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https://www.readbyqxmd.com/read/28231518/early-bronchoalveolar-lavage-for-intubated-trauma-patients-with-tbi-or-chest-trauma
#1
Tyler J Loftus, Stephen J Lemon, Linda L Nguyen, Stacy A Voils, Scott C Brakenridge, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Frederick A Moore, Philip A Efron, Alicia M Mohr
PURPOSE: To evaluate the efficacy of an early bronchoalveolar lavage (E-BAL) protocol. BAL was performed within 48 h for intubated patients with traumatic brain injury or chest trauma. We hypothesized that E-BAL would decrease antibiotic use and improve outcomes compared to late BAL (L-BAL) triggered by clinical signs of pneumonia. METHODS: Retrospective cohort analysis of 132 patients with quantitative BAL and ≥1 risk factor: head Abbreviated Injury Score ≥2, ≥3 rib fractures, or radiographic signs of aspiration or pulmonary contusion...
February 12, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28231370/significance-of-imaging-in-the-diagnosis-of-olfactory-disorder
#2
Teemu Harju, Markus Rautiainen, Ilkka Kivekäs
The aim of this retrospective analysis was to examine olfactory disorders among the patients in the Ear, Nose, and Throat Clinic of Tampere University Hospital, Finland, from 2001 to 2011, and to evaluate the necessity of imaging in the examination of patients with olfactory disorders. Charts of 143 consecutive patients with a primary olfactory disorder were examined, and 69 patients who had undergone the necessary testing were included in the study. The most common causes of olfactory disorder were upper respiratory infection (23%), chronic rhinosinusitis (19%), head trauma (17%), and allergic or nonallergic rhinitis (6%)...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28230635/valproic-acid-modulates-platelet-and-coagulation-function-ex-vivo
#3
Ted Bambakidis, Simone E Dekker, Ihab Halaweish, Baoling Liu, Vahagn C Nikolian, Patrick E Georgoff, Patryk Piascik, Yongqing Li, Martin Sillesen, Hasan B Alam
Trauma-induced coagulopathy is associated with adverse patient outcome. Animal models demonstrate that histone deacetylase inhibitors, such as valproic acid (VPA), improve survival following injury. While in-vivo data suggest that improved survival may in part be because of an attenuation of coagulopathy, it remains unknown whether this is a direct effect of the drug, or the establishment of an overall prosurvival phenotype. We thus conducted an ex-vivo experiment to determine if VPA has an effect on coagulation and platelet function...
February 21, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/28230629/point-of-injury-tourniquet-application-during-operation-protective-edge-what-de-we-learn
#4
Amir Shlaifer, Avraham Yitzhak, Erez N Baruch, Avi Shina, Alexandra Satanovsky, Amiram Shovali, Ofer Almog, Elon Glassberg
BACKGROUND: Hemorrhage is a leading cause of preventable death on the battlefield. Timely tourniquet application to massively bleeding extremity wounds is critical for casualty survival albeit with reported adverse effects to extremity integrity. The aim of this study was to describe the immediate and short term outcomes of point of injury (POI) tourniquet applications during 'Operation Protective Edge' (OPE). METHODS: A case series study regarding tourniquet application at the POI during OPE was collected...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28230627/surgical-outcomes-after-trauma-pneumonectomy-revisited
#5
Kazuhide Matsushima, Alberto Aiolfi, Caroline Park, David Rosen, Aaron Strumwasser, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
INTRODUCTION: Trauma pneumonectomy has been historically associated with an exceedingly high morbidity and mortality. The recent advent of standardized reporting and data-collecting measures has facilitated large volume data-analysis on predictors and outcomes of trauma pneumonectomy. The purpose of this study is to describe patient characteristics and outcomes of the patients who underwent trauma pneumonectomy in the modern era and identify clinical factors associated with postoperative mortality...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28230626/resiliency-and-quality-of-life-trajectories-after-injury
#6
Ben L Zarzaur, Teresa M Bell, Stephen A Zanskas
BACKGROUND: Injury can greatly impact patients' long-term quality of life. Resilience refers to an individual's ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between pre-injury resiliency scores and quality of life after injury. METHODS: 225 adults admitted with an injury severity score > 10 but without neurological injury were included. The SF-36 was administered at the time of admission and repeated at 1, 2, 4 and 12 months after injury...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28230584/microsurgical-replantation-of-total-avulsed-scalp-extending-the-limits
#7
Yunbo Jin, Chen Hua, Xiaojie Hu, Hui Chen, Gang Ma, Yun Zou, Bin Chen, Dongze Lyu, Mathias Tremp, Xiaoxi Lin
BACKGROUND: Avulsion of the scalp is a rare but severe trauma and challenging to the reconstructive surgeon. It poses not only physical concussion but also significant persisting psychological distress to the patients. METHODS: Medical records from 5 patients who suffered scalp avulsion were reviewed retrospectively. The following data and methods were assessed: age, number of vessels repaired, method of replantation, vein grafts required, blood transfusion, ischemia time, total operating time, and percentage of scalp survival...
February 22, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28230573/global-sagittal-imbalance-due-to-change-in-pelvic-incidence-after-traumatic-spinopelvic-dissociation
#8
Han-Dong Lee, Chang-Hoon Jeon, Nam-Su Chung, Suk-Hyeong Won
OBJECTIVES: Traumatic spinopelvic dissociation separates the spinal column from the pelvis, which usually creates lumbosacral kyphosis. We aimed to examine how the spinopelvic profiles changes after traumatic spinopelvic dissociation, and which are the relevant factors for the sagittal imbalance of the spine. DESIGN: Retrospective analysis. SETTING: Level I trauma center PATIENTS:: Thirty-nine consecutive patients who were diagnosed with traumatic spinopelvic dissociation and had a minimum 2-year radiological follow-up were included...
February 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28230571/infection-and-complications-following-low-velocity-intra-articular-gunshot-injuries
#9
Mai P Nguyen, Michael S Reich, Jeffrey A O'Donnell, Jonathan C Savakus, Nicholas F Prayson, Joseph F Golob, Amy A McDonald, John J Como, Heather A Vallier
OBJECTIVES: The purpose of this study is to characterize the demographics, interventions, infection rates, and other complications following intra-articular gunshot wounds. DESIGN: Retrospective review. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Fifty-three patients with 55 civilian low-velocity intra-articular gunshot injuries with a minimum of four weeks follow-up were included in the study. Seven patients had associated vascular injuries...
February 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28230248/effectiveness-of-early-administration-of-tranexamic-acid-in-patients-with-severe-trauma
#10
A Shiraishi, S Kushimoto, Y Otomo, H Matsui, A Hagiwara, K Murata
BACKGROUND: A reduction in mortality with the early use of tranexamic acid has been demonstrated in severely injured patients who are bleeding. However, the modest treatment effect with no reduction in blood transfusion has raised concerns. The aim of the present study was to estimate the effectiveness of regular use of tranexamic acid in severely injured patients. METHODS: This multicentre observational study used retrospectively collected data from consecutive injured patients (Injury Severity Score at least 16) treated in 15 Japanese academic institutions in 2012...
February 23, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28229615/bacteremia-with-raoultella-planticola-in-the-setting-of-acute-pancreatitis-complicated-with-acute-cholangitis
#11
Esther Merino Rodríguez, Susana Rebolledo Olmedo, Joaquín Miquel Plaza
The bacterium Raoultella planticola (R planticola) is a rare pathogen in humans. We report a case of mild acute pancreatitis (MAP) of biliary origin with cholangitis and bacteremia with R planticola in association with pancreatic panniculitis (PP). A 55-year-old woman with rheumatic multiple valvulopathy presented with epigastric pain radiating to the back in a belt-like fashion for 48 hours, jaundice, choluria, acholia, and fever (38.2oC). Lab tests showed: amylase 2126 U/L, ALT 124 U/L, AST 169 U/L, GGT 3548 U/L, AP 1516 U/L, TBil 12...
February 23, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28229571/transnasal-transsphenoidal-brain-injury-by-a-fencing-foil-an-unusual-case-report-and-brief-literature-review
#12
Rafet Özay, Mehmet S Balkan, Çağhan Tönge, Zeki Şekerci
BACKGROUND: In this report, the authors present an unusual case of a 10-year-old child who suffered a severe headache and rhinorrhea that occurred as a result of fencing foil sports injury via transnasal-transsphenoidal (TNTS) pathway. METHODS: Following to trauma, the child had shown neurological symptoms such a pupil dilatation, change in consciousness and mild hemiparesia. Imaging demonstrated destruction of bone structures including posterior wall of sphenoid sinus and anterosuperior part of sella turcica, and also a contusion at right thalamic region...
February 22, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/28229432/spontaneous-torsion-of-the-right-upper-lung-lobe-a-case-report
#13
Yusuke Kita, Tetsuhiko Go, Kazuhito Nii, Natsumi Matsuura, Hiroyasu Yokomise
BACKGROUND: Pulmonary torsion is usually caused by thoracic surgery or trauma. Spontaneous pulmonary torsion caused by tumor and pleural effusion is very rare. CASE PRESENTATION: A 76-year-old Asian male with a chronic cough and suspected lung or pleural tumor presented with sudden dyspnea. Computed tomography showed that the right upper lung lobe contained a large tumor in the region of S1-3; the tumor had shifted to the posterior thoracic space and rotated 90° counterclockwise, potentially impeding blood flow...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28229175/survival-prediction-of-trauma-patients-a-study-on-us-national-trauma-data-bank
#14
I Sefrioui, R Amadini, J Mauro, A El Fallahi, M Gabbrielli
BACKGROUND: Exceptional circumstances like major incidents or natural disasters may cause a huge number of victims that might not be immediately and simultaneously saved. In these cases it is important to define priorities avoiding to waste time and resources for not savable victims. Trauma and Injury Severity Score (TRISS) methodology is the well-known and standard system usually used by practitioners to predict the survival probability of trauma patients. However, practitioners have noted that the accuracy of TRISS predictions is unacceptable especially for severely injured patients...
February 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28228900/intraneural-hemorrhage-in-traumatic-oculomotor-nerve-palsy
#15
Thomas Sartoretti, Elisabeth Sartoretti, Christoph Binkert, David Czell, Sabine Sartoretti-Schefer
Isolated traumatic oculomotor nerve palsy without internal ophthalmoplegia is a rare condition after closed head trauma. The nerve strain leads to intraneural edema with nerve swelling on T2-weighted magnetic resonance (MR) images and traumatic disruption of the blood peripheral nerve barrier with contrast enhancement on T1-weighted MR images. In this patient, susceptibility-weighted MR imaging allowed the direct visualization of the intraneural hemorrhage after suspected traumatic diffuse neuronal axonal injury...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228886/transjugular-intrahepatic-portosystemic-shunt-for-chylous-ascites-in-a-patient-with-recurrent-cirrhosis-following-liver-transplantation
#16
Jason T Salsamendi, Francisco J Gortes, Prasoon P Mohan, Ji Fan, Govindarajan Narayanan
Chylous ascites (CA) is the extravasation of lipid-rich lymphatic fluid into the peritoneal space following trauma or obstruction of the lymphatic system. Refractory cases of cirrhosis-related CA may be amendable to transjugular intrahepatic portosystemic shunting (TIPS). We present a case of TIPS in the setting of refractory CA secondary to cirrhosis of a transplanted liver graft. Following TIPS, the patient reported immediate improvement in abdominal pain and no longer requires paracentesis. Our case suggests TIPS to be a safe and effective treatment option for CA in liver transplant patients with cirrhosis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228884/spontaneous-subcutaneous-emphysema-of-the-scalp-following-hair-coloring-treatment
#17
Sanjit O Tewari, Raihan M Faroqui, Nicholas Fuca, Mansoor Khan, Michael T Mantello
Subcutaneous emphysema of the scalp is a process often attributed to secondary factors such as trauma, infection, or a myriad of iatrogenic etiologies. Here, we are presenting a case report of an adult patient with spontaneous subcutaneous emphysema of the scalp following a hair coloring/treatment. We performed an extensive review of literature on this topic, however, could not find a single case with similar presentation of subcutaneous emphysema. This case demonstrates an unreported etiology for this diagnosis and is thus being reported for its uniqueness and to raise clinical awareness...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228875/traumatic-nonanastomotic-axilloprofundal-ptfe-bypass-rupture-a-case-report
#18
Borna K Barth, Fabian Hässler, Oliver Graubitz
A 76-year-old male patient was admitted to our emergency department with painful swelling of the right lateral chest after a fall. Imaging revealed a hematoma, secondary to rupture of a synthetic axilloprofundal bypass. In an emergency surgical procedure, the spelled hematoma was evacuated and the graft legs were successfully ligated. The patient was discharged after an uneventful hospital stay. Traumatic bypass rupture because of blunt trauma is an exceedingly rare event; however, it must be taken into consideration in a patient with bypass surgery in his/her history...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228789/long-term-outcome-of-grade-iii-and-iv-chondral-injuries-of-the-knee-treated-with-steadman-microfracture-technique
#19
Marco Pellegrino, Ermanno Trinchese, Michele Bisaccia, Giuseppe Rinonapoli, Luigi Meccariello, Gabriele Falzarano, Antonio Medici, Luigi Piscitelli, Pellegrino Ferrara, Auro Caraffa
INTRODUCTION: The aim of our study is to demonstrate the effectiveness of Steadman microfracture technique in the management of high-grade chondral defects at the level of the knee by clinical follow-ups at eleven years. MATERIALS AND METHODS: This is a study conducted on fifteen patients suffering from Outerbridge grade III and IV chondral lesions of the knee, who underwent Steadman microfracture surgery between 2003 and 2004. Selective exclusion criteria to prevent that other treatments or comorbidities could invalidate the results were used...
September 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/28228201/five-year-retrospective-review-of-blunt-renal-injuries-at-a-level-i-trauma-center
#20
Jessica Burns, Megan Brown, Zakaria I Assi, Eric J Ferguson
We report the experience of a Level I trauma center in the management of blunt renal injury during a 5-year period, with special attention to those treated using angiography with embolization. The institutional trauma registry was queried for all patients with blunt renal injury between September 1, 2009 and August 30, 2014. Each injury was graded using the American Association for the Surgery of Trauma guidelines. Patients that underwent angiography with embolization were reviewed for case-specific information including imaging findings, treatment, materials used, clinical course, and mortality...
February 1, 2017: American Surgeon
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