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https://www.readbyqxmd.com/read/28720216/the-effects-of-red-cell-transfusion-donor-age-on-nosocomial-infection-among-trauma-patients
#1
Tyler J Loftus, Ryan M Thomas, Travis W Murphy, Linda L Nguyen, Frederick A Moore, Scott C Brakenridge, Philip A Efron, Alicia M Mohr
BACKGROUND: We hypothesized that packed red blood cell (PRBC) transfusions from older donors would be associated with fewer nosocomial infections among trauma patients. METHODS: We performed a four-year retrospective analysis of 264 consecutive adult trauma patients who received ≥1 PRBC transfusion during admission. The capacity of donor age to predict nosocomial infection was assessed by logistic regression. RESULTS: Thirty-three percent of all patients developed a nosocomial infection...
July 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28720040/distal-radius-fractures-aaos-appropriate-use-criteria-versus-actual-management-at-a-level-i-trauma-center
#2
James C Kyriakedes, Eugene Y Tsai, Douglas S Weinberg, Charles C Yu, Harry A Hoyen, Kevin Malone, Blaine T Bafus
BACKGROUND: The aim of this study is to determine whether the American Academy of Orthopaedic Surgeons' (AAOS) Appropriate Use Criteria (AUC) for distal radius fractures correlates with actual treatment by orthopedic hand surgeons at a level I trauma center. METHODS: ICD-9 codes were used to retrospectively identify patients who presented with wrist fractures over 1 year. Patients with isolated distal radius fractures were evaluated using the AAOS AUC application for distal radius fractures...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28717984/falls-in-older-people-comparing-older-and-younger-fallers-in-a-developing-country
#3
R R Yogi, I Sammy, J F Paul, P Nunes, P Robertson, V Ramcharitar Maharaj
PURPOSE: While falls are common in older people, causing significant mortality and morbidity, this phenomenon has not been extensively studied in the Caribbean. This study aimed to compare falls in older and younger people in this setting. METHODS: We conducted a prospective observational study of older trauma patients in Trinidad, comparing older and younger patients sustaining falls. RESULTS: 1432 adult trauma patients were included (1141 aged 18-64 years and 291 aged 65 years and older)...
July 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28712604/-sometimes-you-feel-like-the-freak-show-a%C3%A2-qualitative-assessment-of-emergency-care-experiences-among-transgender-and-gender-nonconforming-patients
#4
Elizabeth A Samuels, Chantal Tape, Naomi Garber, Sarah Bowman, Esther K Choo
STUDY OBJECTIVE: Transgender, gender-variant, and intersex (trans) people have decreased access to care and poorer health outcomes compared with the general population. Little has been studied and documented about such patients' emergency department (ED) experiences and barriers to care. Using survey and qualitative research methods, this study aims to identify specific areas for improvement and generate testable hypotheses about the barriers and challenges for trans individuals needing acute care...
July 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28711594/hepatic-mitochondrial-bioenergetics-in-aged-c57bl-6-mice-exhibit-delayed-recovery-from-severe-burn-injury
#5
Christopher Auger, Thibacg Sivayoganathan, Abdikarim Abdullahi, Alexandra Parousis, Marc G Jeschke
Severe burn injuries initiate a cascade of downstream events, culminating in multiple organ dysfunction, sepsis, and even death. The elderly are in particular vulnerable to such outcomes, due primarily to a scarcity of knowledge on trauma progression at the biomolecular level in this population. Mitochondria, the cellular powerhouses, have been increasingly scrutinized recently for their contribution to trauma outcomes. We hypothesized that elderly have a worse outcome compared to adult patients due to failed recovery of hepatic mitochondria...
July 12, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28708779/midshaft-fracures-of-the-clavicle-a-meta-analysis-comparing-surgical-fixation-via-anteroinferior-plating-versus-superior-plating
#6
Alex Nourian, Satvinder Dhaliwal, Sitaram Vangala, Peter S Vezeridis
OBJECTIVE: Tto compare the outcomes of clavicle fracture fixation using anteroinferior versus superior plate placement. METHODS: We performed a meta-analysis of studies that have reported on outcomes following superior or anteroinferior plate fixation for acute midshaft clavicle fractures (OTA 15-B). A computerized literature search in the Pubmed, Scopus, and Cochrane Library databases was utilized to identify relevant articles. Only full text articles without language restrictions were evaluated...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28706393/cotrimoxazole-a-wonder-drug-in-the-era-of-multiresistance-case-report-and-review-of-literature
#7
Priyam Batra, Vishant Deo, Purva Mathur, Amit Kumar Gupta
Antimicrobial resistance is one of the greatest threats to human health worldwide. The rate of development of newer antibiotics is much slower than the rate of development of antibiotic resistance. A survey reported that it takes 15 years and US$800 million (including preclinical and clinical costs) to bring a single drug to the market, whereas the reuse of the older drugs for antimicrobial use takes $17 million, thereby circumventing 40% of the overall cost. The first case is a patient with nosocomial pyrexia of unknown origin who was given treatment with tigecycline and cefepime/tazobactam but failed to respond to the same...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28704554/trends-in-the-incidence-and-outcomes-of-bicycle-related-injury-in-the-emergency-department-a-nationwide-population-based-study-in-south-korea-2012-2014
#8
Youn-Jung Kim, Dong-Woo Seo, Jae-Ho Lee, Yoon-Seon Lee, Bum-Jin Oh, Kyoung-Soo Lim, Won Young Kim
OBJECTIVE: This study aimed to examine trends in the incidence and outcomes of bicycle-related injuries in emergency departments (ED) in South Korea. METHODS: We analysed data from the National Emergency Department Information System database for adult patients (≥20 years) with bicycle-related injuries presenting to EDs in South Korea between January 2012 and December 2014. Riders and bicycle passengers whose injuries were associated with bicycle use were included...
2017: PloS One
https://www.readbyqxmd.com/read/28703089/a-traumatic-tale-of-two-cities-a-comparison-of-outcomes-for-adults-with-major-trauma-who-present-to-differing-trauma-centres-in-neighbouring-canadian-provinces
#9
Jefferson Hayre, Colin Rouse, James French, Jacqueline Fraser, Ian Watson, Sue Benjamin, Allison Chisholm, George Stoica, Beth Sealy, Mete Erdogan, Robert Green, Paul Atkinson
OBJECTIVES: While the use of formal trauma teams is widely promoted, the literature is not clear that this structure provides improved outcomes over emergency physician delivered trauma care. The goal of this investigation was to examine if a trauma team model with a formalized, specialty-based trauma team, with specific activation criteria and staff composition, performs differently than an emergency physician delivered model. Our primary outcome was survival to discharge or 30 days...
July 13, 2017: CJEM
https://www.readbyqxmd.com/read/28697017/risk-factors-for-deep-vein-thrombosis-and-pulmonary-embolism-after-traumatic-injury-a-competing-risks-analysis
#10
Jan-Michael Van Gent, Richard Y Calvo, Ashley L Zander, Erik J Olson, C Beth Sise, Michael J Sise, Steven R Shackford
BACKGROUND: Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is typically reported as a composite measure of the quality of trauma center care. Given recent data suggesting post-injury DVT and PE are distinct clinical processes, a better understanding may result from analyzing them as independent, competing events. Using competing risks analysis, we evaluated our hypothesis that the risk factors and timing of post-injury DVT and PE are different...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28693654/cut-and-rip-and-cut-alone-techniques-versus-usual-practice-in-the-removal-of-trauma-patient-clothing
#11
Aaron K Sibley, Trevor N Jain, Brent Nicholson, Paul Atkinson
Introduction Rapid exposure of a trauma patient is an essential component of the primary survey. No gold standard exists regarding the best technique to remove clothing from a trauma patient. The purpose of this study is to compare two techniques of clothing removal versus usual practice using standard trauma shears. METHODS: Advanced Care Paramedic (ACP) students were randomized to either the Cut and Rip (CAR) or Cut Alone (CAL) techniques to remove clothing from a standardized trauma mannequin...
July 11, 2017: CJEM
https://www.readbyqxmd.com/read/28692621/challenges-in-the-management-of-geriatric-trauma-a-case-report
#12
Ashley Gaebel, Megan Keiser
This article describes geriatric trauma and commonly associated difficulties emphasizing both the epidemiology and assessment of geriatric trauma. There is little data guiding decisions for trauma patients 65 years or older, as there are many unique characteristics to the geriatric population, including comorbidities, medications, and the aging physiology. The geriatric population in the United States has been steadily climbing for the last 20 years and is projected to continue on this trend. Although each patient presents differently, there remains a need for the consistent utilization of standard guidelines to help dictate care for geriatric patients, particularly for patients not receiving care at a trauma center...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692620/delirium-in-the-icu-what-about-the-floor
#13
Anthony Cahill, Christopher Pearcy, Vaidehi Agrawal, Phillip Sladek, Michael S Truitt
Delirium was first described in the 1800s as acute, fluctuating confusion. Recent studies note an incidence of 15% in adult intensive care unit patients. Here we present the first prospective study to evaluate the incidence and risk factors for delirium in patients admitted to the trauma surgeon (TS) in non-critical care areas (NCCAs). Patients 18 years or older admitted to any TS in the designated NCCA were evaluated and consented for participation over a 3-month period. Participants were screened with the Confusion Assessment Method (CAM) every 12 hr...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692616/development-of-a-falls-registry-a-pilot-study
#14
Gina M Berg, Tara Carlson, Joanne Fairchild, Courtney Edwards, Ryan Sorell
Each year approximately 1 in 4 healthy older adults aged 65+ years and 1 in 2 aged 80+ years living in the community will fall. Fall-related injuries are the leading cause of death and disability and cost the United States approximately $31 billion annually. Currently, no repository of scene data exists that informs prevention programs regarding circumstances that contribute to older adult falls. This was a multicenter (4 sites: Kansas, Maryland, Oregon, and Texas) pilot study consisting of interviews of older (55+ years) patients who had been admitted to a trauma center with fall-related injuries...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692451/the-value-of-musculoskeletal-ultrasound-in-geriatric-care-and-rehabilitation
#15
Büşra Can, Murat Kara, Özgür Kara, Zekeriya Ülger, Walter Frontera, Levent Özçakar
The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions)...
July 7, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28692445/normal-cerebral-vascular-pulsations-in-humans-changes-with-age-and-implications-for-microvascular-disease
#16
Mi O Kim, Yan Li, Fangfei Wei, Jiguang Wang, Michael F O'Rourke, Audrey Adji, Alberto P Avolio
BACKGROUND: Cerebral syndromes in older humans, secondary stroke in younger persons following trauma, and sickle cell anaemia in children, are linked by unexplained microvascular damage and high cerebral pressure or flow pulsations. The aim of this study was to characterize age-related pressure and flow waveforms patterns entering the brain, to explain these in terms of disturbed physiological function, and to consider clinical implications. METHOD: Blood flow velocity waves were measured in four cerebral vascular territories by transcranial Doppler of 1020 apparently normal patients (497 men, 21-78 years)...
July 7, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28689194/risk-factors-and-outcomes-associated-with-post-traumatic-headache-after-mild-traumatic-brain-injury
#17
Yilmaz Tansel, Gerwin Roks, Myrthe de Koning, Myrthe Scheenen, Harm van der Horn, Gerben Plas, Gerard Hageman, Guus Schoonman, Jacoba Spikman, Joukje van der Naalt
OBJECTIVES: To determine the prevalence and potential risk factors of acute and chronic post-traumatic headache (PTH) in patients with mild to moderate traumatic brain injury (TBI) in a prospective longitudinal observational multicentre study. Acute PTH (aPTH) is defined by new or worsening of pre-existing headache occurring within 7 days after trauma, whereas chronic PTH (cPTH) is defined as persisting aPTH >3 months after trauma. An additional goal was to study the impact of aPTH and cPTH in terms of return to work (RTW), anxiety and depression...
July 8, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28688640/clinical-phenotypes-of-us-level-i-trauma-centers-use-of-clustering-methodology
#18
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David A Spain, Kristan Staudenmayer
BACKGROUND: American College of Surgeons Level I Trauma Centers (ACSL1TCs) meet the same personnel and structural requirements but serve different populations. We hypothesized that these nuanced differences may amenable to description through mathematical clustering methodology. METHODS: The National Trauma Data Bank 2014 was used to derive information on ACSL1TCs. Explorative cluster hypothesis generation was performed using Ward's linkage to determine expected number of clusters based on patient and injury characteristics...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28682941/reduction-in-mortality-rates-of-postinjury-multiple-organ-dysfunction-syndrome-a-shifting-paradigm-a-prospective-population-based-cohort-study
#19
Karlijn J P van Wessem, Luke P H Leenen
INTRODUCTION: The incidence of Multiple Organ Dysfunction Syndrome (MODS) has decreased in the last decade by improvement in trauma care. However, it still remains a major cause of morbidity and mortality. This study investigated the current incidence and mortality of MODS in polytrauma patients. MATERIALS AND METHODS: A 3-year prospective study included consecutive trauma patients admitted to a Level-1 Trauma Center ICU. Isolated head injuries, drowning, asphyxiation and burns were excluded...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28676385/syncope-workup-greater-yield-in-select-trauma-population
#20
Melike Harfouche, Michael Cline, Michael Mazzei, Thomas Santora
BACKGROUND: There is great variation in practice regarding the assessment of trauma patients who present with syncope. The purpose of this study was to determine the yield of screening studies (electrocardiogram, echocardiogram, and carotid duplex) and define characteristics to identify groups that may benefit from these investigations. METHODS: We conducted a retrospective cohort study of all trauma patients from 2003 to 2015 who received a carotid duplex as part of a syncope evaluation at our urban Level 1 Trauma Center...
July 1, 2017: International Journal of Surgery
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