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https://www.readbyqxmd.com/read/28441973/treatment-limiting-decisions-in-patients-with-severe-traumatic-brain-injury-in-a-norwegian-regional-trauma-center
#1
Annette Robertsen, Reidun Førde, Nils Oddvar Skaga, Eirik Helseth
BACKGROUND: Treatment-limiting decisions (TLD) for severe traumatic brain injury (sTBI) have been sparsely studied. This study determine prevalence, main reason for, categories and timing of TLDs in a Norwegian regional trauma setting. METHODS: A retrospective study of a 2-year cohort of 579 sTBI patients admitted to Oslo University Hospital (OUH). Prospectively collected data in the OUH Trauma Registry were combined with retrospective data from a chart review regarding TLDs...
April 26, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28441071/efficacy-and-safety-of-23-gauge-pars-plana-vitrectomy-silicone-oil-tamponade-combination-for-treatment-of-pediatric-post-traumatic-endophthalmitis
#2
Wei Jin, Yaopeng Xu, Wenjun Wang, Yiqiao Xing, Anhuai Yang
PURPOSE: To determine (i) the etiology, epidemiology, mechanism of injury, and risk factors associated with open globe injuries (OGIs) in children and (ii) visual outcomes of pediatric patients with post-traumatic endophthalmitis following 23-gauge pars plana vitrectomy (PPV) combined with silicone oil tamponade (SOT). METHODS: A total of 107 consecutive patients, <15 years of age, who had been diagnosed with post-traumatic endophthalmitis between September 2009 and October 2015, were included in this 6-year retrospective study...
April 25, 2017: Current Eye Research
https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#3
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429381/the-structural-connectome-of-children-with-traumatic-brain-injury
#4
Marsh Königs, L W Ernest van Heurn, Roel Bakx, R Jeroen Vermeulen, J Carel Goslings, Bwee Tien Poll-The, Marleen van der Wees, Coriene E Catsman-Berrevoets, Jaap Oosterlaan, Petra J W Pouwels
This study aimed to investigate the impact of mild to severe pediatric TBI on the structural connectome. Children aged 8-14 years with trauma control (TC) injury (n = 27) were compared to children with mild TBI and risk factors for complicated TBI (mild(RF+) , n = 20) or moderate/severe TBI (n = 16) at 2.8 years post-injury. Probabilistic tractography on diffusion tensor imaging data was used in combination with graph theory to study structural connectivity. Functional outcome was measured using neurocognitive tests and parent and teacher questionnaires for behavioral functioning...
April 21, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28422917/an-adapted-clavien-dindo-scoring-system-in-trauma-as-a-clinically-meaningful-non-mortality-endpoint
#5
David N Naumann, Laura E Vincent, Nicola Pearson, Alastair Beaven, Iain M Smith, Kieran Smith, Emma Toman, Helen R Dorrance, Keith Porter, Charles E Wade, Bryan A Cotton, John B Holcomb, Mark J Midwinter
BACKGROUND: There is no consensus on reporting non-mortality trauma complications in a graded manner. The Clavien-Dindo scale of complications was originally for elective surgery, and requires adaptation to provide meaningful data for trauma patients. In particular the original score does not account for those treated without surgery. We report an adapted Clavien-Dindo in trauma (ACDiT) scale and apply it to patients managed operatively and non-operatively. METHODS: A combined prospective and retrospective international multi-center observational study was undertaken to apply the ACDiT scale to 484 trauma patients at 3 university teaching hospitals (Birmingham, England (n=303); Houston, Texas (n=113); and Glasgow, Scotland (n=68))...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28417184/comparison-of-epidemiology-of-the-injuries-and-outcomes-in-two-first-level-trauma-centers-in-colombia-using-the-pan-american-trauma-registry-system
#6
Anu Ramachandran, Anju Ranjit, Cheryl K Zogg, Juan P Herrera-Escobar, Jessica R Appelson, Luis F Pino, Michel B Aboutanous, Adil H Haider, Carlos A Ordonez
INTRODUCTION: The aim of this study was to compare the epidemiology of traumatic injuries and mortality outcomes between two tertiary-care trauma centers in Colombia using data from Pan-American Trauma Registry (PATR). METHODS: January 1-December 31, 2012, data from the Hospital Universitario del Valle (HUV, public) and Fundacion Valle del Lili (FVL, private) in Cali, Colombia, were considered. Differences in demographic and clinical information were compared using descriptive statistics...
April 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28415025/unusual-combination-of-femoral-head-dislocation-associated-acetabular-fracture-with-multipart-femoral-fractures-case-report
#7
Erdal Uzun, Ali Eray Günay, İbrahim Karaman, Abdülhamit Mısır, Turan Bilge Kızkapan, Mustafa Özçamdallı
INTRODUCTION: Traumatic hip dislocation associated with femur intertrocanteric fracture is a rare and severe injury and it frequently occurs following a high energy trauma, Associated acetabular fractures with this injury are even more rare and potentially cause devastating consequences including avascular necrosis of the femoral head and subsequent early secondary osteoarthritis of the hip joint. PRESENTATION OF CASE: In this case report, we present a 20year old polytraumatized patient with traumatic hip dislocation associated with ipsilateral acetabulum fracture and simultaneous fractures of the ipsilateral femur...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28411701/lack-of-symmetry-in-the-major-lower-limb-veins
#8
Anirudh Chandrashekar, Antonios Gasparis, Nicos Labropoulos
BACKGROUND: Contemporary texts frequently present the venous system of the lower limb as a prime example of bilateral symmetry. However, overt bilateral asymmetry may be noted. This study was designed to examine and to quantify the level of symmetry in the lower extremity veins. METHODS: This prospective cohort study evaluated major anatomic differences between right and left lower extremity veins in adult patients. Two hundred patients presenting with signs and symptoms of chronic venous disease (CVD; class 2-6) and venous reflux on duplex ultrasound were examined...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28410604/the-association-of-patient-and-trauma-characteristics-with-the-health-related-quality-of-life-in-a-dutch-trauma-population
#9
Amy Gunning, Mark van Heijl, Karlijn van Wessem, Luke Leenen
BACKGROUND: It is suggested in literature to use the Health Related Quality of Life (HRQoL) as an outcome indicator for evaluating trauma centre performances. In order to predict HRQoL, characteristics that could be of influence on a predictive model should be identified. This study identifies patient and injury characteristics associated with the HRQoL in a general trauma population. METHODS: Retrospective study of trauma patients admitted from 1st January 2007 through 31th December 2012...
April 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28403000/the-combined-use-of-a-neurocutaneous-flap-and-the-ilizarov-technique-for-reconstruction-of-large-soft-tissue-defects-and-bone-loss-in-the-tibia
#10
Jia Xu, Wan-Run Zhong, Liang Cheng, Chun-Yang Wang, Gen Wen, Pei Han, Yi-Min Chai
BACKGROUND: Management of posttraumatic large soft tissue defects and bone loss remains a therapeutic and surgical challenge for orthopedic surgeons. We assessed the use of a neurocutaneous flap and the Ilizarov technique in the reconstruction of severe composite defects in the tibia. METHODS: We retrospectively reviewed 18 consecutive patients with trauma-related soft tissue defects and bone loss. The size of the soft tissue defect ranges from 8 × 9 cm to 14 × 18 cm...
May 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28402091/thoracic-trauma-and-acute-respiratory-distress-syndrome-in-polytraumatized-patients-admitted-to-a-level-i-trauma-center-a-retrospective-analysis
#11
Thomas Haider, Gabriel Halat, Thomas Heinz, Stefan Hajdu, Lukas L Negrin
BACKGROUND: Although thoracic trauma has often been associated with the development of ARDS in general, its impact on ARDS in combination with severe concomitant injuries has still to be elucidated. Therefore, the objective of this study was to determine the frequency of thoracic trauma and ARDS in polytraumatized patients, and to evaluate the impact of thoracic trauma on the occurrence and the onset of ARDS. METHODS: Included in this retrospective cohort study were all polytraumatized patients over 18 years of age, with an injury severity score (ISS) of at least 16, who were admitted to our level I trauma center over a three-year time period...
April 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#12
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28384071/estimate-of-mortality-reduction-with-implementation-of-advanced-automatic-collision-notification
#13
Ellen Lee, Jingshu Wu, Thomas Kang, Matthew Craig
OBJECTIVE: Advanced Automatic Collision Notification (AACN) is a system on a motor vehicle that notifies a Public Safety Answering Point (PSAP), either directly or through a third party that the vehicle has had a crash. AACN systems enable earlier notification of a motor vehicle crash and provide an injury prediction that can help dispatchers and first responders make better decisions about how and where to transport the patient, thus getting the patient to definitive care sooner. The purpose of the current research is to identify the target population that could benefit from AACN, and develop a reasonable estimate range of potential lives saved with implementation of AACN within the vehicle fleet...
April 6, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28383625/the-saxophonist-s-hernia-a-rare-case-report-of-anterior-primary-perineal-hernia-in-a-young-male-patient
#14
V D Palumbo, B Di Trapani, B Molinelli, S Tomasini, A Bruno, G Tomasello
Perineal hernia is the protrusion of an intra-abdominal structure into the perineal area, that could be primitive or secondary to trauma or abdominoperineal resection. Main treatment could be transabdominal, transperineal or combined. Here is a rare case of anterior perineal hernia in a young saxophone male patient, treated with a mininvasive perineal approach. A 25-year-old Caucasian male patient referred 1-year history of perineal pain. The pain was more severe when he played his saxophone. Local exam was negative but a dynamic perineal ultrasonography revealed a small anterior perineal hernia...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28383409/clinical-case-series-report-of-traumatic-cauda-equina-herniation-a-pathological-phenomena-occurring-with-thoracolumbar-and-lumbar-burst-fractures
#15
Liang Yan, Yang Liu, Baorong He, Jijun Liu, Zhenguo Luo, Dingjun Hao
RATIONALE: Burst fractures in thoracolumbar and lumbar spine typically occur from severe trauma, which may result in cauda equina herniation (CEH). In this study, we attempted to document the incidence and evaluate the sequelae of CEH that were found during decompression and fusion surgery for patients with burst fractures. PATIENT CONCERNS: A total of 416 patients were enrolled in this study. DIAGNOSES: The patients had been operated on through an anterior or posterior approach for treatments of thoracolumbar and lumbar burst fractures at our department between June 1, 2008 and June 1, 2011...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28382259/traumatic-tension-pneumocephalus-two-cases-and-comprehensive-review-of-literature
#16
REVIEW
Promod Pillai, Rohit Sharma, Larami MacKenzie, Eugene F Reilly, Paul R Beery, Thomas J Papadimos, Stanislaw Peter A Stawicki
Although traumatic pneumocephalus is not uncommon, it rarely evolves into tension pneumocephalus (TP). Characterized by the presence of increasing amounts of intracranial air and concurrent appearance or worsening neurological symptoms, TP can be devastating if not recognized and treated promptly. We present two cases of traumatic TP and a concise review of literature on this topic. Two cases of traumatic TP are presented. In addition, a literature search revealed 20 additional cases, of which 18 had sufficient information for inclusion...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28382256/prognostication-of-traumatic-brain-injury-outcomes-in-older-trauma-patients-a-novel-risk-assessment-tool-based-on-initial-cranial-ct-findings
#17
Stanislaw P Stawicki, Thomas R Wojda, John D Nuschke, Ronnie N Mubang, James Cipolla, William S Hoff, Brian A Hoey, Peter G Thomas, Joan Sweeney, Daniel Ackerman, Jonathan Hosey, Steven Falowski
INTRODUCTION: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28377911/distal-femoral-arteriovenous-fistula-with-iliac-vein-thrombosis-after-blunt-trauma
#18
Duk Sil Kim, Sung Wan Kim, Hyun Seok Lee, Kyung Hwan Byun, Michael SungPil Choe
A 39-year-old woman arrived at our emergency department, complaining of severe pain and swelling of her left leg. She had slipped down stairs and injured on her left leg about 3 months ago. Computed tomography angiography showed left distal superficial femoral artery's pseudoaneurysm with arteriovenous fistula and thrombotic occlusion of left common iliac vein. We decided to do endovascular intervention due to severe venous hypertension and chronic inflammation around the fistula. The femoral arteriovenous fistula was closed via stent-graft (7 mm×5, 9 mm×5 cm) deployment...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28377088/jules-tinel-1879-1952-beyond-the-eponym-the-man-and-his-forgotten-neurological-contributions
#19
REVIEW
O Walusinski
The trauma of World War I had a lasting impact on clinician and physiologist Jules Tinel (1879-1952). His treatment of peripheral nervous system injuries led him, in 1917, to describe the eponymous sign that he linked to activity of the sympathetic nervous system. Among the sequelae of nerve injuries, he was confronted with causalgia that he attributed, here again, to the autonomic nervous system, the main focus of his laboratory research throughout his career. Tinel's sign became so well known that it eclipsed the originality of his seminal descriptions of exertional headache and of hypertensive emergency caused by pheochromocytoma, which could also have been associated with his name...
April 1, 2017: Revue Neurologique
https://www.readbyqxmd.com/read/28374949/post-traumatic-stress-disorder-and-beyond-an-overview-of-rodent-stress-models
#20
REVIEW
Johanna Schöner, Andreas Heinz, Matthias Endres, Karen Gertz, Golo Kronenberg
Post-traumatic stress disorder (PTSD) is a psychiatric disorder of high prevalence and major socioeconomic impact. Patients suffering from PTSD typically present intrusion and avoidance symptoms and alterations in arousal, mood and cognition that last for more than 1 month. Animal models are an indispensable tool to investigate underlying pathophysiological pathways and, in particular, the complex interplay of neuroendocrine, genetic and environmental factors that may be responsible for PTSD induction. Since the 1960s, numerous stress paradigms in rodents have been developed, based largely on Seligman's seminal formulation of 'learned helplessness' in canines...
April 4, 2017: Journal of Cellular and Molecular Medicine
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