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Trauma patient

Bogdan Andrei Suciu, Ioana Halmaciu, Vasile Bud, Decebal Fodor, Vlad Vunvule, Klara Brinzaniuc, Constantin Copotoiu, Calin Molnar
The tracheo-oesophageal fistula is a severe condition endangering the patients' live. The main cause of this condition is the prolonged ventilation. The purpose of this paper is to present an innovative technique in treating this affection. CASE REPORT: We present the case of a 32 years old female patient with multiple trauma due to traffic accident. The patient was hospitalized with the diagnosis of brain injury, subarachnoid hemorrhage, and fractured femur. After 11 days of mechanical ventilation and intubation via endotracheal route, the patient was diagnosed with a large (7x3 cm) tracheo-oesophageal fistula with dilaceration of the membranous wall of the trachea...
July 10, 2018: Annali Italiani di Chirurgia
O Uleberg, K Pape, T Kristiansen, P R Romundstad, P Klepstad
BACKGROUND: Functional outcome measures are important as most patients survive trauma. The aim of this study was to describe the long-term impact of trauma within a healthcare region from a social perspective. METHODS: People active in work or education and admitted to hospitals in Central Norway in the interval 1 June 2007 to 31 May 2010 after sustaining trauma were included in the study. Clinical data were linked to Norwegian national registers of cause of death, sickness and disability benefits, employment and education...
September 17, 2018: British Journal of Surgery
Kemal Tolga Saracoglu, Ali Demir, Gokhan Pehlivan, Ayten Saracoglu, Zeynep Eti
BACKGROUND: Ease and speed of insertion, reduced trauma incidence, integral bite block, gastric access, non-inflatable cuff and superior seal pressure are the advantages of I-gel. The primary goal of this study was to compare airway leak pressures and fiberoptic view in supine and lateral positions. Our secondary aim was to analyze the effects of I-gel insertion on hemodynamic parameters. METHODS: One hundred patients undergoing saturation biopsy due to prostatic hyperplasia were recruited in this prospective randomized study...
September 17, 2018: Anaesthesiology Intensive Therapy
Marian Rikkert, Yanda van Rood, Carlijn de Roos, Julia Ratter, Marcel van den Hout
Background: While normal tinnitus is a short-term sensation of limited duration, in 10-15% of the general population it develops into a chronic condition. For 3-6% it seriously interferes with many aspects of life. Objective: The aim of this trial was to assess effectiveness of a trauma-focused approach, eye movement desensitization and reprocessing (EMDR), in reducing tinnitus distress. Methods: The sample consisted of 35 adults with high levels of chronic tinnitus distress from five general hospitals in the Netherlands...
2018: European Journal of Psychotraumatology
Florian Dussing, Fabian Plachel, Teresa Grossauer, Thomas Hoffelner, Eva Schulz, Arvind von Keudell, Alexander Auffarth, Philipp Moroder
Background: Recurrence rates after primary traumatic shoulder dislocation are distinctly high. We hypothesized that concomitant isolated fractures of the greater tuberosity are associated with low rates of persistent instability but decreased range of motion. Methods: Between 2007 and 2013, 66 consecutive shoulders in 64 patients were treated for primary shoulder dislocation combined with an isolated fracture of the greater tuberosity with either a nonsurgical (48 shoulders, 72...
2018: Obere Extremität
Jessica van Trigt, Niels Schep, Rolf Peters, Carel Goslings, Tim Schepers, Jens Halm
INTRODUCTION: There is no consensus on how pelvic X-rays should be ordered selectively in blunt trauma patients which may save time, reduce radiation exposure and costs. The aim of this systematic review and meta-analysis was to assess the need for routine pelvic X-rays in awake, respiratory and hemodynamically (HD) stable blunt trauma patients without signs of pelvic fracture. Criteria to identify patients who could safely forgo pelvic X-ray were evaluated. METHODS: A literature search was performed for prospective comparative cohort studies...
September 6, 2018: Injury
David Wennergren, Carl Bergdahl, Jan Ekelund, Hans Juto, Mikael Sundfeldt, Michael Möller
INTRODUCTION: There is a lack of epidemiological studies of fractures in all segments of the tibia classified by orthopaedic surgeons according to the AO/OTA classification. Since 2011, the Swedish Fracture Register (SFR) has provided prospectively collected, population-based data on fractures of all types, treated both surgically and non-surgically. The aim of this study was to describe the epidemiology and incidence of fractures in all segments of the tibia in a cohort of consecutive tibia fractures over a period of five years at Sahlgrenska University Hospital, Gothenburg, Sweden...
September 7, 2018: Injury
M Kärkkäinen, T Wilkman, K Mesimäki, J Snäll
Preoperative virtual planning and the use of patient-specific implants enable exact reconstruction of orbital fractures. We present our results and experience of reconstruction of isolated orbital fractures with patient-specific implants, according to the Helsinki protocol, in 15 patients who were followed up for at least three months postoperatively. The mean (range) difference between the positions of virtually planned, and postoperative, implants was 1.9 (0.5-5.6) mm. The postoperative volume of the fractured orbit was 1...
September 13, 2018: British Journal of Oral & Maxillofacial Surgery
A Haapanen, H Thorén, S Apajalahti, A L Suominen, J Snäll
Our aims were to document the occurrence of neurosensory disturbances of the infraorbital nerve six months after operation for an orbital blow-out fracture, and to find out whether dexamethasone facilitates neurosensory regeneration. Patients were randomly assigned to one of two groups: the study group was given a total of dexamethasone 30mg, whereas the control group were given neither glucocorticoid nor placebo. Each patient's infraorbital neurosensory state was recorded preoperatively, immediately postoperatively, and six months later...
September 13, 2018: British Journal of Oral & Maxillofacial Surgery
Phuong D Nguyen, David Y Khechoyan, John H Phillips, Christopher R Forrest
BACKGROUND: CAD-CAM patient-specific implants offer cerebral protection and improved facial balance without the disadvantages of autologous bone grafting such as donor site morbidity and unpredictable resorption. Several alloplastic materials are available, but titanium, polymethylmethacrylate (PMMA), and polyetheretherketone (PEEK) are the current popular choices. We reviewed our experience of applying different alloplastic CAD-CAM materials in the reconstruction of complex pediatric craniofacial deformities...
August 2, 2018: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Xu Liu, Ying Liu, Qilong He, Yumei Cheng, Yaya Chen, Lunsheng Jiang, Jing Jiang, Demeng Yang, Zhongyi Zhan, Difen Wang
OBJECTIVE: To understand the situations of departments of intensive care units (ICUs) of different level hospitals in Guizhou Province, and to provide directions and evidences for improving quality control in critical care medicine. METHODS: A county-level hospital and a provincial-level hospital's comprehensive ICU in Guizhou Province were selected to record and analyze and compare the structural indicators, patient admission and transfer, disease distribution, ventilator associated pneumonia (VAP), intravascular catheter related blood stream infection (CRBSI) and catheter-associated urinary tract infection (CAUTI) of the two hospitals' comprehensive ICU in 2017...
August 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Tze Phei Kee, Raphael Shih Zhu Yin, Tien Jin Tan, Chin Kong Goh
CT head has been increasingly performed in the Emergency Department for patients presented with trauma, acute neurological or psychological symptoms. Most of the emergency physicians and radiologists have undergone dedicated training and are capable of identifying and interpreting life-threatening cerebral pathologies. However, as most attention is directed to the brain, the extracerebral non-traumatic pathologies on CT head can easily be overlooked, and some of them harbour clinically significant pathologies...
September 15, 2018: Emergency Radiology
Jakob Emanuel Brune, Denis Laurent Kaech, Daniel Wyler, Raphael Jeker
We present a case of a young male patient with a fatal pulmonary air embolism following a penetrating gunshot head injury. He suffered from severe head trauma including a laceration of the superior sagittal sinus. Operative neurosurgical intervention did not establish a watertight closure of the wounds. Eight days after the trauma, the patient suddenly collapsed and died after an attempt to mobilise him to the vertical. Forensic autopsy indicated pulmonary air embolism as the cause of death. Retrospectively, we postulate an entry of air to the venous system via the incompletely occluded wounds and the lacerated superior sagittal sinus while mobilisation to the vertical created a negative pressure in the dural sinus...
September 15, 2018: BMJ Case Reports
Mu Qiao, Bang-Ping Qian, Yong Qiu, Sai-Hu Mao, Yi-Hua Wang
OBJECTIVE: To investigate the pathogenesis of pseudarthrosis in ankylosing spondylitis (AS) based on the pathological analysis of specimens harvested during surgery. METHODS: Radiographic and clinical data for 17 consecutive AS patients with pseudarthrosis were retrospectively analyzed. Meanwhile, the pathological analysis of specimens obtained during surgery was also performed. RESULTS: In total, 18 extensive Andersson lesions were included...
September 15, 2018: Journal of Rheumatology
Jody A Vogel, W Gannon Sungar, Dowin Boatright, Jordan Ryan, Benjamin Murphy, Jesse Loar, Sabrina Adams, Jason S Haukoos
BACKGROUND: Early identification of trauma patients who need specialized healthcare resources may facilitate goal-directed resuscitation and effective secondary triage. OBJECTIVE: To estimate associations between Denver Emergency Department (ED) Trauma Organ Failure (TOF) Score and healthcare resource utilization. METHODS: Retrospective study of adult trauma patients at Denver Health Medical Center. The outcome was resource utilization including: intensive care unit (ICU) length of stay (LOS), hospital LOS, procedures, and costs...
August 30, 2018: American Journal of Emergency Medicine
Anna E Sharrock, Kyle N Remick, Mark J Midwinter, Rory F Rickard
BACKGROUND: Haemorrhage is the leading cause of death on the battlefield. Seventy percent of injuries are due to explosive mechanisms. Anecdotally, these patients have had poorer outcomes when compared to those with penetrating mechanisms of injury (MOI). We wished to test the hypothesis that outcomes following vascular reconstruction were worse in blast-injured than non blast-injured patients. METHODS: Retrospective cohort study. British and American combat casualties with arterial injuries sustained in Iraq or Afghanistan (2003-2014) were identified from the UK Joint Theatre Trauma Registry (JTTR)...
September 1, 2018: Injury
John D Koerner, Melissa Blatt, Tania Zielonka, Jyoti Sharma, Sanjeev Kaul
No abstract text is available yet for this article.
June 1, 2018: American Surgeon
Nasser M Aldossary, Mamdouh Ali Kotb, Ahmed M Kamal
BACKGROUND: Traumatic brain injury (TBI) is the major public health problem worldwide, particularly in the Middle East. Diffuse axonal injury (DAI) is commonly found in TBI. Although DAI can lead to physical and psychosocial disabilities, its prognostic value is still a matter of debate. Magnetic Resonance (MR) is more sensitive for detecting DAI lesions. OBJECTIVE: To identify the radiological and clinical factors associated with the functional capacity one year after the traumatic brain injury...
September 5, 2018: Journal of Affective Disorders
Anastasia Plotkin, Matthew G Bartley, Kathryn E Bowser, Jeniann A Yi, Gregory A Magee
The search for etiology of stroke in a young patient may present a diagnostic challenge. In rare cases, chronic trauma to the carotid artery may be the cause of cerebral thromboembolic events. The hyoid bone lies in close proximity to the carotid artery bifurcation, and anatomic variants have been implicated in carotid compression, stenosis, dissection, and pseudoaneurysm. We report a case of recurrent strokes in a 32 year-old woman due to an elongated hyoid bone causing thrombus formation in her right internal carotid artery (ICA) resulting in recurrent embolic strokes confirmed on diffusion-weighted magnetic resonance imaging (MRI)...
September 12, 2018: Annals of Vascular Surgery
Jinlong Shi, Jian Chen, TengFei Chen, Xide Xu, Zhongzheng Jia, Lanchun Ni, Yu Zhang, Shi Wei
BACKGROUND: Both the pterygopalatine fossa (PPF) and the infratemporal fossa (ITF) lie outside the midline of the skull base. Lesions in the PPF or ITF include trigeminal schwannoma (trigeminal schwannoma, TS), which originates from the second or third branch of the trigeminal nerve (maxillary nerve or mandibular nerve). Due to their typically deep anatomical location, lesions in the PPF or ITF can be difficult to treat using traditional surgical approaches. In recent years, because of their advantages, which include the fact that they allow the problem to be observed close up, neuroendoscopic techniques are increasingly being applied in skull base surgery, especially in treatment of lesions around the midline of the base of the skull...
September 12, 2018: World Neurosurgery
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