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Trauma patient

Dennis Mazingi, George C Jakanani, Prudance Mushayavanhu
INTRODUCTION: The Morel-Lavallée lesion is an infrequently described, post-traumatic closed de-gloving wound that results from separation of the skin and subcutaneous tissues from the underlying deep fascia as a result of shearing forces that tear perforating vessels and lymphatics. This condition is rare in children and to our knowledge it represents the youngest case of Morel-Lavallée lesion yet reported. PRESENTATION OF CASE: We report on a twelve-month-old girl who presented after a motor vehicle accident with a tender fluctuant mass of the back and buttocks...
July 12, 2018: International Journal of Surgery Case Reports
Ruijue Ma, Yuanyuan Liu, Lin Zhang, Yulin Lei, Jie Hou, Zhengwei Shen, Xianglong Yi, Yan Wang
Purpose: The purpose of this study was to characterize corneal thickness from multiple regions and determine accurate reference values in young adults for diagnosis and treatment. Methods: This cross-sectional observational study was conducted from January 2008 through October 2016 using examiner-blinded clinical measurements and included 37,375 healthy eyes from young adults who exhibited normal corneal morphology, had no history of eye surgery or trauma, had stopped wearing soft contact lenses for ≥2 weeks (rigid contact lenses for ≥4 weeks), and had undergone topographies of both eyes on same day...
July 2, 2018: Investigative Ophthalmology & Visual Science
Konrad Oppelt, Doreen Hähnlein, Jürgen Boschert, Maike Küffer, Paul Alfred Grützner, Matthias Münzberg, Michael Kreinest
PRIMARY OBJECTIVE: We evaluated the neurologic, psychological and vegetative outcome, the health status and changes of the personal and occupational status of patients after traumatic brain injuries (TBIs). Correlations between outcome parameters and basic demographic factors and initial clinical status parameters of the patients were assessed. RESEARCH DESIGN: Monocentric, retrospective follow-up analysis. METHODS AND PROCEDURES: We evaluated the neurologic, psychological and vegetative outcome and health status of patients, who survived TBI with a mean follow-up time of 54 months...
July 19, 2018: Brain Injury: [BI]
S Di Saverio, E Segalini, A Birindelli, S Todero, M Podda, A Rizzuto, G Tugnoli, A Biondi
BACKGROUND: Ideal surgical treatment for acute duodenal injuries should offer a definitive treatment, with low morbidity and mortality. It should be simple and easily reproducible by acute care surgeons in an emergency. Duodenal injury, due to major perforated or bleeding peptic ulcers or iatrogenic/traumatic perforation, represents a surgical challenge, with high morbidity and mortality. The aim was to review definitive surgery with pancreas-sparing, ampulla-preserving duodenectomy for these patients...
July 19, 2018: British Journal of Surgery
Lei Ma, Feng-Yu Liu, Li-Shuang Huo, Zheng-Qi Zhao, Xian-Ze Sun, Feng Li, Wen-Yuan Ding
BACKGROUND: Laminoplasty (LP) and laminectomy with fusion (LF) were recognized as two reliable and effective way in treating multilevel cervical ossification of the posterior longitudinal ligament (OPLL). However, there was no clear conclusion on which method is better. A meta-analysis was conducted to evaluate the clinical results between LP and LF in the treatment of multilevel cervical OPLL. METHODS: An extensive search of literature was performed in PubMed, Embase, the Cochrane library, CNKI (Chinese database), and WANFANG (Chinese database)...
July 2018: Medicine (Baltimore)
Cori A Palermo, Bethany L Brand
OBJECTIVE: The first objective was to understand how individuals with complex dissociative disorders (CDD) score on the Trauma Symptom Inventory-2 (TSI-2). These individuals have high elevations on many psychological measures' validity and clinical scales because of the severe traumatic reactions they experience; thus, creating a challenge for clinicians who seek to determine whether these individuals are exaggerating reported symptoms. The second objective was to compare coached CDD simulators to CDD profiles on the TSI-2s clinical and validity scales...
July 19, 2018: Psychological Trauma: Theory, Research, Practice and Policy
Ahmet Korkut Belli, Önder Özcan, Funda Dinç Elibol, Cenk Yazkan, Cem Dönmez, Ethem Acar, Okay Nazlı
Objective: The spleen is the most vulnerable organ in blunt abdominal trauma. Spleen-preserving treatments are non-operative management with or without splenic angioembolization, partial splenectomy, and splenorrhaphy. The aim of the present study was to determine the rate of SPTs and to evaluate the usefulness of Injury Severity Score after traumatic splenic injury. Material and Methods: We searched our institution's database between May 2012 and December 2015...
2018: Turkish Journal of Surgery
Bodil Just Christensen, Julie Berg Schmidt, Mette Søndergaard Nielsen, Louise Tækker, Lotte Holm, Susanne Lunn, Wender L P Bredie, Christian Ritz, Jens Juul Holst, Torben Hansen, Anja Hilbert, Carel W le Roux, Oliver J Hulme, Hartwig Siebner, Tobias Morville, Lars Naver, Andrea Karen Floyd, Anders Sjödin
Despite substantial research efforts, the mechanisms proposed to explain weight loss after gastric bypass (RYGB) and sleeve gastrectomy (SL) do not explain the large individual variation seen after these treatments. A complex set of factors are involved in the onset and development of obesity and these may also be relevant for the understanding of why success with treatments vary considerably between individuals. This calls for explanatory models that take into account not only biological determinants but also behavioral, affective and contextual factors...
June 2018: Contemporary Clinical Trials Communications
Samuel R Brown, Carlos Fernandez, Robert Bertellotti, Juan Antonio Asensio
A 53-year-old man was admitted to our trauma center after sustaining thoracoabdominal injuries, secondary to a rear-end motor vehicle collision. As he stepped out of his vehicle, he was struck by a tractor trailer at 55 mph. The following were the initial vital signs on his arrival: heart rate 140 beats/min, blood pressure 142/80 mm Hg, respiratory rate 28 breaths/min, temperature 36.8°C, and oxygen saturation 93%. The Glasgow Coma Scale score was 15 and the Injury Severity Score was 59. He was evaluated and resuscitated per the advanced trauma life support protocols...
2018: Trauma surgery & acute care open
Desiree Raygor, James Cunningham, Joseph Costa, Marie Crandall, David Skarupa
A 69-year-old obese man was involved in a high-speed head-on motor vehicle collision. He was tachycardic and normotensive on arrival. He subsequently developed hemodynamic instability requiring blood transfusion. On examination he had bilateral pneumothoraces, an anterior-posterior compression (APC) pelvic fracture, an open wound at the left groin, and gross hematuria after Foley catheter placement.CT imaging revealed hemoperitoneum, right hepatic lobe grade II lacerations, splenic laceration, mesenteric root injury with extravasated contrast, intraperitoneal and extraperitoneal bladder rupture, bilateral ureteral injuries at the level of the pelvic inlet (see figure 1), APC pelvic fracture, bilateral rib fractures, pneumothoraces, and pulmonary contusions...
2018: Trauma surgery & acute care open
Andrew James Kerwin, Alexandra Mercel, David J Skarupa, Joseph J Tepas, Jin H Ra, David Ebler, Albert Hsu, Joseph Shiber, Marie L Crandall
Background: Recent legislation repealing the Sustainable Growth Rate mandates gradual replacement of fee for service with alternative payment models (APMs), which will include service bundling. We analyzed the 2 years' experience at our state-designated level I trauma center to determine the feasibility of such an approach for trauma care. Methods: De-identified data from all injured patients treated by the trauma service during 2014 and 2015 were reviewed to determine individual patient injury profiles...
2018: Trauma surgery & acute care open
Koichi Inukai, Shuhei Uehara, Yoshiteru Furuta, Masanao Miura
PURPOSE: The success rate of nonoperative management (NOM) of traumatic liver injury is approximately 90%. Although NOM has become the standard treatment when patients' vital signs are stable, open surgical hemostasis is often selected when these signs are unstable. At our hospital, we extensively use NOM along with transcatheter arterial embolization (TAE) to treat patients with severe abdominal trauma, as per our original protocol. We also apply NOM for severe liver injury with unstable hemodynamics...
July 19, 2018: Emergency Radiology
Martina Sladkova, Rawan Alawadhi, Rawan Jaragh Alhaddad, Asmaa Esmael, Shoug Alansari, Munerah Saad, Jenan Mulla Yousef, Lulwa Alqaoud, Giuseppe Maria de Peppo
Segmental bone defects caused by trauma and disease represent a major clinical problem worldwide. Current treatment options are limited and often associated with poor outcomes and severe complications. Bone engineering is a promising alternative solution, but a number of technical challenges must be addressed to allow for effective and reproducible construction of segmental grafts that meet the size and geometrical requirements needed for individual patients and routine clinical applications. It is important to devise engineering strategies and standard operating procedures that make it possible to scale up the size of bone-engineered grafts, minimize process and product variability, and facilitate technology transfer and implementation...
July 18, 2018: Scientific Reports
M Gabrielle Pagé, Irina Kudrina, Hervé Tchala Vignon Zomahoun, Daniela Ziegler, Pierre Beaulieu, Céline Charbonneau, Jennifer Cogan, Raoul Daoust, Marc O Martel, Andrée Néron, Philippe Richebé, Hance Clarke
BACKGROUND: When patients have been on opioid therapy for more than 90 days, more than half of them continue using opioids years later. Knowing that long-term opioid consumption could lead to harmful side effects including misuse, abuse, and addiction, it is important to understand the risks of transitioning to prolonged opioid therapy to reduce its occurrence. Perioperative and trauma contexts are ideal models commonly used to study such transition. Long-term use of opioids might be associated with transformation of acute pain to chronic, which might be an example of a risk factor...
July 18, 2018: Systematic Reviews
Konstantinos Bromis, Maria Calem, Antje A T S Reinders, Steven C R Williams, Matthew J Kempton
OBJECTIVE: The authors conducted a comprehensive meta-analysis of MRI region-of-interest and voxel-based morphometry (VBM) studies in posttraumatic stress disorder (PTSD). Because patients have high rates of comorbid depression, an additional objective was to compare the findings to a meta-analysis of MRI studies in depression. METHOD: The MEDLINE database was searched for studies from 1985 through 2016. A total of 113 studies met inclusion criteria and were included in an online database...
July 19, 2018: American Journal of Psychiatry
Yu Fang, Jingfei Hu, Zhenhua Wang, Huili Zong, Lu Zhang, Ruifang Zhang, Limin Sun
OBJECTIVE: Sepsis is a whole-body inflammation disease after severe trauma, burn injury, infection and major surgeries, accompanied by multiple organs failure. We sought to investigate the potential mechanism of Aquaporin 1 (AQP1), miRNA-874, and lncRNA H19 in lipopolysaccharide (LPS) sepsis and the anti-inflammatory responses related to sepsis myocardial dysfunction. MATERIAL AND METHODS: Serum from peripheral blood samples of sepsis patients and in vivo mice model were collected for AQP1, H19, and miR-874 expression...
September 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Amanda M Eisenberg, Christine N Eppelheimer, Tamara A Fulop, Lisa L Abramson
History A 57-year-old woman presented with right breast swelling and enlargement and a palpable mass in the right lower inner breast. There was no history of fever, trauma, skin redness, or nipple discharge. The patient had a history of breast augmentation, with retropectoral silicone implants placed 2.5 years ago. Screening mammography (images not shown) 7 months prior revealed bilateral breast implants but no other abnormality. Mammography and US of the right breast were performed at the initial evaluation...
August 2018: Radiology
Sarah Luu, Claire Dendle, Penelope Jones, Samar Ojaimi, Ian J Woolley
OBJECTIVE: To evaluate quality of patient knowledge and rates of adherence to guidelines amongst splenectomised patients registered to the Spleen Australia registry. METHOD: Registrants recruited for assessment of residual splenic function post-splenectomy also underwent an assessment of quality of knowledge and a review of their long-term management. Eligible patients were ≥ 18 years of age, registered to the Spleen Australia clinical registry and had been splenectomised at least 1 year prior to their visit...
July 18, 2018: Human Vaccines & Immunotherapeutics
Joyce Li
Nearly 50% of children will experience dental trauma by the age of 4 years. Timely and effective care is important in the management of dental injuries, as several studies have shown poor outcomes with delayed treatment. The current evidence in the management of dental injuries is primarily from a dentist's perspective, with limited evidence specific to management in the emergency department. The goal of pediatric dental injury management is dictated largely by whether the dentition is primary or permanent...
August 2018: Pediatric Emergency Medicine Practice
Juan Pablo Herrera-Escobar, Michel Apoj, Christina Weed, Alyssa Fitzpatrick Harlow, Syeda Sanam Al Rafai, Elizabeth Lilley, George Kasotakis, Karen Brasel, Haytham Ma Kaafarani, George Velmahos, Ali Salim, Adil Hussein Haider
BACKGROUND: Chronic pain after trauma is associated with serious clinical, social, and economic burden. Due to limitations in trauma registry data and previous studies, the current prevalence of chronic pain after trauma is unknown, and little is known about the association of pain with other long-term outcomes. We sought to describe the long-term burden of self-reported pain after injury, and determine its association with positive screen for posttraumatic stress disorder (PTSD), functional status, and return to work...
July 17, 2018: Journal of Trauma and Acute Care Surgery
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