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https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#1
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#2
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28315803/cranioplasty-complications-and-costs-a-national-population-level-analysis-using-the-marketscan-longitudinal-database
#3
Amy Li, Tej Deepak Azad, Anand Veeravagu, Inderpreet Bhatti, Chao Long, John K Ratliff, Gordon Li
OBJECTIVE: To characterize cranioplasty complications and costs at a population level using a longitudinal national claims database. METHODS: We identified cranioplasty patients between 2007-2014 in the MarketScan national database. We evaluated age, autograft usage, cranioplasty size, and cranioplasty timing on postoperative outcomes. We further analyzed associated costs. A subset analysis of adult cranioplasty patients with emergent indications, including stroke and trauma, was also performed...
March 15, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28314434/acceptability-of-medication-and-nonmedication-treatment-for-insomnia-among-female-veterans-effects-of-age-insomnia-severity-and-psychiatric-symptoms
#4
Najwa C Culver, Yeonsu Song, Sarah Kate McGowan, Constance H Fung, Michael N Mitchell, Juan Carlos Rodriguez, Joseph M Dzierzewski, Karen R Josephson, Stella Jouldjian, Donna L Washington, Elizabeth M Yano, C Amanda Schweizer, Cathy A Alessi, Jennifer L Martin
PURPOSE: Female veterans are at high risk for sleep problems, and there is a need to provide effective treatment for this population who experience insomnia. This study's primary goal was to compare the acceptability of medication versus nonmedication treatments for insomnia among female veterans. In addition, we examined the role of patient age, severity of sleep disturbance, and psychiatric symptoms on acceptability of each treatment approach and on the differences in acceptability between these approaches...
November 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/28302115/arthroscopic-release-using-f-and-c-method-versus-conventional-open-release-method-in-the-treatment-of-gluteal-muscle-contracture-a-comparative-study
#5
Saroj Rai, Shengyang Jin, Chunqing Meng, Nabin Chaudhary, Nira Tamang, Xiaohong Wang, Xianzhe Liu, Hong Wang, Shuhua Yang
BACKGROUND: Gluteal muscle contracture (GMC), a debilitating disease, usually starts in early childhood after variable dose of injections around the buttock, if left untreated it worsens gradually and persists throughout the life. Because the disease mostly affects adolescents and adults, there is always an aesthetic concerns. Purposeof the study was to introduce the arthroscopic F and C method of GMC release, and to compare its clinical efficiency with conventional open surgery in terms of clinical outcome, rate of complications, patient's satisfactions, and recurrence...
March 16, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28301646/traumatic-facial-injuries-among-elderly-nursing-home-residents-never-event-or-frequent-occurrence
#6
Michael Bobian, Nour El-Kashlan, Curtis J Hanba, Peter F Svider, Adam J Folbe, Jean Anderson Eloy, Giancarlo F Zuliani, Michael Carron
Importance: As the nursing home population continues to increase, an understanding of preventable injuries becomes exceedingly important. Although other fall-related injuries have been characterized, little attention has been dedicated to facial trauma. Objectives: To estimate the incidence of facial trauma among nursing home residents and detail mechanisms of injury, injury characteristics, and patient demographic data. Design, Setting, and Participants: The National Electronic Injury Surveillance System was used to calculate a weighted national incidence of facial trauma among individuals older than 60 years from a nationally representative collection of emergency departments from January 1, 2011, through December 31, 2015...
March 16, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28295120/geometric-analysis-of-the-proximal-humerus-in-elderly-japanese-patients-implications-for-implant-selection-in-reverse-shoulder-arthroplasty
#7
Keisuke Matsuki, Hiroyuki Sugaya, Shota Hoshika, Yusuke Ueda, Norimasa Takahashi, Morihito Tokai, Kazutomo Onishi, Scott A Banks
The implants used in reverse shoulder arthroplasty were originally designed for white patients; thus, they might not be optimal for smaller Asian patients. The selection of reverse shoulder arthroplasty systems is limited in Japan. The purpose of this study was to measure the geometry of the proximal humerus in elderly Japanese patients to inform implant selection according to humerus size. This study included 155 shoulders from 148 patients 50 years or older who underwent computed tomography for shoulder disorders other than arthritis and trauma...
March 14, 2017: Orthopedics
https://www.readbyqxmd.com/read/28293996/effective-pain-management-in-patients-in-hospital
#8
Candy McCabe
Chronic pain is experienced by between one third and one half of the UK population. Nurses should ensure that patients' pain is assessed and managed when they present to hospital, including pre-existing chronic pain and acute pain as a result of trauma or surgical interventions. Acute pain that is inadequately managed may result in chronic pain, impeding the patient's return to normal function and daily activities. Depression and increasing age affect the likelihood of patients experiencing chronic pain. Nurses should be familiar with the pain assessment tools available for use with older people and be aware of the potential issues of polypharmacy and altered sensitivity to medication in older people...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28286822/ability-of-ultrasonography-in-detection-of-different-extremity-bone-fractures-a-case-series-study
#9
Farzad Bozorgi, Massoud Shayesteh Azar, Seyed Hossein Montazer, Aroona Chabra, Seyed Farshad Heidari, Alireza Khalilian
INTRODUCTION: Despite radiography being the gold standard in evaluation of orthopedic injuries, using bedside ultrasonography has several potential supremacies such as avoiding exposure to ionizing radiation, availability in pre-hospital settings, being extensively accessible, and ability to be used on the bedside. The aim of the present study is to evaluate the diagnostic accuracy of ultrasonography in detection of extremity bone fractures. METHODS: This study is a case series study, which was prospectively conducted on multiple blunt trauma patients, who were 18 years old or older, had stable hemodynamic, Glasgow coma scale 15, and signs or symptoms of a possible extremity bone fracture...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28285742/peripheral-quantitative-computed-tomography-pqct-measures-contribute-to-the-understanding-of-bone-fragility-in-older-patients-with-low-trauma-fracture
#10
Hongyuan Jiang, Christopher J Yates, Alexandra Gorelik, Ashwini Kale, Qichun Song, John D Wark
Dual-energy X-ray absorptiometry (DXA) as currently used has limitations in identifying patients with osteoporosis and predicting occurrence of fracture. We aimed to express peripheral quantitative computed tomography (pQCT) variables of patients with low-trauma fracture as T-scores by using T-score scales obtained from healthy young women, and to evaluate the potential clinical utility of pQCT for the assessment of bone fragility. Fracture patients were recruited from a fracture liaison service at the Royal Melbourne Hospital...
March 9, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28282696/analysis-of-ocular-firework-related-injuries-and-common-eye-traumata-a-5-year-clinical-study
#11
S Frimmel, O M Theusinger, C Kniestedt
Background A comparative study of eye injuries related to fireworks or acts of violence around New Year's Eve and the Swiss National Day on August 1st. The two groups were compared with respect to the overall numbers of eye accidents within the period of review. Patients and Methods Retrospective analysis of emergency consultations at the Department of Ophthalmology, University Hospital Zurich with eye accidents around the Swiss National Day on August 1st and New Year's Eve over the last 5 years. Two subgroups were formed: (1) Firework-related eye traumata, (2) Eye injuries due to acts of violence...
March 10, 2017: Klinische Monatsblätter Für Augenheilkunde
https://www.readbyqxmd.com/read/28274471/the-nexus-criteria-are-insufficient-to-exclude-cervical-spine-fractures-in-older-blunt-trauma-patients
#12
Gabriel Paykin, Gerard O'Reilly, Helen M Ackland, Biswadev Mitra
BACKGROUND AND OBJECTIVE: The National Emergency X-Radiography Utilization Study (NEXUS) criteria are used to assess the need for imaging to evaluate cervical spine integrity after injury. The aim of this study was to assess the sensitivity of the NEXUS criteria in older blunt trauma patients. METHODS: Patients aged 65 years or older presenting between 1st July 2010 and 30th June 2014 and diagnosed with cervical spine fractures were identified from the institutional trauma registry...
February 22, 2017: Injury
https://www.readbyqxmd.com/read/28272850/computerised-tomographic-angiography-cta-in-extremity-trauma-a-level-one-hospital-experience
#13
P Jordaan, S Roche, S Maqungo
INTRODUCTION: The aim of this study was to audit the use of Computerised Tomographic Angiography (CTA) in assessing extremity vascular injuries at our institution and to compare it to international standards. The primary aim was to assess the number of CTAs performed and the indications for doing them. The secondary aim was to look at CTA results and clinical findings and to correlate the two. METHOD: This is a retrospective review of all patients aged 13 years and older who had CTA performed for suspected extremity vascular injuries due to blunt trauma or gunshot injuries, who presented from January 2012 to December 2012...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28270245/paediatric-cardiac-catheterisation-in-norway-rates-and-types-of-complications-in-new-terms
#14
Maren E A Ravndal, Anders H Christensen, Gaute Døhlen, Henrik Holmstrøm
We determined the incidence, type, and severity of complications after cardiac catheterisation in children with heart disease in Norway, and we present the results in terms of the International Paediatric and Congenital Cardiac Code (IPCCC) nomenclature for complications. All paediatric cardiac catheterisations in Norway are performed in one clinical centre. All procedures performed during a 5-year period beginning in 2010 were prospectively registered, and medical records for cases with complications were reviewed to confirm the event and to re-classify the type, severity, and attributability of the complication according to the IPCCC nomenclature...
March 8, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#15
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28267125/clinical-evaluation-of-a-skin-protectant-for-the-management-of-incontinence-associated-dermatitis-an-open-label-nonrandomized-prospective-study
#16
Mary R Brennan, Catherine T Milne, Marie Agrell-Kann, Bruce P Ekholm
PURPOSE: The purpose of this study was to evaluate the efficacy of an investigational skin protectant product at managing severe skin breakdown associated with incontinence. DESIGN: Open-label, nonrandomized, prospective study. SUBJECTS AND SETTING: The sample comprised 16 patients; inclusion criteria were: patients older than 18 years, cared for in the intensive care unit of a level I trauma center hospital or in long-term care facilities in the northeast region of the United States, and had incontinence-associated dermatitis (IAD)...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28266943/traumatic-brain-injury-in-the-netherlands-trends-in-emergency-department-visits-hospitalization-and-mortality-between-1998-and-2012
#17
Crispijn L Van den Brand, Lennard B Karger, Susanne T M Nijman, Myriam G M Hunink, Peter Patka, Korné Jellema
BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. The effects of epidemiological changes such as ageing of the population and increased traffic safety on the incidence of TBI are unknown. OBJECTIVE: The objective of this study was to evaluate trends in TBI-related emergency department (ED) visits, hospitalization and mortality in the Netherlands between 1998 and 2012. DESIGN: This was a retrospective observational, longitudinal study...
March 6, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28265730/does-beta-blockade-reduce-the-risk-of-depression-in-patients-with-isolated-severe-extracranial-injuries
#18
Rebecka Ahl, Galinos Barmparas, Louis Riddez, Eric J Ley, Göran Wallin, Olle Ljungqvist, Shahin Mohseni
BACKGROUND: Approximately half of trauma patients develop post-traumatic depression. It is suggested that beta-blockade impairs trauma memory recollection, reducing depressive symptoms. This study investigates the effect of early beta-blockade on depression following severe traumatic injuries in patients without significant brain injury. METHODS: Patients were identified by retrospectively reviewing the trauma registry at an urban university hospital between 2007 and 2011...
March 6, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28264245/clinical-course-and-results-of-surgery-for-chronic-subdural-hematomas-in-patients-on-drugs-affecting-hemostasis
#19
Tomasz Andrzej Dziedzic, Przemysław Kunert, Andrzej Marchel
OBJECTIVE: An apparent increase of use of drugs affecting hemostasis in our neurosurgical department since the 1990s has encouraged us to investigate whether these drugs influence the clinical course and results of surgery for chronic subdural hematoma (CSDH). METHODS: This retrospective analysis included 178 patients admitted for CSDH from 2007 to 2011 who were divided into two groups: on drugs affecting hemostasis (40; 22%) and no bleeding disorders (138; 78%)...
March 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/28260154/the-cost-and-mortality-of-hip-fractures-in-centenarians
#20
J Moore, O Carmody, B Carey, J A Harty, D Reidy
BACKGROUND: Centenarians are the fastest rising age group in Ireland. Hip fractures most commonly affect older adults and are associated with significant morbidity and mortality, as well as the financial cost of healthcare resources. Despite this, very little is known regarding hip fractures in centenarians. The aim of this study was to investigate our experience with hip fractures in this group and to record the cost of treating these fractures to identify both the social and economic impact these injuries impose on the health system...
March 4, 2017: Irish Journal of Medical Science
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