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Trauma patient

J Ming, P Lei, J L Duan, J H Tan, H P Lou, D Y Di, D Y Wang
Airway edema, stenosis, obstruction and even asphyxia are easy to occur in patients with extensive burn, deep burn of head, face, and neck area, inhalation injuries, etc., which threaten life. Timely tracheotomy and intubation is an important treatment measure, but lack of knowledge and improper handling in some hospitals resulted in airway obstruction. The technique of percutaneous tracheotomy and intubation provides convenience for emergency treatment of critical burns and mass burn. The Chinese Geriatrics Society organized some experts in China to discuss the indications, timing, methods, extubation, and precautions of tracheotomy and intubation for burn patients...
November 9, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
W Y Zhang, W Y Wang
As a newly developed technique for hemodynamic monitoring, pulse contour cardiac output (PiCCO) monitoring takes great advantages in guiding shock resuscitation and fluid administration. PiCCO has been used more and more in burn patients in recent years, however there is no clinic consensus on how to apply PiCCO monitoring, understand the significance of PiCCO monitored parameters, and guide the treatment using PiCCO monitored parameters in patients with severe burns. Based on the current literatures and the experts' clinical experience, national experts consensus on application of pulse contour cardiac output monitoring technique in severe burn treatment (2018 version ) is now issued by the Burn and Trauma Branch of Chinese Geriatrics Society, aiming to provide practical guidance for its usage in clinic...
November 9, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
F Guo, Y S Zhu, J Huang, Y H Wu, Z F Sun, X B Xia, X B Fu
Inhalation injury is caused by inhalation of heat, toxic or irritating gases which lead to respiratory and pulmonary parenchyma damage. At present, the clinical understanding about it is still limited and lack of effective diagnosis and treatment standard. Based on the experience of diagnosis and treatment of domestic inhalation injury, combined with reports of international researches, criteria (expert consensus) for inhalation injury were systematically discussed from pathological and pathophysiological changes, clinical diagnosis and evaluation, and clinical treatment, which provides reference for clinical diagnosis and treatment of patients inflicted with inhalation injury...
November 9, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
G Z Lyu
Collagen, as the main structural protein in human body, plays an important role in the wound healing process. Due to their inherent hemostatic characteristics, good biocompatibility, low immunogenicity, as well as controllable biodegradability, collagen-based materials have attracted much attention. In this article, we mainly introduce the characteristics of collagen-based wound biomaterials and the application mechanism as scaffold and wound dressing. And the standard and unified experts' consensus formed on the clinical indications, recommended applications, contraindications, and matters needing attention...
November 9, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Loren K Liebrecht, Jason Newton, Erika J Martin, Nina Wickramaratne, Sudha Jayaraman, Jinfeng Han, Michel Aboutanos, Donald F Brophy, Martin J Mangino
BACKGROUND: Low volume resuscitation (LVR) in shock prevents deleterious effects of crystalloid loading in pre-hospital settings. Polyethylene glycol 20,000 (PEG-20k) based LVR solutions are 20-fold more effective at maintaining perfusion and survival in shock compared to conventional crystalloids. The aim of this study was to determine coagulation and platelet function of whole blood treated with 10% PEG-20k. METHODS: Citrated blood from volunteers (n = 25) or early admission severely injured trauma patients (n = 9) were diluted 10% with various LVR solutions in a matched design with a paired volume control (saline), and studied using thromboelastography (TEG)...
2018: PloS One
Mildred Ngaage, Mark Agius
Scars can result from a range of causes: accidents, surgery, and even acne. The resultant change in appearance can negatively affect body image and self-confidence. Scarring is stigmatised in society because of the premium placed on beauty - disfigurement or unsightly features are still used to portray evil in horror films, comic strips, and fairy tales. Patients describe scars as living with the trauma and sufferers can feel devalued by society. Scars are inflexible and cause functional impairment which may prompt a change in career and have financial repercussions...
November 2018: Psychiatria Danubina
Shentong Wang, Amelia Oldfield
Music therapy and attachment is an expanding field and the number of studies addressing the theoretical work is slowly growing. There are both qualitative and quantitative approaches to studying the effect of regular music therapy sessions on parent-child interactions and these cover a range of patient populations including: children at risk of neglect, parents with a trauma history, children coping with bereavement and a large number addressing the disability population, including autism spectrum disorder...
November 2018: Psychiatria Danubina
Denis Jacques, Aurélie Maricq, Thomas Dubois, Brice Lepiece, Nicolas Zdanowicz, Etienne Delgrange
BACKGROUND: Denial of pregnancy is an issue that is often discovered a posteriori with sometimes dramatic complications. Denial of pregnancy is considered partial when the woman becomes aware of the pregnancy after the fifth month before delivery. The populations studied were heterogeneous, which made it impossible to establish a standard algorithm of the treatment and support of a discovery of partial denial of pregnancy. SUBJECTS AND METHODS: Based on a literature review and a discussion of partial denial of pregnancy case and the consequential treatment with a five-year follow-up, the global management recommendations need consideration in the case of partial denial of pregnancy...
November 2018: Psychiatria Danubina
Nate Milburn, Lori Yap, Gargi Raval
Heterotrophic ossification (HO) is a well-described phenomenon in patients with spinal cord injury, head injury, burns, hip replacement, and general trauma. However, it has also been described through a relative paucity of case reports that repeated microtrauma from the use of weight-bearing leg prostheses is an additional possible cause of HO. In our case, we examine a patient who developed an extreme case of HO after he began an exercise regimen with assistance from a running limb. This abnormal formation was actually advantageous because it created a more snug fit of the prosthetic device and improved the patient's ability to run...
November 14, 2018: Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine
Sang Min Lee, Jin-A Baek, Yongsoo Kim
PURPOSE: Extra-articular temporomandibular bony ankylosis between the zygomatic bone and coronoid process is a rare condition. Currently, there are fewer than 40 cases reported in the English-language literature. The aim of this study was to report a case of zygomatico-coronoid ankylosis with surgical intervention and a literature review. MATERIALS AND METHODS: Through a PubMed search from 1946 to February 2018, using the terms ("extra-capsular" OR "zygomatico-coronoid" OR "extra-articular") AND ("ankylosis"), 61 articles were initially identified...
October 18, 2018: Journal of Oral and Maxillofacial Surgery
Xingjie Li, Jing Yu, Wenjuan Huang, Qi Huang, Jun Yan, Huaping Liang, Yu Sun
OBJECTIVE: To investigate the risk factors of acute respiratory distress syndrome (ARDS) occurrence in intensive care unit (ICU) traumatic patients. METHODS: Clinical data of traumatic patients in ICU of the People's Hospital of Liangping in Chongqing from January 1st, 2012 to June 30th, 2018 were retrospectively analyzed. According to the outcomes, the patients were divided into ARDS group and non-ARDS group. The differences of demographic indexes (gender, age), time of admission, type of injury, atrial fibrillation, trachea cannula, multiple injury, open injury, shock, surgery, blood transfusion, central venous indwelling catheter, infection, and blood routine indexes [white blood cell count (WBC), red blood cell count (RBC), platelet count (PLT), plateletcytocrit (PCT), hematocrit (Hct)], biochemical indexes [total bilirubin (TBil), albumin (Alb), serum creatinine (SCr), blood sodium, blood calcium, blood potassium, blood glucose], arterial blood gas analysis indexes [partial pressure of carbon dioxide (PaCO2 ), partial pressure of oxygen (PaO2 ), oxygenation index (PaO2 /FiO2 ), blood pH], coagulation indicators [activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), international normalized ratio (INR), fibrinogen (Fib)], injury severity score (ISS), new injury severity score (NISS), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA), Glasgow coma scale (GCS) within 24 hours of admission, and the length of ICU stay between the two groups were analyzed, and the possible influencing factors were screened out...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Lijuan Wang, Lanju Zhao, Xiaojuan Yang, Xigang Ma
OBJECTIVE: To evaluate the difference and correlation of 24-hour energy expenditure in patients with multiple trauma receiving mechanical ventilation predicted by indirect calorimetry (IC) and HB formula. METHODS: 140 patients with multiple trauma receiving mechanical ventilation admitted to intensive care unit (ICU) of the General Hospital of Ningxia Medical University from December 1st, 2016 to August 31st, 2017 were enrolled. The 24-hour energy expenditure of patients was repeatedly measured at 1, 3, 5, and 7 days after ICU admission by IC method, and the 24-hour energy expenditure measured by IC method was used as the "gold standard" to calculate the 24-hour kilogram body weight energy expenditure...
October 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
Michael Caspers, Marc Maegele, Matthias Fröhlich
Despite advances in the treatment of severely injured patients that have resulted in overall improved outcomes, uncontrolled hemorrhage still represents the most common cause of preventable death following major injury. While addressing both endo- and exogenous factors that lead to an acute trauma-induced coagulopathy, massive transfusion plays a key role in managing bleeding trauma patients. However, the best practice for hemostatic control including massive transfusion in these patients is still under debate...
November 15, 2018: Expert Review of Hematology
Kyoung Hoon Lim, Jinyoung Park
RATIONALE: Blunt injury of major visceral arteries such as celiac artery (CA) and superior mesenteric artery (SMA) are very rare but fatal, therefore, these injuries are challenging to trauma surgeons. The patient with occlusion of CA or SMA is theoretically viable by visceral collateral circulation. However, there are very rare cases in clinics. To date, there have been few reports of both CA and SMA occlusions after blunt trauma. Herein we describe our successful conservative treatment of patients with both CA and SMA occlusions...
November 2018: Medicine (Baltimore)
Pin-Han Wang, Kuan-Ting Liu, Yen-Hung Wu, I-Jeng Yeh
RATIONALE: Thyrotoxic periodic paralysis is characterized by a sudden onset of hypokalemia and paralysis. This condition mainly affects the lower extremities and is secondary to thyrotoxicosis. The underlying hyperthyroidism is often subtle without typical symptoms such as palpitations, tremors, anxiety, and weight loss; this causes a difficulty in early diagnosis. Here, we reported a case of periodic paralysis in a patient with hyperthyroidism whose potassium level was within the normal range...
November 2018: Medicine (Baltimore)
Avraham Yitzhak, Ofer Merin, Jonathan Halevy, Bader Tarif
The 7.8 MW (moment magnitude scale) earthquake that hit Nepal on April 25, 2015 caused significant casualties and serious damage to infrastructure.The Israeli Emergency Medical Team (IEMT; later verified as EMT-3) was deployed 80 hours after the earthquake. A Forward Disaster Scout Team (FDST) that was dispatched to the disaster area a few hours after the disaster relayed pre-deployment information.The EMT staff was comprised of 42 physicians. A total of 1,668 patients were treated. The number of non-trauma cases increased as the days went by...
November 15, 2018: Prehospital and Disaster Medicine
Chutima Roomruangwong, Denitsa S Simeonova, Drozdstoy S Stoyanov, George Anderson, Andre Carvalho, Michael Maes
Generalized anxiety disorder (GAD) commonly co-occurs with mood disorders, especially major depressive disorder (MDD) and bipolar disorder (BD), which are accompanied by activated neuro-immune and neuro-oxidative pathways. The aim of this narrative review is to review the phenomenological similarities and dissimilarities and the shared pathways between GAD and mood disorders. We searched PubMed, Scopus, and Google Scholar for articles published in English from 1980 to present. GAD and mood disorders, either MDD or BD, show some phenomenological overlaps and a high degree of comorbidity, especially between GAD and MDD...
November 14, 2018: Current Topics in Medicinal Chemistry
Kaouther Dimassi, Anissa Ben Amor, Ahmed Halouani, Nadida Dali, Leila Ben Farhat, Amel Triki
Uterine arteriovenous malformation (UAVM) is uncommon. They are usually acquired, due to previous intra uterine trauma. We report a case of acquired UAVM in a 28-years-old patient after a medical abortion, diagnosed with ultrasonography and successfully managed with uterine artery embolization.
July 2018: La Tunisie Médicale
Rachel M Nygaard, Ashley P Marek
BACKGROUND: Our aim was to examine the US trauma population before and after the Affordable Care Act (ACA), specifically examining racial disparities in insurance status as well as access to post-hospitalization care in the trauma population. MATERIALS AND METHODS: The National Trauma Data Bank was queried for all non-burn patients age 18 to 64. The patient data was grouped into pre-ACA (2012-2013) and post-ACA (2014-2015). Regression analysis was controlled for age, sex, race (when applicable), type of injury (blunt vs penetrating), ISS, shock, head injury, and mechanical ventilation and clustered by hospital...
November 14, 2018: Journal of Racial and Ethnic Health Disparities
Samuel Marinus Verhage, Pieta Krijnen, Inger Birgitta Schipper, Jochem Maarten Hoogendoorn
BACKGROUND: Traditionally, size of the posterior fragment is considered the most important indicator for fixation in trimalleolar fractures. It remains unclear which factors contribute to worse functional and radiological outcome. This study was designed to determine predictors for the development of posttraumatic osteoarthritis and worse functional outcome in trimalleolar fractures. METHODS: This retrospective cohort study evaluated outcomes of 169 patients with a trimalleolar fracture treated between 1996 and 2013 in a level-1 trauma hospital in the Netherlands after a mean follow-up of 6...
November 14, 2018: Archives of Orthopaedic and Trauma Surgery
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