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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28431334/one-hundred-injured-patients-a-day-multicenter-emergency-room-surveillance-of-trauma-in-pakistan
#2
A A Hyder, S He, W Zafar, M U Mir, J A Razzak
OBJECTIVES: Injuries increasingly contribute to the global burden of disease in low- and middle-income countries. This study presents results from a large-scale surveillance study on injury from several urban emergency departments (EDs) in Pakistan. The objective is to document the burden of injuries that present to the healthcare system in Pakistan and to test the feasibility of an ED-based injury and trauma surveillance system. STUDY DESIGN: Cross-sectional study conducted using active surveillance approach...
April 18, 2017: Public Health
https://www.readbyqxmd.com/read/28426562/asymptomatic-cervical-spine-fractures-current-guidelines-can-fail-older-patients
#3
Christopher D Healey, Sarah K Spilman, Bradley D King, Joseph E Sherrill, Carlos A Pelaez
BACKGROUND: Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#4
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422282/analysis-of-circulating-mir-1-mir-23a-and-mir-26a-in-atrial-fibrillation-patients-undergoing-coronary-bypass-artery-grafting-surgery
#5
Andre Feldman, Dalmo Antonio Ribeiro Moreira, Carlos Gun, Hui-Tzu Lin Wang, Mario Hiroyuki Hirata, Juliana de Freitas Germano, Gabriela Guimarães Sousa Leite, Pedro Farsky
Atrial fibrillation (AF) is the most common arrhythmia after cardiac surgery. From a pathophysiological point of view, a myriad of factors such as trauma, atrial dilation, ischemia, mechanical myopericarditis, autonomic imbalance, loss of connexins, AF nest remodeling, inflammation, sutures, and dysfunction caused by postextracorporeal circulation can contribute to postoperative atrial fibrillation (POAF) resulting in a longer hospital stay and consequently higher cost. Recent studies showed that short fragments of RNA, called microRNA (miRNA), can contribute to the development of several cardiovascular diseases, including AF...
May 2017: Annals of Human Genetics
https://www.readbyqxmd.com/read/28410604/the-association-of-patient-and-trauma-characteristics-with-the-health-related-quality-of-life-in-a-dutch-trauma-population
#6
Amy Gunning, Mark van Heijl, Karlijn van Wessem, Luke Leenen
BACKGROUND: It is suggested in literature to use the Health Related Quality of Life (HRQoL) as an outcome indicator for evaluating trauma centre performances. In order to predict HRQoL, characteristics that could be of influence on a predictive model should be identified. This study identifies patient and injury characteristics associated with the HRQoL in a general trauma population. METHODS: Retrospective study of trauma patients admitted from 1st January 2007 through 31th December 2012...
April 14, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#7
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#8
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28399218/timed-up-and-go-predicts-functional-decline-in-older-patients-presenting-to-the-emergency-department-following-minor-trauma%C3%A2
#9
Debra Eagles, Jeffrey J Perry, Marie-Josée Sirois, Eddy Lang, Raoul Daoust, Jacques Lee, Lauren Griffith, Laura Wilding, Xavier Neveu, Marcel Emond
Background: there is no standardised test for assessing mobility in the Emergency Department (ED). Objective: we wished to evaluate the relationship between the Timed Up and Go (TUG) and frailty, functional decline and falls in community dwelling elders that present to the ED following minor trauma. Methods: this was a secondary analysis of a prospective cohort study conducted at eight Canadian hospitals. Evaluations included: TUG; Study of Osteoporotic Fractures Frailty Index; Older American Resources and Service Functional Scale; and self-reported falls...
March 1, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28396721/resection-of-complex-pancreatic-injuries-benchmarking-postoperative-complications-using-the-accordion-classification
#10
Jake E Krige, Eduard Jonas, Sandie R Thomson, Urda K Kotze, Mashiko Setshedi, Pradeep H Navsaria, Andrew J Nicol
AIM: To benchmark severity of complications using the Accordion Severity Grading System (ASGS) in patients undergoing operation for severe pancreatic injuries. METHODS: A prospective institutional database of 461 patients with pancreatic injuries treated from 1990 to 2015 was reviewed. One hundred and thirty patients with AAST grade 3, 4 or 5 pancreatic injuries underwent resection (pancreatoduodenectomy, n = 20, distal pancreatectomy, n = 110), including 30 who had an initial damage control laparotomy (DCL) and later definitive surgery...
March 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28396047/prediction-of-massive-bleeding-shock-index-and-modified-shock-index
#11
L J Terceros-Almanza, C García-Fuentes, S Bermejo-Aznárez, I J Prieto-Del Portillo, C Mudarra-Reche, I Sáez-de la Fuente, M Chico-Fernández
OBJECTIVE: To determine the predictive value of the Shock Index and Modified Shock Index in patients with massive bleeding due to severe trauma. DESIGN: Retrospective cohort. SETTING: Severe trauma patient's initial attention at the intensive care unit of a tertiary hospital. SUBJECTS: Patients older than 14 years that were admitted to the hospital with severe trauma (Injury Severity Score >15) form January 2014 to December 2015...
April 8, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28394113/dental-fear-in-children-with-repeated-tooth-injuries
#12
Dubravka Negovetić Vranić, Nataša Ivančić Jokić, Danko Bakarčić, Andreja Carek, Željko Rotim, Željko Verzak
Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years...
June 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/28391563/screening-for-osteoporosis-following-non-vertebral-fractures-in-patients-aged-50-and-older-independently-of-gender-or-level-of-trauma-energy-a-swiss-trauma-center-approach
#13
Christoph Hemmeler, Sabrina Morell, Felix Amsler, Thomas Gross
Screening in a standardized manner for osteoporosis in non-vertebral fracture patients aged 50 and older independently of both gender and level of trauma energy yielded the indication for osteoporotic therapy for every fourth male high-energy fracture patient. PURPOSE: This study aimed to identify the rate of osteoporosis in patients of both genders after fracture independently of the underlying level of trauma energy. METHODS: A random cohort of patients aged 50 or older with non-vertebral fractures participated in a standardized diagnostic protocol to evaluate the indication for treatment of osteoporosis (number needed to screen (NNS))...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#14
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28382256/prognostication-of-traumatic-brain-injury-outcomes-in-older-trauma-patients-a-novel-risk-assessment-tool-based-on-initial-cranial-ct-findings
#15
Stanislaw P Stawicki, Thomas R Wojda, John D Nuschke, Ronnie N Mubang, James Cipolla, William S Hoff, Brian A Hoey, Peter G Thomas, Joan Sweeney, Daniel Ackerman, Jonathan Hosey, Steven Falowski
INTRODUCTION: Advanced age has been traditionally associated with worse traumatic brain injury (TBI) outcomes. Although prompt neurosurgical intervention (NSI, craniotomy or craniectomy) may be life-saving in the older trauma patient, it does not guarantee survival and/or return to preinjury functional status. The aim of this study was to determine whether a simple score, based entirely on the initial cranial computed tomography (CCT) is predictive of the need for NSI and key outcome measures (e...
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28382250/what-s-new-in-critical-illness-and-injury-science-the-role-of-a-cranial-computed-tomography-scoring-tool-in-the-care-of-older-trauma-patients
#16
EDITORIAL
Bethany Malone, Michael S Firstenberg
No abstract text is available yet for this article.
January 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28365000/efficacy-and-feasibility-of-a-therapist-guided-internet-based-intervention-for-older-persons-with-childhood-traumatization-a-randomized-controlled-trial
#17
Christine Knaevelsrud, Maria Böttche, Robert H Pietrzak, Harald Jürgen Freyberger, Philipp Kuwert
OBJECTIVE: Although cognitive-behavioral treatment approaches for post-traumatic stress disorder (PTSD) exist, only a small proportion of older adults seeks psychological treatment. Alternative treatment approaches are thus needed to fill the gap between provision and use of psychological interventions. This study aimed to investigate the efficacy and feasibility of an Internet-based, therapist-guided cognitive-behavioral therapy (Internet-based CBT) for older individuals with PTSD symptoms...
March 2, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28363517/assessment-of-mechanism-type-and-severity-of-injury-in-multiple-trauma-patients-a-cross-sectional-study-of-a-trauma-center-in-iran
#18
Hamidreza Reihani, Hossein Pirazghandi, Ehsan Bolvardi, Mohsen Ebrahimi, Elham Pishbin, Koorosh Ahmadi, Mahdi Safdarian, Soheil Saadat, Vafa Rahimi-Movaghar
PURPOSE: To accurately assess the mechanism, type and severity of injury in Iranian multiple trauma patients of a trauma center. METHODS: Patients with multiple traumas referring to the emergency department of Hasheminejad University Hospital in Mashhad, Iran, entered this cross sectional study from March 2013 to December 2013. All the patients with injury severity score (ISS) > 9 were included in this study. Data analysis was performed by SPSS software (Version 11...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28360503/the-role-of-copy-and-paste-function-in-orthopedic-trauma-progress-notes
#19
Wesley Winn, Irshad A Shakir, Heidi Israel, Lisa K Cannada
INTRODUCTION: The electronic medical record (EMR) is standard in institutions. While there is not concern for legibility of notes and access to charts, there is an ease of copy and paste for daily notes. This may not lead to accurate portrayal of patient's status. Our purpose was to evaluate the use of copy and paste functions in daily notes of patients with injuries at high risk for complications. METHODS: IRB approval was obtained for a retrospective review. Inclusion criteria included patients aged 18 and older treated at our Level 1 Trauma Center after implementation of Epic Systems Corporation, Verona, WI, USA...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28358976/analysis-of-bony-and-internal-organ-injuries-associated-with-26-357-adult-femoral-shaft-fractures-and-their-impact-on-mortality
#20
Nidharshan S Anandasivam, Glenn S Russo, Jennifer M Fischer, Andre M Samuel, Nathaniel T Ondeck, Matthew S Swallow, Sophie H Chung, Daniel D Bohl, Jonathan N Grauer
The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality...
March 30, 2017: Orthopedics
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