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https://www.readbyqxmd.com/read/29350048/triple-split-bolus-versus-single-bolus-ct-in-abdominal-trauma-patients-a-comparative-study
#1
Johannes Clemens Godt, Torsten Eken, Anselm Schulz, Cathrine K Johansen, Anette Aarsnes, Johann Baptist Dormagen
Background Split-bolus computed tomography (CT) is a recent development in trauma imaging. Instead of multiple scans in different contrast phases after a single contrast bolus, split-bolus protocols consist of one single scan of the thorax and abdomen after two or three contrast injections at different points of time. Purpose To evaluate and compare image quality and injury findings of a new triple-split-bolus CT (TS-CT) protocol of thorax and abdomen with those of a portal venous phase CT (PV-CT) in the same patient group...
January 1, 2018: Acta Radiologica
https://www.readbyqxmd.com/read/29344707/effects-of-the-establishment-of-a-trauma-center-and-a-new-protocol-on-patients-with-hemodynamically-unstable-pelvic-fractures-at-a-single-institution-in-korea
#2
Min A Lee, Byungchul Yu, Jungnam Lee, Jae Jeong Park, Gil Jae Lee, Kang Kook Choi, Youngeun Park, Jihun Gwak, Ahram Han
PURPOSE: The aim of this study was to determine whether the outcomes of patients with hemodynamically unstable pelvic bone fractures changed after the introduction of a protocol including extraperitoneal pelvic packing (EPP) and the establishment of a trauma center. METHODS: We analyzed data of adult patients (≥ 18 years old) with hemodynamically unstable pelvic bone fractures who visited a single trauma center from February 2009 to October 2016. In July 2014, a new protocol for pelvic fractures was implemented, and a trauma center was established...
January 17, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29342037/preservation-of-cells-of-the-organ-of-corti-and-innervating-dendritic-processes-following-cochlear-implantation-in-the-human-an-immunohistochemical-study
#3
Takefumi Kamakura, Jennifer T O'Malley, Joseph B Nadol
HYPOTHESIS: This study evaluates the degree of preservation of hair cells, supporting cells, and innervating dendritic processes after cochlear implantation in the human using immunohistochemical methods. BACKGROUND: Surgical insertion of a cochlear implant electrode induces various pathologic changes within the cochlea including insertional trauma, foreign body response, inflammation, fibrosis, and neo-osteogenesis. These changes may result in loss of residual acoustic hearing, adversely affecting the use of hybrid implants, and may result in loss of putative precursor cells, limiting the success of future regenerative protocols...
January 16, 2018: Otology & Neurotology
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#4
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29333494/ensuring-adequate-vascular-access-in-patients-with-major-trauma-a-quality-improvement-initiative
#5
Kevin Verhoeff, Rachelle Saybel, Pamela Mathura, Bonnie Tsang, Vanessa Fawcett, Sandy Widder
Ensuring adequate vascular access in major trauma patients prior to decompensative physiological processes is crucial to patient outcomes. Most protocols suggest achieving two 18-gauge or larger intravenous lines immediately in patients with major trauma. We discuss a quality improvement approach to ensure that >90% of patients with major trauma (as defined by an injury severity score ≥12) at a level one trauma centre receive timely and adequate fluid access. Applying Donabedian principles for process improvement, we used the Alberta Trauma Registry to perform a 4-month chart audit on patients with major trauma at the University of Alberta Hospital...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29332557/evaluation-of-a-victim-centered-trauma-informed-victim-notification-protocol-for-untested-sexual-assault-kits-saks
#6
Rebecca Campbell, Jessica Shaw, Giannina Fehler-Cabral
Throughout the United States, hundreds of thousands of sexual assault kits (SAKs) have not been submitted by the police for forensic DNA testing, which raises complex issues regarding how victims ought to be notified about what happened to their kits. In this project, we evaluated a victim-centered, trauma-informed victim notification protocol that was implemented in Detroit, Michigan. Most victims (84%) did not have a strong negative emotional reaction to notification, and most (57%) decided to reengage with the criminal justice system...
April 1, 2017: Violence Against Women
https://www.readbyqxmd.com/read/29326183/transvaginal-natural-orifice-transluminal-endoscopic-surgery-vnotes-adnexectomy-for-benign-pathology-compared-with-laparoscopic-excision-notable-a-protocol-for-a-randomised-controlled-trial
#7
Jan Filip Baekelandt, Peter A De Mulder, Ilse Le Roy, Chantal Mathieu, Annouschka Laenen, Paul Enzlin, Steven Weyers, Ben W J Mol, Jan J A Bosteels
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) uses natural orifices to access the cavities of the human body to perform surgical interventions. NOTES limits the magnitude of surgical trauma and potentially reduces postoperative pain. Our group published a protocol on a randomised study comparing transvaginal NOTES (vNOTES) versus laparoscopy for hysterectomy (HALON). We simultaneously designed a similar randomised controlled trial (RCT) comparing vNOTES with laparoscopy for adnexectomy...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29325583/an-integrated-delivery-of-care-approach-to-improve-patient-reported-physical-function-and-mental-wellbeing-after-orthopedic-trauma-study-protocol-for-a-randomized-controlled-trial
#8
Laura Zdziarski-Horodyski, MaryBeth Horodyski, Kalia K Sadasivan, Jennifer Hagen, Terrie Vasilopoulos, Matthew Patrick, Robert Guenther, Heather K Vincent
BACKGROUND: Orthopedic trauma injury impacts nearly 2.8 million people each year. Despite surgical improvements and excellent survivorship rates, many patients experience poor quality of life (QOL) outcomes years later. Psychological distress commonly occurs after injury. Distressed patients more frequently experience rehospitalizations, pain medication dependence, and low QOL. This study was developed to test whether an integrative care approach (IntCare; ten-step program of emotional support, education, customized resources, and medical care) was superior to usual care (UsCare)...
January 11, 2018: Trials
https://www.readbyqxmd.com/read/29325446/reduction-of-ptsd-symptoms-with-pre-reactivation-propranolol-therapy-a-randomized-controlled-trial
#9
Alain Brunet, Daniel Saumier, Aihua Liu, David L Streiner, Jacques Tremblay, Roger K Pitman
OBJECTIVE: The authors assessed the efficacy of trauma memory reactivation performed under the influence of propranolol, a noradrenergic beta-receptor blocker, as a putative reconsolidation blocker, in reducing symptoms of posttraumatic stress disorder (PTSD). METHOD: This was a 6-week, double-blind, placebo-controlled, randomized clinical trial in 60 adults diagnosed with long-standing PTSD. Propranolol or placebo was administered 90 minutes before a brief memory reactivation session, once a week for 6 consecutive weeks...
January 12, 2018: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29323556/modality-of-primary-hiv-disclosure-and-association-with-mental-health-stigma-and-antiretroviral-therapy-adherence-in-tanzanian-youth-living-with-hiv
#10
Julia V Ramos, Blandina T Mmbaga, Elizabeth L Turner, Leonia L Rugalabamu, Severa Luhanga, Coleen K Cunningham, Dorothy E Dow
Disclosing HIV status to children before adolescence is a major challenge facing families and healthcare providers. This study used a mixed methods approach to explore the youth perspective of how youth living with HIV (YLHIV) found out their status and to quantify the association of disclosure modality with mental health, stigma, adherence, and HIV outcomes in adolescence. Youth 11-24 years of age attending adolescent HIV clinic in Moshi, Tanzania were included. Adolescents answered questions, including when and how they found out they had HIV, mental health surveys (nine-item Patient Health Questionnaire, Strengths and Difficulties Questionnaire, and modified University of California Los Angeles trauma screen), modified Berger's stigma scale, and self-reported adherence...
January 2018: AIDS Patient Care and STDs
https://www.readbyqxmd.com/read/29322585/scapular-fractures-in-the-pan-scan-era
#11
Cortlyn Brown, Karim Elmobdy, Ali S Raja, Robert M Rodriguez
BACKGROUND: Scapular fractures have been traditionally taught to be associated with significant injuries and major morbidity. As we demonstrated with sternal fracture, pulmonary contusion and rib fracture, increased chest CT utilization and head-to-pelvis CT (pan-scan) protocols in blunt trauma evaluation, however, may diagnose minor, clinically irrelevant scapular fractures, possibly rendering previous teachings obsolete. OBJECTIVES: To determine the 1) percentages of scapular fractures seen on chest CT only (SOCTO) versus seen on both CXR and CT and of isolated scapular fracture (scapular fracture without other thoracic injuries), 2) frequencies of associated thoracic injury with scapular fracture, and 3) proportion of patients admitted, mortality, hospital length of stay, and injury severity scores (ISS), comparing four patient groups: scapular fracture, non-scapular fracture, scapular fracture SOCTO, and isolated scapular fracture...
January 11, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29310718/metacognitive-therapy-vs-eye-movement-desensitization-and-reprocessing-for-posttraumatic-stress-disorder-study-protocol-for-a-randomized-superiority-trial
#12
Hans M Nordahl, Joar Øveraas Halvorsen, Odin Hjemdal, Mimoza Rrusta Ternava, Adrian Wells
BACKGROUND: The psychological treatment of choice for patients with severe posttraumatic stress disorder (PTSD) is cognitive behavioural exposure therapy or Eye Movement Desensitisation Reprocessing (EMDR). Whilst these are the most effective treatments, approximately 30-45% of the patients show no significant improvements and follow-up data are sparse. Furthermore, a proportion of patients with severe trauma does not benefit or avoid exposure therapy due to the potential to overwhelm them...
January 8, 2018: Trials
https://www.readbyqxmd.com/read/29310377/fat-grafting-for-resurfacing-an-exposed-implant-in-lower-extremity-a-case-report
#13
Yun-Nan Lin, Chieh-Han Chuang, Shih-Hao Huang, Shu-Hung Huang, Tsai-Ming Lin, I-Wen Lin, Sin-Daw Lin, Yur-Ren Kuo
RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29307034/emergency-department-imaging-of-pediatric-trauma-patients-during-combat-operations-in-iraq-and-afghanistan
#14
Jason F Naylor, Michael D April, Jamie L Roper, Guyon J Hill, Paul Clark, Steven G Schauer
BACKGROUND: Military hospitals in Iraq and Afghanistan treated children with traumatic injuries during the recent conflicts. Diagnostic imaging is an integral component of trauma management; however, few published data exist on its use in the wartime pediatric population. OBJECTIVE: The authors describe the emergency department (ED) utilization of radiology resources for pediatric trauma patients in Iraq and Afghanistan. MATERIALS AND METHODS: We queried the Department of Defense Trauma Registry (DODTR) for all pediatric patients admitted to military fixed-facility hospitals in Iraq and Afghanistan from January 2007 to January 2016...
January 6, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29306970/preoperative-decolonization-to-reduce-infections-in-urgent-lower-extremity-repairs
#15
Daniel S Urias, Merin Varghese, Thomas Simunich, Shawna Morrissey, Russell Dumire
PURPOSE: Medical implants and surgical site infections (SSIs) can be a burden on both patients and healthcare systems with a significant rise in morbidity, mortality and costs. Preoperatively, our practice of a chlorohexidine gluconate (CHG) washcloth bath or solution shower was supplemented with nasal painting using povidone-iodine skin and nasal antiseptic (PI-SNA). We sought to measure the effectiveness in reducing SSIs in patients undergoing repair of lower extremity fractures. METHODS: A retrospective review of trauma patients undergoing orthopedic operations conducted at Conemaugh Memorial Medical Center from 10/1/2012 through 9/30/2016...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29306704/neuroprotective-effect-of-acute-ethanol-intoxication-in-tbi-is-associated-to-the-hierarchical-modulation-of-early-transcriptional-responses
#16
Akila Chandrasekar, Bahar Aksan, Florian Olde Heuvel, Philip Förstner, Daniela Sinske, Rida Rehman, Annette Palmer, Albert Ludolph, Markus Huber-Lang, Tobias Böckers, Daniela Mauceri, Bernd Knöll, Francesco Roselli
Ethanol intoxication is a risk factor for traumatic brain injury (TBI) but clinical evidence suggests that it may actually improve the prognosis of intoxicated TBI patients. We have employed a closed, weight-drop TBI model of different severity (2cm or 3cm falling height), preceded (-30min) or followed (+20min) by ethanol administration (5g/Kg). This protocol allows us to study the interaction of binge ethanol intoxication in TBI, monitoring behavioral changes, histological responses and the transcriptional regulation of a series of activity-regulated genes (immediate early genes, IEGs)...
January 4, 2018: Experimental Neurology
https://www.readbyqxmd.com/read/29290073/implementation-of-trauma-center-and-massive-transfusion-protocol-improves-outcomes-for-major-trauma-patients-a-study-at-a-single-institution-in-korea
#17
Kyungjin Hwang, Junsik Kwon, Jayun Cho, Yunjung Heo, John Cook-Jong Lee, Kyoungwon Jung
BACKGROUND: This study evaluated the effectiveness and clinical outcomes of the implementation of a trauma center and massive transfusion protocol (TCMTP) in a developing country without a well-established trauma system. METHODS: We included patients (1) aged >15 years, (2) with an Injury Severity Score >15, (3) who received ≥10 units of packed red blood cells (PRBCs) within 24 h, (4) who directly visited our institution from 2010 to 2016, and (5) who survived for ≥24 h...
December 31, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29285328/a-new-spiral-dental-implant-a-tool-for-oral-rehabilitation-of-difficult-cases
#18
I Balan, R Calcaterra, D Lauritano, E Grecchi, F Carinci
Spiral dental implant (SDI) is an implant with a conical internal helix that confers the characteristic of self-drilling, self-tapping, and self-bone condensing. These proprieties offer better control during insertion of SDI giving a high primary stabilization, even in poor quality bone. A shorter diameter of SDI results in reduced drilling during insertion and consequently less trauma and minimal bone loss. To address the research purpose, the investigators designed a retrospective cohort study. The study population was composed of 25 patients, 11 males and 14 females that have been treated by Dr...
July 2017: Oral & Implantology
https://www.readbyqxmd.com/read/29284573/case-report-late-reconstruction-of-the-land-mine-injured-heel-with-an-osteomyocutaneous-composite-fibular-flap
#19
Harun Yasin Tuzun, Mustafa Kurklu, Yalcin Kulahci, Selim Turkkan, Arsen Arsenishvili
The heel comprises the epidermis, minimal subcutaneous tissue, a dense septum, and the calcaneus. Injury to any of these structures can impair the ability to walk. The soft tissue or calcaneal bone can be injured by trauma. Injuries incurred in war are usually high-energy traumas caused by weapons such as rifles, rockets, and land mines. Such injuries can be life threatening and involve the loss of tissue, including skin, soft tissue, bone, and neurovascular tissue. Two main treatment protocols are used for such injuries with large tissue defects: amputation and reconstruction...
December 25, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29283970/prehospital-spine-immobilization-spinal-motion-restriction-in-penetrating-trauma-a-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-east
#20
Catherine G Velopulos, Hasan M Shihab, Lawrence Lottenberg, Marcie Feinman, Ali Raja, Jeffrey Salomone, Elliott R Haut
BACKGROUND: Spine immobilization in trauma has remained an integral part of most emergency medical services (EMS) protocols despite a lack of evidence for efficacy and concern for associated complications, especially in penetrating trauma patients. We reviewed the published evidence on the topic of prehospital spine immobilization or spinal motion restriction in adult patients with penetrating trauma to structure a Practice Management Guideline. METHODS: We conducted a Cochrane style systematic review and meta-analysis, and applied GRADE methodology to construct recommendations...
December 28, 2017: Journal of Trauma and Acute Care Surgery
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