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https://www.readbyqxmd.com/read/28926480/postconcussive-symptoms-over-the-first-14-days-after-mild-traumatic-brain-injury-an-experience-sampling-study
#1
Maria Pacella, Arjun Prabhu, Julia Morley, Stephanie Huang, Brian Suffoletto
OBJECTIVE: This study examined changes in postconcussive symptoms (PCS) over the acute postinjury recovery period, focusing on how daily PCSs differ between mild traumatic brain injury (mTBI) and other injury types. SETTING: An urban emergency department (ED) in Western Pennsylvania. SUBJECTS: A total of 108 adult patients with trauma being discharged from the ED were recruited and grouped by injury type: mild TBI (mTBI; n = 39), head injury without mTBI (HI: n = 16), and non-head-injured trauma controls (TCs: n = 53)...
September 18, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28926192/testing-of-a-bioactive-moldable-bone-graft-substitute-in-an-infected-critically-sized-segmental-defect-model
#2
Matt E Brown, Yuan Zou, Rebecca Peyyala, Sarandeep S Huja, Larry L Cunningham, Todd A Milbrandt, Thomas D Dziubla, David A Puleo
Large infected bone defects, often resulting from high energy traumas, are difficult to treat due to their variability in complexity and location. Standard treatment for infected bone defects begins with a protocol that includes a series of debridements in conjunction with an extended course of systemic antibiotics. Only after the infection has been eliminated will repair of the defect commence, typically with implantation of autologous bone. To address some of the shortcomings of the standard treatment methods, such as serial procedures, limited grafting material, and the need for a second surgical site for autologous bone, a sequential, dual drug-releasing, moldable, calcium sulfate-based bone graft substitute was developed previously...
September 19, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28923035/comparison-of-volar-flexion-ulnar-deviation-and-functional-position-cast-immobilization-in-the-non-operative-treatment-of-distal-radius-fracture-in-elderly-patients-a-pragmatic-randomized-controlled-trial-study-protocol
#3
Lauri Raittio, Antti Launonen, Teemu Hevonkorpi, Toni Luokkala, Juha Kukkonen, Aleksi Reito, Bakir Sumrein, Minna Laitinen, Ville M Mattila
BACKGROUND: Distal radius fractures (DRFs) are the second most common fractures, after hip fractures, seen in clinical practice. The high incidence of low-energy trauma DRFs in elderly patients raises questions about the best treatment method in terms of function, pain, and quality of life. Although the majority of these fractures are treated non-operatively with cast immobilization, valid scientific evidence of the optimal cast immobilization is lacking. In addition, several publications, including Cochrane review have outlined the need for more evidence to determine the most appropriate method of cast immobilization...
September 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28922710/paediatric-mild-head-injury-is-routine-admission-to-a-tertiary-trauma-hospital-necessary
#4
Krishna Tallapragada, Ratna Soundarya Peddada, Mark Dexter
BACKGROUND: Previous studies have shown that children with isolated linear skull fractures have excellent clinical outcomes and low risk of surgery. We wish to identify other injury patterns within the spectrum of paediatric mild head injury, which need only conservative management. Children with low risk of evolving neurosurgical lesions could be safely managed in primary hospitals. METHODS: We retrospectively analysed all children with mild head injury (i.e. admission Glasgow coma score 13-15) and skull fracture or haematoma on a head computed tomography scan admitted to Westmead Children's Hospital, Sydney over the years 2009-2014...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28918120/moment-by-moment-in-women-s-recovery-randomized-controlled-trial-protocol-to-test-the-efficacy-of-a-mindfulness-based-intervention-on-treatment-retention-and-relapse-prevention-among-women-in-residential-treatment-for-substance-use-disorder
#5
Hortensia Amaro, David S Black
Although therapeutic treatments exist for substance use disorder (SUD), about half of individuals who enter treatment leave early and relapse to substance use. Early dropout from residential treatment places individuals at risk of relapse, and women in SUD residential treatment represent a vulnerable population. Evidence gaps persist for the use of mindfulness-based interventions (MBIs) among racially and ethnically diverse women with SUDs, especially regarding the efficacy of MBIs adapted to prevent residential dropout and relapse...
September 13, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#6
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28901621/objective-comparison-of-high-contrast-spatial-resolution-and-low-contrast-detectability-for-various-clinical-protocols-on-multiple-ct-scanners
#7
Damien Racine, Anaïs Viry, Fabio Becce, Sabine Schmidt, Alexandre Ba, François O Bochud, Sue Edyvean, Alexander Schegerer, Francis R Verdun
PURPOSE: We sought to compare objectively computed tomography (CT) scanner performance for three clinically relevant protocols using a task-based image quality assessment method in order to assess the potential for radiation dose reduction. METHODS: Four CT scanners released between 2003 and 2007 by different manufacturers were compared with four CT scanners released between 2012 and 2014 by the same manufacturers using ideal linear model observers (MO): prewhitening (PW) MO and channelized Hotelling (CHO) MO with Laguerre-Gauss channels for high-contrast spatial resolution and low-contrast detectability (LCD) performance, respectively...
September 2017: Medical Physics
https://www.readbyqxmd.com/read/28900890/high-level-of-venous-thromboembolism-in-critically-ill-trauma-patients-despite-early-and-well-driven-thromboprophylaxis-protocol
#8
S R Hamada, C Espina, T Guedj, R Buaron, A Harrois, S Figueiredo, J Duranteau
BACKGROUND: Venous thromboembolism (VTE) is one of the most common preventable causes of in-hospital death in trauma patients surviving their injuries. We assessed the prevalence, incidence and risk factors for deep venous thrombosis (DVT) and pulmonary embolism (PE) in critically ill trauma patients, in the setting of a mature and early mechanical and pharmacological thromboprophylaxis protocol. METHODS: This was a prospective observational study on a cohort of patients from a surgical intensive care unit of a university level 1 trauma centre...
September 12, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28894892/using-emergency-trauma-team-activations-to-measure-trauma-activity-and-injury-severity-10%C3%A2-years-of-experience-using-an-australian-major-trauma-centre-registry
#9
M M Dinh, S Roncal, K Curtis, R Ivers
OBJECTIVES: To describe the outcomes of Emergency Department trauma team activations over a 10-year period with respect to injury severity and hospital length of stay. METHODS: This was a retrospective study using trauma registry data at a single Major Trauma Centre in Australia. All trauma team activations and arrivals on pre-hospital major trauma (T1) protocol recorded in the trauma registry between June 2006 and July 2016 were included. The outcome of interest was major trauma, defined as an Injury Severity Score (ISS) >12 or length of stay >3 days or requiring urgent operative intervention or admission to the Intensive Care Unit following trauma...
September 11, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28892066/effects-of-vagus-nerve-stimulation-on-extinction-of-conditioned-fear-and-post-traumatic-stress-disorder-symptoms-in-rats
#10
L J Noble, I J Gonzalez, V B Meruva, K A Callahan, B D Belfort, K R Ramanathan, E Meyers, M P Kilgard, R L Rennaker, C K McIntyre
Exposure-based therapies help patients with post-traumatic stress disorder (PTSD) to extinguish conditioned fear of trauma reminders. However, controlled laboratory studies indicate that PTSD patients do not extinguish conditioned fear as well as healthy controls, and exposure therapy has high failure and dropout rates. The present study examined whether vagus nerve stimulation (VNS) augments extinction of conditioned fear and attenuates PTSD-like symptoms in an animal model of PTSD. To model PTSD, rats were subjected to a single prolonged stress (SPS) protocol, which consisted of restraint, forced swim, loss of consciousness, and 1 week of social isolation...
August 22, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28886784/development-of-a-new-infusion-protocol-for-austere-trauma-resuscitations
#11
Stewart A Stancil
Intravenous fluid therapy for hemorrhagic shock has undergone enormous changes since it was first conducted almost 200 years ago. In the past 40 years especially, practices have dramatically changed with regards to fluid resuscitation. In pre-hospital, combat, austere, and rural emergency medicine the stakes are especially high to deliver an effective and logical resuscitation fluid strategy to a patient that is suffering from hemorrhagic shock. This article follows a prior article published in July 2014. It highlights the development of new cutting edge intravenous therapy regimens that maximize hemodynamic outcomes that can be effected by those providers that care for injured patients without the benefit of ample resources...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28882905/cost-comparison-of-orthopaedic-fracture-pathways-using-discrete-event-simulation-in-a-glasgow-hospital
#12
Gillian H Anderson, Paul J Jenkins, David A McDonald, Robert Van Der Meer, Alec Morton, Margaret Nugent, Lech A Rymaszewski
OBJECTIVE: Healthcare faces the continual challenge of improving outcome while aiming to reduce cost. The aim of this study was to determine the micro cost differences of the Glasgow non-operative trauma virtual pathway in comparison to a traditional pathway. DESIGN: Discrete event simulation was used to model and analyse cost and resource utilisation with an activity-based costing approach. Data for a full comparison before the process change was unavailable so we used a modelling approach, comparing a virtual fracture clinic (VFC) with a simulated traditional fracture clinic (TFC)...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28881894/outcomes-following-the-main-treatment-options-in-patients-with-a-leaking-esophagus-a-systematic-literature-review
#13
S Persson, I Rouvelas, T Irino, L Lundell
Leakage from the esophagus and gastroesophageal junction can be lethal due to uncontrolled contamination of the mediastinum. The most predominant risk factors for the subsequent clinical outcome are the patients' delay as well as the delay of diagnosis. Two major therapeutic concepts have been advocated: either prompt closure of the leakage by insertion of a self-expandable metal stent (SEMS) or more traditionally, surgical exploration. The objective of this review is to carefully scrutinize the recent literature and assess the outcomes of these two therapeutic alternatives in the management of iatrogenic perforation-spontaneous esophageal rupture as separated from those with anastomotic leak...
December 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28880807/-my-heart-is-in-his-hands-the-lived-spiritual-experiences-of-congolese-refugee-women-survivors-of-sexual-violence
#14
Melissa A Smigelsky, Alison R Gill, Deb Foshager, Jamie D Aten, Hannah Im
The Democratic Republic of Congo (DRC) has experienced widespread violence, including sexual violence. Sexual violence toward women includes rape, genital mutilation, and sexual slavery. Many Congolese have sought to escape such conditions as refugees in the USA. In the present study, we examined lived spiritual experiences of nine Congolese refugee women survivors of sexual violence. Overall, this study provides new insights into participants' experiences of spirituality in the aftermath of sexual trauma and in living as a refugees...
October 2017: Journal of Prevention & Intervention in the Community
https://www.readbyqxmd.com/read/28877594/a-medial-malleolar-fleck-sign-may-predict-ankle-instability-in-ligamentous-supination-external-rotation-ankle-fractures
#15
Kenneth Nwosu, Brian Andrew Schneiderman, Stephen Joseph Shymon, Thomas Harris
BACKGROUND: Ankle joint stability dictates treatment in ligamentous supination external rotation ankle injuries (LSERAI). Investigation of the medial structures that support the ankle mortise is critical, and a small avulsion fracture, or "fleck", of the medial malleolus is occasionally encountered. This study aimed to assess the utility of this medial malleolus fleck sign (MMFS) in diagnosing instability requiring surgery in LSERAI. METHODS: This retrospective observational study examined 166 LSERAI at a single level I trauma center...
September 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28875125/ultrasound-diagnosis-of-fractures-in-mass-casualty-incidents
#16
EDITORIAL
Fikri M Abu-Zidan
The role of point-of-care ultrasound in mass casualty incidents (MCIs) is still evolving. Occasionally, hospitals can be destroyed by disasters resulting in large number of trauma patients. CAVEAT and FASTER ultrasound protocols, which are used in MCIs, included extremity ultrasound examination as part of them. The literature supports the use of ultrasound in diagnosing extremity fractures both in hospitals and MCIs. The most recent systematic review which was reported by Douma-den Hamer et al in 2016 showed that the pooled ultrasound sensitivity and specificity for detecting distal forearm fractures was 97% and 95% respectively...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28870847/bundle-of-care-for-blunt-chest-trauma-patients-improves-analgesia-but-increases-rates-of-intensive-care-unit-admission-a-retrospective-case-control-study
#17
Cédric Carrie, Laurent Stecken, Elsa Cayrol, Vincent Cottenceau, Laurent Petit, Philippe Revel, Matthieu Biais, François Sztark
INTRODUCTION: This single-centre retrospective case-control study aimed to assess the effectiveness of a multidisciplinary clinical pathway for blunt chest trauma patients admitted in emergency department (ED). PATIENTS AND METHODS: All consecutive blunt chest trauma patients with more than 3 rib fractures and no indication of mechanical ventilation were compared to a retrospective cohort over two 24-month periods, before and after the introduction of the bundle of care...
September 1, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28870622/how-can-we-influence-the-incidence-of-secondary-fragility-fractures-a-review-on-current-approaches
#18
H-C Pape, H A Bischoff-Ferrari
With the increasing number of elderly patients presenting with fragility fractures, their care has become a focus among trauma and orthopaedic surgeons. Protocols are ever evolving to improve the clinical pathways and treatment modalities targeting a more efficient and patient centred service. In this article, current approaches and their potential to reduce mortality and re-fracture in these patients are discussed.
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28865685/association-between-compliance-with-triage-directions-from-an-organized-state-trauma-system-and-trauma-outcomes
#19
Benjamin Martinez, John T Owings, Christopher Hector, Paige Hargrove, Shoichiro Tanaka, Margaret Moore, Patrick Greiffenstein, Joseph Giaimo, Shahrzad Talebinejad, John P Hunt
BACKGROUND: The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. STUDY DESIGN: Trauma patients directed by LERN from the field in 2014 were included...
August 26, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28865659/prioritizing-possibilities-for-child-and-family-health-an-agenda-to-address-adverse-childhood-experiences-and-foster-the-social-and-emotional-roots-of-well-being-in-pediatrics
#20
Christina D Bethell, Michele R Solloway, Stephanie Guinosso, Sandra Hassink, Aditi Srivastav, David Ford, Lisa A Simpson
OBJECTIVE: A convergence of theoretical and empirical evidence across many scientific disciplines reveals unprecedented possibilities to advance much needed improvements in child and family well-being by addressing adverse childhood experiences (ACEs), promoting resilience, and fostering nurturance and the social and emotional roots of healthy child development and lifelong health. In this article we synthesize recommendations from a structured, multiyear field-building and research, policy, and practice agenda setting process to address these issues in children's health services...
September 2017: Academic Pediatrics
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