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https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#1
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29781944/early-comparative-outcomes-of-carbon-fiber-reinforced-polymer-plate-in-the-fixation-of-distal-femur-fractures
#2
Phillip M Mitchell, Adam K Lee, Cory A Collinge, Bruce H Ziran, Kate G Hartley, A Alex Jahangir
OBJECTIVE: To evaluate the early clinical results of distal femur fractures treated with carbon fiber reinforced - polyetheretherketone (CFR-PEEK) plates compared to stainless steel (SS) lateral locking plates. DESIGN: Retrospective comparative cohort study SETTING:: ACS Level I trauma center. PATIENTS/PARTICIPANTS: Twenty-two patients (11 SS, 11 CFR-PEEK) with closed distal femur fractures treated by a single surgeon over a 6-year period...
May 16, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29778596/anterior-vs-posterior-approach-for-thoracic-corpectomy-an-analysis-of-risk-factors-outcomes-and-complications
#3
Ryan G Chiu, Jonathan Hobbs, Darian R Esfahani, Saavan Patel, David Rosenberg, Clayton L Rosinski, Akash S Patel, Anisse N Chaker, Ankit I Mehta
BACKGROUND: Thoracic corpectomies are performed for various reasons including spinal deformity, trauma, neoplasms, and infection. Regardless of indication, both anterior and posterior approaches are surgical options, selected based on pathology, anatomy, patient characteristics, and surgical experience. Risk profiles and outcomes for these procedures are poorly characterized, however, and the choice between the two approaches remains inconclusive. OBJECTIVE: To compare risk factors and complications for adult patients undergoing anterior and posterior thoracic corpectomies...
May 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29778416/the-use-of-the-shock-index-as-a-predictor-of-active-bleeding-in-trauma-patients
#4
Andrea Campos-Serra, Sandra Montmany-Vioque, Pere Rebasa-Cladera, Heura Llaquet-Bayo, Raquel Gràcia-Roman, Anna Colom-Gordillo, Salvador Navarro-Soto
INTRODUCTION: Vital signs indicate the presence of bleeding only after large amounts of blood have been lost, with high morbidity and mortality. The Shock Index (SI) is a hemorrhage indicator with a cut-off point for the risk of bleeding at 0.9. The aim of this study is to assess whether a cut-off of≥0.8 is more sensitive for detecting occult bleeding, providing for early initiation of therapeutic maneuvers. METHODS: SI analytical validation study of severe trauma patients older than 16 years of age...
May 16, 2018: Cirugía Española
https://www.readbyqxmd.com/read/29766143/when-should-screening-of-pediatric-trauma-patients-for-adult-behaviors-start
#5
Adrian A Maung, Robert D Becher, Kevin M Schuster, Kimberly A Davis
Background: Care of patients with trauma is not only limited to the sustained physical injuries but also requires addressing social issues, such as substance abuse and interpersonal violence, which are responsible for trauma-related recidivism. This study investigates whether there are age-related variations in these problematic social behaviors to analyze whether there is an age cut-off at which point adolescents should be screened for adult social behaviors. Methods: Retrospective review of patients with trauma aged 12-21 admitted to an urban Level 1 adult and pediatric trauma center between February 2013 and April 2016...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29766128/a-multi-decade-joinpoint-analysis-of-firearm-injury-severity
#6
Bindu Kalesan, Yi Zuo, Ziming Xuan, Michael B Siegel, Jeffrey Fagan, Charles Branas, Sandro Galea
Background: Non-fatal firearm injuries constitute approximately 70% of all firearm trauma injuries in the United States. Patterns of severity of these injuries are poorly understood. We analyzed the overall, age-, sex- and intent-specific temporal trends in the injury severity of firearm hospitalizations from 1993 to 2014. Methods: We assessed temporal trends in the severity of patients hospitalized for firearm using Nationwide Inpatient Sample (NIS) data over a 22 year period...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29765245/the-epidemiology-of-outpatient-pain-treatment-in-pediatrics
#7
Stacy Baldridge, Laura Wallace, Aditi Kadakia
Background: There is limited real-world, population-level data on the prevalence and treatment of pain in children. An understanding of pediatric pain conditions and its management can help inform provider education, treatment guidelines, and design of pediatric pain studies. Therefore, in this study, we aimed to describe the prevalence of conditions associated with acute and chronic pain in pediatric patients and to characterize pediatric pain treatment with nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, opioids (immediate release or extended release), antidepressants, topical analgesics, anticonvulsants, and other therapies based on a large, real-world sample...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29763252/charcot-foot-clinical-clues-diagnostic-strategies-and-treatment-principles
#8
Valerie S Marmolejo, Jonathan F Arnold, Mario Ponticello, Charles A Anderson
Acute Charcot neuroarthropathy of the foot and ankle is often difficult to diagnose because of limited findings in the patient history, physical examination, imaging, and laboratory studies. Delay in treatment results in the development of rigid foot and ankle deformities, increasing the risk of ulceration, infection, and major lower extremity amputation. Acute Charcot neuroarthropathy should be suspected in any patient 40 years or older with obesity and peripheral neuropathy who presents with an acutely swollen foot following minimal or no recalled trauma and who reports minimal to no pain, particularly if radiography and laboratory markers of infection are normal...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29760965/age-and-other-risk-factors-influencing-long-term-mortality-in-patients-with-traumatic-cervical-spine-fracture
#9
Matthew Bank, Katie Gibbs, Cristina Sison, Nawshin Kutub, Angelos Paptheodorou, Samuel Lee, Adam Stein, Ona Bloom
Objective: To identify clinical or demographic variables that influence long-term mortality, as well as in-hospital mortality, with a particular focus on the effects of age. Summary and Background Data: Cervical spine fractures with or without spinal cord injury (SCI) disproportionately impact the elderly who constitute an increasing percentage of the US population. Methods: We analyzed data collected for 10 years at a state-designated level I trauma center to identify variables that influenced in-hospital and long-term mortality among elderly patients with traumatic cervical spine fracture with or without SCI...
2018: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29751092/overdosing-of-benzodiazepines-z-drugs-and-falls-in-older-adults-costs-for-the-health-system
#10
María José Díaz-Gutiérrez, Mónica Martínez Cengotitabengoa, Cristina Bermúdez-Ampudia, Sainza García, Purificación López, Mayte Martínez-Cengotitabengoa, Ana González-Pinto
INTRODUCTION: Benzodiazepines and Z drugs (BZD/Z drugs) are commonly used for the treatment of insomnia and anxiety in older adults for long periods of time. Given the physiological and metabolic characteristics of this group of patients, they are more prone to the adverse effects of these drugs which include falls. The recommendations for use of BZD/Z drugs include the need to adjust the dose and select those with a short half-life, to avoid adverse events, which as well as potentially affecting patient outcome, increase healthcare costs...
May 8, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29747958/emergency-department-intubation-success-with-succinylcholine-versus-rocuronium-a-national-emergency-airway-registry-study
#11
Michael D April, Allyson Arana, Daniel J Pallin, Steven G Schauer, Andrea Fantegrossi, Jessie Fernandez, Joseph K Maddry, Shane M Summers, Mark A Antonacci, Calvin A Brown
STUDY OBJECTIVE: Although both succinylcholine and rocuronium are used to facilitate emergency department (ED) rapid sequence intubation, the difference in intubation success rate between them is unknown. We compare first-pass intubation success between ED rapid sequence intubation facilitated by succinylcholine versus rocuronium. METHODS: We analyzed prospectively collected data from the National Emergency Airway Registry, a multicenter registry collecting data on all intubations performed in 22 EDs...
May 7, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29746363/lower-extremity-fractures-in-hospitalized-pediatric-patients-following-road-traffic-accidents
#12
Shay Tenenbaum, Jason T Bariteau, Ofir Chechik, Adi Givon, Kobi Peleg, Ran Thein
Lower extremity fractures (LEFs) caused by road traffic accidents (RTAs) can result in significant morbidity and account for a substantial part of nonfatal injuries requiring hospitalization. This study investigated the epidemiology of RTA-associated LEFs in the pediatric population. Based on the National Trauma Registry, data of 28,924 RTA hospitalized pediatric patients were reviewed. Data were analyzed according to LEF mechanism of injury, age distribution, fracture types, associated injuries, surgical treatment, and their interrelations...
May 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29742634/successful-implementation-of-an-alcohol-screening-brief-intervention-and-referral-to-treatment-program
#13
Eric Zimmermann, Jason M Sample, Mary Ellen Zimmermann, Francesca Sullivan, Sarah Stankiewicz, Pierre Saldinger
Devastating effects of alcohol are well established in trauma. To address this, thve American College of Surgeons Committee on Trauma (ACS-COT) requires ACS-verified Level 1 trauma centers to have an active screening, brief intervention, and referral to treatment (SBIRT) program. In 2015, NewYork-Presbyterian/Queens successfully implemented an SBIRT program. Previous studies indicate difficulty in achieving a high level of SBIRT compliance. We explored the effects of a multidisciplinary approach in implementing a standardized screening protocol for every trauma-activated patient 15 years or older...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742630/perceived-changes-in-quality-of-life-in-trauma-patients-a-focus-group-study
#14
Nena Kruithof, Marjan Johanna Traa, Maria Karabatzakis, Suzanne Polinder, Jolanda de Vries, Mariska Adriana Cornelia de Jongh
Quality of life (QoL) following a physical trauma is still insufficiently known from a patient perspective. The aim of this study was to qualitatively report perceived changes in QoL after trauma. Focus groups were conducted. Patients admitted to the hospital were eligible for inclusion if they had a lower extremity trauma, severe injuries, or severe traumatic brain injury (TBI). Patients 75 years or older were invited. To analyze the perceived changes in QoL, open coding was used. Patients (n = 20, M = 55 years) reported comparable consequences...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29742628/evaluation-of-dwell-time-for-peripheral-intravenous-catheters-started-in-the-field-for-geriatric-blunt-trauma-patients
#15
Darcy L Day, Francisco Conde
Replacement time for peripheral intravenous (PIV) catheters started in the field is unclear. The purpose of this study was to compare field-start PIV catheter dwell time of 2 days or less versus field-start PIV catheter dwell time of more than 2 days for the development of indicators of infection for geriatric blunt trauma patients. A retrospective case series was conducted at the state-designated trauma referral center. Activated trauma team patients with blunt injury were included if 65 years or older and if admitted from the field for 7 days or more with a PIV catheter placed prehospital...
May 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29739286/sixfold-post-fracture-mortality-in-16-to-30-year-old-patients-suicides-homicides-and-intoxications-among-leading-causes-of-death
#16
A Somersalo, J Paloneva, E Lönnroos, M Heinänen, H Koponen, I Kiviranta
BACKGROUND AND AIMS: The death of any young individual is associated with the loss of many potentially fulfilling years of life. It has been suggested that the relative mortality of fracture patients may be higher in younger age groups than in older cohorts. We determined the mortality and causes of death in a cohort of 16- to 30-year-old patients that had been hospitalized for fractures. MATERIAL AND METHODS: We collected data using criteria based on the diagnosis code (International Statistical Classification of Diseases and Related Health Problems, 10th Revision), surgical procedure code (Nordic Medico-Statistical Committee), and seven additional characteristics of patients admitted to the trauma ward at the Central Finland Hospital between 2002 and 2008...
May 1, 2018: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/29738400/using-a-validated-middle-age-and-geriatric-risk-tool-to-identify-early-48hr-hospital-mortality-and-associated-cost-of-care
#17
Ariana Lott, Jack Haglin, Hesham Saleh, Jordan Hall, Kenneth A Egol, Sanjit R Konda
OBJECTIVES: 1) Demonstrate that a validated trauma triage score for middle-aged and geriatric patients could identify those at high risk for mortality within the first two days of hospitalization and 2) determine the cost of care for this cohort of patients DESIGN:: Prospective cohort study SETTING:: Single Level 1 Trauma Center PATIENTS:: Patients 55 years and older who were evaluated in the emergency department setting by Orthopaedics or who met American College of Surgeons Tier 1-3 criteria INTERVENTION:: Calculation of validated trauma triage score, Score for Trauma Triage in Geriatric and Middle Aged (STTGMA), using patient's demographic, injury severity, and functional statusMain Outcome Measurements: length of stay, inpatient mortality, time between presentation and time of death, and direct variable costs of hospitalization RESULTS:: A total of 1470 consecutive patients (mean age of 72...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29735284/music-intervention-to-prevent-delirium-among-older-patients-admitted-to-a-trauma-intensive-care-unit-and-a-trauma-orthopaedic-unit
#18
Kari Johnson, Julie Fleury, Darya McClain
PURPOSE: Evaluate music listening for delirium prevention among patients admitted to a Trauma Intensive Care and Trauma Orthopaedic Unit. The Roy Adaptation Model provided the theoretical framework focusing on modifying contextual stimuli. METHODS: Randomised controlled trial, 40 patients aged 55 and older. INTERVENTION: Participants randomly assigned to receive music listening or usual care for 60 minutes, twice a day, over three days. Pre-recorded self-selected music using an iPod and headsets, with slow tempo, low pitch and simple repetitive rhythms to alter physiologic responses...
May 4, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29730987/stigma-associated-with-medication-treatment-for-young-adults-with-opioid-use-disorder-a-case-series
#19
Scott E Hadland, Tae Woo Park, Sarah M Bagley
BACKGROUND: Opioid-related overdose deaths have risen sharply among young adults. Despite this increase, access to evidence-based medication for opioid agonist treatment (OAT) for youth remains low. Among older adults, barriers to OAT include the paucity of buprenorphine-waivered prescribers and low rates of prescribing among waivered physicians. We have increasingly found in our clinical practice significant stigma related to using OAT to treat addiction for young adults. In this series, we describe three cases of young adults who faced significant stigma related to their treatment...
May 7, 2018: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/29728285/comparison-of-bedside-screening-methods-for-frailty-assessment-in-older-adult-trauma-patients-in-the-emergency-department
#20
Sachita P Shah, Kevin Penn, Stephen J Kaplan, Michael Vrablik, Karl Jablonowski, Tam N Pham, May J Reed
BACKGROUND: Frailty is linked to poor outcomes in older patients. We prospectively compared the utility of the picture-based Clinical Frailty Scale (CFS9), clinical assessments, and ultrasound muscle measurements against the reference FRAIL scale in older adult trauma patients in the emergency department (ED). METHODS: We recruited a convenience sample of adults 65 yrs. or older with blunt trauma and injury severity scores <9. We queried subjects (or surrogates) on the FRAIL scale, and compared this to: physician-based and subject/surrogate-based CFS9; mid-upper arm circumference (MUAC) and grip strength; and ultrasound (US) measures of muscle thickness (limbs and abdominal wall)...
April 14, 2018: American Journal of Emergency Medicine
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