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https://www.readbyqxmd.com/read/29346229/anatomical-variations-of-the-vertebral-artery-in-the-upper-cervical-spine-clinical-relevance-for-procedures-targeting-the-c1-c2-and-c2-c3-joints
#1
Maria Francisca Elgueta, Johanna Ortiz Jimenez, Nina Nan Wang, Almudena Pérez Lara, Jeffrey Chankowsky, Roshanak Charghi, De Q Tran, Roderick J Finlayson
BACKGROUND AND OBJECTIVES: Accidental breach of the vertebral artery (VA) during the performance of cervical pain blocks can result in significant morbidity. Whereas anatomical variations have been described for the foraminal (V2) segment of the VA, those involving its V3 portion (between the C2 transverse process and dura) have not been investigated and may be of importance for procedures targeting the third occipital nerve or the lateral atlantoaxial joint. METHODS: Five hundred computed tomography angiograms of the neck performed in patients older than 50 years for the management of cerebrovascular accident or cervical trauma (between January 2010 and May 2016) were retrospectively and independently reviewed by 2 neuroradiologists...
January 16, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29344706/long-term-follow-up-of-1217-consecutive-short-stem-total-hip-arthroplasty-tha-a-retrospective-single-center-experience
#2
REVIEW
H Wacha, G Domsel, E Herrmann
BACKGROUND: An arthroplasty registry in Germany has been recently established but long-term results for most short-stem innovations are missing. Short-stem hip arthroplasty is usually indicated in young active patients. Our indication was extended to older age groups, femoral neck fractures (FNF), and dysplasia. We evaluated all total hip arthroplasties (THAs) in this population with a collum femoris preserving stem (CFP) performed from 2003 to 2013. METHODS: A consecutive cohort of 1217 CFP THAs with a mean age of 68...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#3
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29336768/is-routine-continuous-eeg-for-traumatic-brain-injury-beneficial
#4
Lia Aquino, Christopher Y Kang, Megan Y Harada, Ara Ko, Amy Do-Nguyen, Eric J Ley, Daniel R Margulies, Rodrigo F Alban
Severe traumatic brain injury (TBI) is associated with increased risk for early clinical and subclinical seizures. The use of continuous electroencephalography (cEEG) monitoring after TBI allows for identification and treatment of seizures that may otherwise occur undetected. Benefits of "routine" cEEG after TBI remain controversial. We examined the rate of subclinical seizures identified by cEEG in TBI patients admitted to a Level I trauma center. We analyzed a cohort of trauma patients with moderate to severe TBI (head Abbreviated Injury Score ≥3) who received cEEG within seven days of admission between October 2011 and May 2015...
December 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/29335475/discontinuous-ventilator-weaning-of-patients-with-acute-sci
#5
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29331979/now-you-see-me-a-pragmatic-cohort-study-comparing-first-and-final-radiological-diagnoses-in-the-emergency-department
#6
Björn Mattsson, David Ertman, Aristomenis Konstantinos Exadaktylos, Luca Martinolli, Wolf E Hautz
OBJECTIVES: To (1) compare timely but preliminary and definitive but delayed radiological reports in a large urban level 1 trauma centre, (2) assess the clinical significance of their differences and (3) identify clinical predictors of such differences. DESIGN, SETTING AND PARTICIPANTS: We performed a retrospective record review for all 2914 patients who presented to our university affiliated emergency department (ED) during a 6-week period. In those that underwent radiological imaging, we compared the patients' discharge letter from the ED to the definitive radiological report...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#7
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29324488/storage-injury-and-blood-transfusions-in-trauma-patients
#8
Peter M Spieth, Haibo Zhang
PURPOSE OF REVIEW: The aim of the present review was to concisely summarize recent studies and current knowledge about effects of red blood cell storage injury in trauma patients. RECENT FINDINGS: Despite a pathophysiological rationale for older packed red blood cells (PRBCs) being associated with adverse events in the host organism, recent large clinical trials failed to show negative effects of transfusion with older PRBCs on clinically relevant outcomes in mixed patient population...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29323835/recurring-vivid-dreams-in-an-older-hmong-man-with-complex-trauma-experience-and-cognitive-impairment
#9
Wajih Askar, Ariba Khan, Soo Borson, Michael L Malone
INTRODUCTION: Health care workers need to consider the culture and ethnic preferences prevalent in the Hmong community in order to provide optimal care. We describe an older Hmong man to illustrate the challenges faced and competencies needed by primary care. CASE PRESENTATION: An 80-year-old non-English speaking Hmong man with diabetes, nerve sheath tumor, and hypertension presented to the outpatient clinic with his grandson complaining of sleep problems. He had had 2 vivid recurring dreams during the previous few months...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29319649/decreasing-radiation-exposure-in-pediatric-trauma-related-to-cervical-spine-clearance-a-quality-improvement-project
#10
Valerie Ann Waddell, Susan Connelly
STUDY DESIGN: Quality improvement project. OBJECTIVES: Reduce the amount of radiation exposure in the pediatric trauma population 5 years of age and older in relation to cervical spine clearance. BACKGROUND: The evaluation of pediatric cervical spine injuries must be accurate and timely to avoid missed injuries. The difficult clinical examination in pediatric trauma patients necessitates the use of radiologic examinations to avoid missing catastrophic injuries...
January 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#11
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29317144/comparison-of-clinicoradiological-findings-between-patients-with-recovering-diplopia-and-those-with-residual-diplopia-after-surgery-for-pure-orbital-blowout-fracture
#12
Hye Na Jung, Sang-Il Suh, Hyung-Jin Kim, Inseon Ryoo
PURPOSE: Diplopia is a common symptom of blowout fracture (BOF), and can persist after proper surgical management. We compared clinicoradiological findings between patients with recovering diplopia and those with residual diplopia after surgery for orbital BOF. MATERIALS AND METHODS: We retrospectively evaluated the CT images of 170 patients with orbital BOF and preoperative diplopia. We reviewed the following factors: sex, age, mechanism of injury, presence of diplopia before surgery, presence of enophthalmos before surgery, presence of an ocular motility abnormality before surgery, time interval between the trauma and surgery, fracture type, fracture size, volume of herniated orbital soft tissue, ratio of the volume of herniated orbital soft tissue to fracture size, number of points of contact between the extraocular muscle (EOM) and bony edge, EOM swelling, EOM swelling ratio, EOM displacement, EOM circling, EOM tenting, and EOM entrapment...
December 15, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29305651/-management-of-osteoporosis-after-fragility-fractures
#13
M Gosch, U Stumpf, C Kammerlander, W Böcker, H J Heppner, S Wicklein
Osteoporosis is defined as a systemic bone disease with decreased bone strength and an increased susceptibility for fractures. Older people in particular face an increased risk of fractures. These kind of fractures are usually caused by an inadequate trauma and are the so-called fragility fractures. In older adults immediate fracture stabilization and early mobilization have become the standard procedure after a fragility fracture. Treatment of the underlying osteoporosis often plays a minor role in clinical practice...
January 5, 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29304054/injury-mechanisms-patterns-and-outcomes-of-older-polytrauma-patients-an-analysis-of-the-dutch-trauma-registry
#14
Rob de Vries, Inge H F Reininga, Oliver Pieske, Rolf Lefering, Mostafa El Moumni, Klaus Wendt
BACKGROUND: Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. METHODS: Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18-59) and older (Group B: ages ≥60) polytrauma patients were compared...
2018: PloS One
https://www.readbyqxmd.com/read/29298241/is-observation-for-traumatic-hemothorax-safe
#15
Leah Demetri, Myriam M Martinez Aguilar, Jordan D Bohnen, Ryan Whitesell, D Dante Yeh, David King, Marc de Moya
BACKGROUND: EAST guidelines suggest tube thoracostomy (TT) be considered for all traumatic hemothoraces. However, previous research has suggested that some traumatic hemothoraces may be observed safely. We sought to 1) determine the safety of selective observation for traumatic hemothorax, and 2) identify predictors of failed observation. METHODS: All patients with traumatic hemothorax from 2000-2014 at a Level I Trauma Center were identified and categorized by size as small (<300cc) or large (≥300cc) based on chest CT-scan measurements...
January 2, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29286969/simultaneous-ipsilateral-dislocation-of-the-hip-and-the-knee-a-case-report
#16
Antonio Arenas Miquelez, Filippo Familiari, Lucas Arbeloa, Andrea D'Arrigo Azzarelli
CASE: A patient was struck by an agricultural vehicle and sustained ipsilateral hip and knee dislocations. Closed reduction of the hip was accomplished in the emergency department; the patient required general anesthesia in the operating room to reduce the knee dislocation. Nonoperative treatment was used for both injuries, with a good long-term outcome. CONCLUSION: Simultaneous ipsilateral hip and knee dislocations are rare and complex injuries that usually result from high-energy trauma...
October 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29273999/distal-duodenogastrostomy-or-proximal-jejunogastrostomy-in-the-management-of-ultra-short-bowel
#17
Tjipke Olivier Hofker, Mirjam Anna Kaijser, Vincent B Nieuwenhuijs, Johan Frederick Michel Lange, Hendrik Sijbrand Hofker
Inflammatory bowel disease, vascular disease, volvulus, adhesions, or abdominal trauma may necessitate extensive small-bowel resection resulting in an ultra-short distal duodenal or jejunal stump. If this distal duodenal or short jejunal stump is too short for stoma creation and bowel continuity restoration is hazardous or not possible at all, a distal duodenogastrostomy or proximal jejunogastrostomy in combination with drainage of the stomach is an option to prevent stump leakage. Although successful, this distal duodenogastrostomy has been described only in very few patients and in older records...
December 22, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29251711/beta-blockers-in-critically-ill-patients-with-traumatic-brain-injury-results-from-a-multi-center-prospective-observational-aast-study
#18
Eric J Ley, Samuel D Leonard, Galinos Barmparas, Navpreet K Dhillon, Kenji Inaba, Ali Salim, Karen R OʼBosky, Danielle Tatum, Hooman Azmi, Chad G Ball, Paul T Engels, Julie A Dunn, Matthew M Carrick, Jonathan P Meizoso, Sarah Lombardo, Bryan A Cotton, Thomas J Schroeppel, Sandro Rizoli, David S J Chang, Luis Alejandro de León, Joao Rezende-Neto, Tomas Jacome, Jimmy Xiao, Gina Mallory, Krishnamurti Rao, Lars Widdel, Samuel Godin, Angela Coates, Leo Andrew Benedict, Raminder Nirula, Sanjeev Kaul, Tong Li
BACKGROUND: Beta blockers, a class of medications that inhibit endogenous catecholamines interaction with beta adrenergic receptors, are often administered to patients hospitalized after traumatic brain injury (TBI). We tested the hypothesis that beta blocker use after TBI is associated with lower mortality, and secondarily compared propranolol to other beta blockers. METHODS: The AAST Clinical Trial Group conducted a multi-institutional, prospective, observational trial in which adult TBI patients who required ICU admission were compared based on beta blocker administration...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#19
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248096/adolescent-and-young-adult-injuries-in-developing-economies-a-comparative-analysis-from-oman-and-kenya
#20
Abdulgafoor M Bachani, Niloufer Taber, Amber Mehmood, Yuen Wai Hung, Isaac Botchey, Ammar Al-Kashmiri, Adnan A Hyder
BACKGROUND: Adolescence is a distinct period of rapid and dramatic biological, cognitive, psychological, and social development. The burden of injuries among young people (aged 10-24) is both substantial and maldistributed across regions and levels of economic development. OBJECTIVES: Our objective was to compare sociodemographic correlates of injury cause, intentionality, and mortality between Kenya and Oman, 2 countries with different levels of economic development and position in the demographic and epidemiologic transitions...
September 2017: Annals of Global Health
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