitate direct transport and transfer of patients with major/complex traumatic injuries to designated TCs. Emerging literature suggests that uninsured patients are more likely to be transferred...
July 12, 2018: Annals of Surgery
Gunilla Pousette Lundgren, Gun-Inger Morling Vestlund, Göran Dahllöf
OBJECTIVES: Amelogenesis imperfecta (AI) is a rare, genetically determined defect in enamel mineralization. Several problems are associated with AI: hypersensitivity, wear, restorations requiring replacement, gingivitis, aesthetic problems, and social avoidance. We conducted a randomized controlled trial of crown therapy in young individuals with AI showing excellent results. This study reports results from a long-term-follow-up with focus on quality, longevity and adverse events. METHODS: The RCT included 27 patients (aged 11-22 years) with severe AI in need of crown therapy and used a split-mouth technique...
July 9, 2018: Journal of Dentistry
Blake D Murphy, Mahalakshmi Nagarajan, Christine B Novak, Mélissa Roy, Steven J McCabe
BACKGROUND: Scapholunate advanced collapse (SLAC) is the most common pattern of wrist arthritis. Sparse data exist regarding the SLAC wrist pattern of arthritis. This study aimed to document the epidemiology of advanced SLAC in terms of patients' sociodemographics and possible association with trauma. METHODS: Sixty-one patients with severe SLAC wrist were included. Baseline sociodemographic characteristics were reviewed. To evaluate the relationship to injury, this group of cases was compared with a control group of 61 patients with first carpometacarpal osteoarthritis (CMC OA)...
July 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Nathan Heineman, Avneesh Chhabra, Lihua Zhang, Riham Dessouky, Dane Wukich
BACKGROUND: The two most widely used measurements for diagnosing and assessing the severity of hallux valgus are the hallux valgus angle (HVA) and the intermetatarsal angle (IMA). Traditionally, these have been measured by using the midaxial lines approximating the axis of each bone. A new simpler point method has been recently suggested for measuring these angles by connecting points along the medial corners of each bone. Interreader reliability of these measurements on X-ray and MRI as well as intermethod and intermodality differences have not been assessed...
July 12, 2018: Skeletal Radiology
Hind Alquthami, Abdulaziz M Almalik, Faisal F Alzahrani, Lana Badawi
Endodontic-periodontal diseases often present great challenges to the clinician in their diagnosis, management, and prognosis. Understanding the disease process through cause-and-effect relationships between the pulp and supporting periodontal tissues with the aid of rational classifications leads to successful treatment outcomes. In this report, we present several treatment modalities in patients with different endodontic-periodontal lesions. A modification to the new endodontic-periodontic classification, Al-Fouzan's classification, was also added...
2018: Case Reports in Dentistry
Tomoya Hirose, Hiroshi Ogura, Hiroki Takahashi, Masahiro Ojima, Kang Jinkoo, Youhei Nakamura, Takashi Kojima, Takeshi Shimazu
Background: C1 inhibitor (C1-INH), which belongs to the superfamily of serine protease inhibitors, regulates the complement system and also the plasma kallikrein-kinin, fibrinolytic, and coagulation systems. The biologic activities of C1-INH can be divided into the regulation of vascular permeability and anti-inflammatory functions. The objective of this study was to clarify the serial change of C1-INH in patients with sepsis and evaluate the relationship with the shock severity. Methods: This was a single-center, prospective, observational study...
2018: Journal of Intensive Care
Ahmed Alshammari, Basam Alanazi, Ismail Almogbil, Saud M Alfayez
Introduction: Traumatic hip dislocation is a severe injury with the potential for significant morbidity and mortality. Bilateral hip dislocation is rare representing 1.25% of all hip dislocations. Presentation of the case: A 19-year-old male had a high-speed motor vehicle accident. After stabilizing the patient, it was noticed that the position of the right lower limb was in adduction and internal rotation while the left was in external rotation and abduction. Pelvis x-ray showed right superior posterior and left anterior inferior hip dislocations...
August 2018: Annals of Medicine and Surgery
Limin Wu, Joon Y Chung, Shivani Saith, Lorenzo Tozzi, Erin M Buckley, Bharat Sanders, Maria A Franceschini, Sevda Lule, Saef Izzy, Josephine Lok, William J Edmiston, Lauren M McAllister, Sloane Mebane, Gina Jin, Jiaxi Lu, John S Sherwood, Sarah Willwerth, Suzanne Hickman, Joseph El Khoury, Eng H Lo, David Kaplan, Michael J Whalen
Repetitive mild traumatic brain injury during adolescence can induce neurological dysfunction through undefined mechanisms. Interleukin-1 (IL-1) contributes to experimental adult diffuse and contusion TBI models, and IL-1 antagonists have entered clinical trials for severe TBI in adults; however, no such data exist for adolescent TBI. We developed an adolescent mouse repetitive closed head injury (rCHI) model to test the role of IL-1 family members in post-injury neurological outcome. Compared to one CHI, three daily injuries (3HD) produced acute and chronic learning deficits and emergence of hyperactivity, without detectable gliosis, neurodegeneration, brain atrophy, and white matter loss at one year...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
Roberto González L, Alejandra Riquelme U, Alberto Fuentes E, René Saldías F, Rodrigo Reyes M, Enrique Seguel S, Aleck Stockins L, Andrés Jadue T, Jorge Canales Z, Emilio Alarcón C
BACKGROUND: Trauma is the leading cause of death in young patients and thoracic trauma (TT) is responsible for 25-35% of trauma deaths. AIM: To describe and compare features, trauma severity indexes and morbidity of patients admitted for TT in the past three decades. MATERIAL AND METHODS: Review of a TT database, operative notes and medical records of patients. These were separated by decade of admission (1981-1990, 1991-2000, 2001-2010). TT characteristics were compared...
February 2018: Revista Médica de Chile
Xu-Bo Yang, Yuan-Yuan Liu, Zhi-Xuan Huang, Yu Mao, Li Zhao, Zhu-Ping Xu
Background: Infectious endophthalmitis is a severe ocular inflammation which can cause devastating visual loss. The aim of the study was to identify the demographic and clinical features of infectious endophthalmitis in Western China for better prophylaxis and treatment of this disease. Methods: A. retrospective, cross-sectional study was conducted based on the medical records of inpatients having infectious endophthalmitis in a tertiary referral center in Western China between 2005 and 2016...
July 20, 2018: Chinese Medical Journal
Adrien Jean-Pierre Schwitzguebel, Guillaume Muff, Emiko Naets, Christos Karatzios, Mathieu Saubade, Vincent Gremeaux
Acute muscle lesions are frequent conditions in sports traumato-logy. Intrinsic traumatic mechanism (excessive stretch) is more prevalent that extrinsic mechanism (direct shock or lacerations). The diagnosis is generally based on the injury mechanism description together with the clinical examination. The ultrasonography is helpful in order to evaluate the severity of the lesion and the time to sports resumption. The initial management is based on the POLICE acronym: Protection, Optimal loading, Ice, Compression, and Elevation...
July 11, 2018: Revue Médicale Suisse
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