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https://www.readbyqxmd.com/read/28099983/-the-relevance-of-abducent-nerve-palsy-in-ent
#1
Veit Maria Hofmann, Stephan M Niehues, Annett Pudszuhn
Patients suffering from abducent nerve palsy are usually primary seen by a conservative medical Specialist. In most cases the ENT specialist is secondary involved for treatment. In the majority of cases abducent nerve palsy is a temporary symptom associated with neurologic or vascular diseases. Rarely inflammation, neoplasm or fracture of the skull base cause this symptom and lead to an intervention done by the ENT surgeon. This case series describes retrospectively the abducent palsy seen through the eyes of an ENT surgeon...
January 18, 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28074459/comparison-of-revised-trauma-score-injury-severity-score-and-trauma-and-injury-severity-score-for-mortality-prediction-in-elderly-trauma-patients
#2
Shahrokh Yousefzadeh-Chabok, Marieh Hosseinpour, Leila Kouchakinejad-Eramsadati, Fatemeh Ranjbar, Reza Malekpouri, Alireza Razzaghi, Zahra Mohtasham-Amiri
BACKGROUND: Trauma is the fifth leading cause of death in patients 65 years and older. This study is a comparison of results of Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in prediction of mortality in cases of geriatric trauma. METHODS: This is a cross-sectional study of records of 352 elderly trauma patients who were admitted to Pour-Sina Hospital in Rasht between 2010 and 2011. Injury scoring systems were compared in terms of specificity, sensitivity, and cut-off points using receiver operating characteristic curve of patient prognosis...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073305/human-amniotic-mesenchymal-stromal-cells-as-favourable-source-for-cartilage-repair
#3
Emma Muinos-López, Tamara Hermida-Gómez, Isaac Fuentes-Boquete, Francisco Javier de Toro-Santos, Francisco J Blanco, Silvia María Díaz-Prado
INTRODUCTION: Localized trauma-derived breakdown of the hyaline articular cartilage may progress towards osteoarthritis, a degenerative condition characterized by total loss of articular cartilage and joint function. Tissue engineering technologies encompass several promising approaches with high therapeutic potential for the treatment of these focal defects. However, most of the research in tissue engineering is focused on potential materials and structural cues, while little attention is directed to the most appropriate source of cells endowing these materials...
January 10, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28054124/-severe-blunt-thoracic-trauma-caused-by-ski-collision
#4
S J Lochner, M Scherr, M Perl, C Grove
An approximately 25-year-old skier collided in a ski-run intersection. At high speed, he first hit another skier and then smashed into a snow cannon. He died from his injuries a short time later in hospital. A whole-body CT scan was conducted under resuscitation conditions, which was followed by an autopsy. The investigation revealed a severe blunt thoracic trauma as cause of death. The detailed analysis was the result of the combination of the two methods of investigation, CT scan and autopsy. The methods complemented each other effectively and allowed for a detailed presentation of the injury pattern...
January 4, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28053156/targeted-clinical-control-of-trauma-patient-coagulation-through-a-thrombin-dynamics-model
#5
Amor A Menezes, Ryan F Vilardi, Adam P Arkin, Mitchell J Cohen
We present a methodology for personalizing the clinical treatment of severely injured patients with acute traumatic coagulopathy (ATC), an endogenous biological response of impaired coagulation that occurs early after trauma and shock and that is associated with increased bleeding, morbidity, and mortality. Despite biological characterization of ATC, it is not easily or rapidly diagnosed, not always captured by slow laboratory testing, and not accurately represented by coagulation models. This lack of knowledge, combined with the inherent time pressures of trauma treatment, forces surgeons to treat ATC patients according to empirical resuscitation protocols...
January 4, 2017: Science Translational Medicine
https://www.readbyqxmd.com/read/28030710/association-of-radiologic-indicators-of-frailty-with-1-year-mortality-in-older-trauma-patients-opportunistic-screening-for-sarcopenia-and-osteopenia
#6
Stephen J Kaplan, Tam N Pham, Saman Arbabi, Joel A Gross, Mamatha Damodarasamy, Itay Bentov, Lisa A Taitsman, Steven H Mitchell, May J Reed
Importance: Assessment of physical frailty in older trauma patients admitted to the intensive care unit is often not feasible using traditional frailty assessment instruments. The use of opportunistic computed tomography (CT) scans to assess sarcopenia and osteopenia as indicators of underlying frailty may provide complementary prognostic information on long-term outcomes. Objective: To determine whether sarcopenia and/or osteopenia are associated with 1-year mortality in an older trauma patient population...
December 28, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#7
REVIEW
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27994716/peculiarities-in-ankle-cartilage
#8
REVIEW
Matthew J Kraeutler, Tanyaporn Kaenkumchorn, Cecilia Pascual-Garrido, Markus A Wimmer, Susanna Chubinskaya
Posttraumatic osteoarthritis (PTOA) is the most common form of osteoarthritis (OA) of the ankle joint. PTOA occurs as a result of several factors, including the poor regenerative capacity of hyaline articular cartilage as well as increased contact stresses following trauma. The purpose of this article is to review the epidemiology, pathogenesis, and potential targets for treatment of PTOA in the ankle joint. Previous reviews primarily addressed clinical approaches to ankle PTOA, while the focus of the current article will be specifically on the newly acquired knowledge of the cellular mechanisms that drive PTOA in the ankle joint and means for potential targeted therapeutics that might halt the progression of cartilage degeneration and/or improve the outcome of surgical interventions...
January 2017: Cartilage
https://www.readbyqxmd.com/read/27993357/amputation-not-a-failure-for-severe-lower-extremity-combat-injury
#9
Thijs T C F van Dongen, Eelco P Huizinga, Loes G M de Kruijff, Arie C van der Krans, Jochem M Hoogendoorn, Luke P H Leenen, Rigo Hoencamp
INTRODUCTION: The use of improvised explosive devices is a frequent method of insurgents to inflict harm on deployed military personnel. Consequently, lower extremity injuries make up the majority of combat related trauma. The wounding pattern of an explosion is not often encountered in a civilian population and can lead to substantial disability. It is therefore important to study the impact of these lower extremity injuries and their treatment (limb salvage versus amputation) on functional outcome and quality of life...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/27993205/trauma-experts-versus-pediatric-experts-comparison-of-outcomes-in-pediatric-penetrating-injuries
#10
Shin Miyata, Jayun Cho, Olga Lebedevskiy, Kazuhide Matsushima, Esther Bae, David W Bliss
BACKGROUND: While pediatric trauma centers (PTCs) can uniquely care for pediatric patients, adult trauma centers (ATCs) may be more accessible. Evidence is scarce regarding outcomes of pediatric patients with penetrating trauma treated at PTCs versus ATCs. MATERIALS AND METHODS: We performed a retrospective study using the National Trauma Data Bank to identify pediatric patients aged ≤18 y with penetrating injuries from 2007 to 2012, treated at stand-alone PTCs or ATCs...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27990258/case-report-84-year-old-woman-with-alien-hand-syndrome
#11
Ihtesham Aatif Qureshi, Daniel Korya, Darine Kassar, Mohammed Moussavi
Background: Alien hand syndrome [AHS] is a rare and ill-defined neurological disorder. It produces complex, goal-directed motion of one hand that is involuntarily instigated. This syndrome characteristically arises after brain trauma, brain surgery, stroke or encephalitis. We describe a case of AHS in a patient who had a previous episode of subarachnoid hemorrhage affecting the left frontal lobe and corpus callosum. Case presentation: An 84-year-old woman presented to the emergency department complaining of headaches and several episodes of her left arm moving as if it was groping around trying to grab at her own body...
2016: F1000Research
https://www.readbyqxmd.com/read/27984449/operative-treatment-of-rib-fractures-in-flail-chest-injuries-a-meta-analysis-and-cost-effectiveness-analysis
#12
Eric Swart, Joseph Laratta, Gerard Slobogean, Samir Mehta
OBJECTIVES: Flail chest is a common injury sustained by patients who suffer from high energy blunt chest trauma, and results in severe respiratory compromise due to altered mechanics of respiration. There has been increased interest in operative fixation of these injuries with the intention of restoring the mechanical integrity of the chest wall, and several studies have shown that ventilation requirements and pulmonary complications may be decreased with operative intervention. The purpose of this study was to evaluate fixation of rib fractures in flail chest injuries using cost effectiveness analysis, supported by systematic review and meta-analysis...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27982430/severe-retinal-hemorrhages-with-retinoschisis-in-infants-are-not-pathognomonic-for-abusive-head-trauma
#13
Mark J Shuman, Kenneth D Hutchins
The combination of subdural hemorrhage (SDH), retinal hemorrhage (RH), and encephalopathy, or the presence of severe retinal hemorrhages alone in infants, is often attributed to and has been stated to be pathognomonic for abusive head trauma (AHT) or shaken baby syndrome. These beliefs have been challenged, because the same constellation of findings has been identified in accidental head injuries and natural diseases, and most if not all of the studies that support the concept of diagnostic specificity have serious flaws in their methodology...
December 16, 2016: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/27959967/transfusion-80%C3%A2-c-frozen-blood-products-are-safe-and-effective-in-military-casualty-care
#14
Femke Noorman, Thijs T C F van Dongen, Marie-Christine J Plat, John F Badloe, John R Hess, Rigo Hoencamp
INTRODUCTION: The Netherlands Armed Forces use -80°C frozen red blood cells (RBCs), plasma and platelets combined with regular liquid stored RBCs, for the treatment of (military) casualties in Medical Treatment Facilities abroad. Our objective was to assess and compare the use of -80°C frozen blood products in combination with the different transfusion protocols and their effect on the outcome of trauma casualties. MATERIALS AND METHODS: Hemovigilance and combat casualties data from Afghanistan 2006-2010 for 272 (military) trauma casualties with or without massive transfusions (MT: ≥6 RBC/24hr, N = 82 and non-MT: 1-5 RBC/24hr, N = 190) were analyzed retrospectively...
2016: PloS One
https://www.readbyqxmd.com/read/27938387/impact-of-cushing-s-sign-in-the-prehospital-setting-on-predicting-the-need-for-immediate-neurosurgical-intervention-in-trauma-patients-a-nationwide-retrospective-observational-study
#15
Tetsuya Yumoto, Toshiharu Mitsuhashi, Yasuaki Yamakawa, Atsuyoshi Iida, Nobuyuki Nosaka, Kohei Tsukahara, Hiromichi Naito, Atsunori Nakao
BACKGROUND: Cushing's reflex usually results from intracranial hypertension. Although Cushing's sign can implicate severe traumatic brain injury (TBI) in injured patients, no major investigations have been made. The purpose of this study was to assess the predictability of life-threatening brain injury requiring immediate neurosurgical intervention (LT-BI) among trauma patients with Cushing's sign in the prehospital setting. METHODS: This was a retrospective study using data from the Japan Trauma Data Bank from the period of 2010 to 2014...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27934650/parenteral-or-enteral-arginine-supplementation-safety-and-efficacy
#16
REVIEW
Martin D Rosenthal, Phillip W Carrott, Jayshil Patel, Laszlo Kiraly, Robert G Martindale
Arginine supplementation has the potential to improve the health of patients. Its use in hospitalized patients has been a controversial topic in the nutrition literature, especially concerning supplementation of septic patients. In this article, we review the relevant literature both for and against the use of arginine in critically ill, surgical, and hospitalized patients. The effect of critical illness on arginine metabolism is reviewed, as is its use in septic and critically ill patients. Although mounting evidence supports immunonutrition, there are only a few studies that suggest that this is safe in patients with severe sepsis...
December 2016: Journal of Nutrition
https://www.readbyqxmd.com/read/27930542/the-incidence-and-risk-factors-of-postoperative-neurological-deterioration-after-posterior-decompression-with-or-without-instrumented-fusion-for-thoracic-myelopathy
#17
Hui Wang, Lei Ma, Rui Xue, Dalong Yang, Tao Wang, Yanhong Wang, Sidong Yang, Wenyuan Ding
The aim of this study was to explore the incidence and risk factors of postoperative neurological deterioration after posterior decompression with or without instrumented fusion for thoracic myelopathy, and hope to provide references in decision-making and surgical planning for both spinal surgeon and thoracic stenosis patients.By retrieving the medical records from January 2001 to November 2015, 168 patients were retrospectively reviewed. According to the occurrence of postoperative neurological deterioration, patients were divided into 2 groups: neurological deterioration (ND) group and non-ND group...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27923726/single-stage-soft-tissue-reconstruction-and-orbital-fracture-repair-for-complex-facial-injuries
#18
Peng Sen Wu, Reshvin Matoo, Hong Sun, Li Yuan Song, Don O Kikkawa, Wei Lu
BACKGROUND: Orbital fractures with open periorbital wounds cause significant morbidity. Timing of debridement with fracture repair and soft tissue reconstruction is controversial. This study focuses on the efficacy of early single-stage repair in combined bony and soft tissue injuries. METHODS: Retrospective review. Twenty-three patients with combined open soft tissue wounds and orbital fractures were studied for single-stage orbital reconstruction and periorbital soft tissue repair...
November 11, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27913815/-volume-therapy-in-the-severely-injured-patient-recommendations-and-current-guidelines
#19
Sigune Kaske, Marc Maegele
BACKGROUND: Volume therapy is a cornerstone of early resuscitation of severely injured trauma patients, but the optimal strategy remains under debate. A recent Cochrane review could not find evidence for or against early volume replacement or large versus small amounts of fluid. METHOD: Current recommendations and guidelines regarding volume therapy in severely injured patients are summarized based upon the updated European Trauma Guideline on the management of major bleeding and coagulopathy following trauma (fourth edition) and the S3-Guideline Polytrauma and combined with a selective review of the literature...
January 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/27913446/use-of-bioresorbable-implants-for-orbital-fracture-reconstruction
#20
Stephanie M Young, Gangadhara Sundar, Thiam-Chye Lim, Stephanie S Lang, George Thomas, Shantha Amrith
PURPOSE: Bioresorbable implants offer several advantages over permanent implants and serve as a useful alternative in the reconstruction of orbital fractures. Our aim of the study was to evaluate the clinical effectiveness and safety of various bioresorbable implants in the repair of orbital fractures. METHODS: A retrospective review of all patients who had undergone orbital fracture repair with bioresorbable implants in a single tertiary trauma centre from January 2005 to December 2014 was performed...
December 2, 2016: British Journal of Ophthalmology
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