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https://www.readbyqxmd.com/read/28101655/percutaneous-vertebral-augmentation-in-fragility-fractures-indications-and-limitations
#1
O Gonschorek, S Hauck, T Weiß, V Bühren
INTRODUCTION: There is still no general consensus about the management of osteoporotic vertebral fractures. Recommendations depend on type of fracture, grade of instability, bone quality, and general conditions of the patient. Spontaneous fractures may be considered to be treated different compared to cases with high-velocity trauma. METHODS: According to the DVO, patients without trauma should first be treated conservatively. However, there is no more strict time protocol of 3 or 6 week conservative treatment before operations may be indicated...
January 18, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28099390/to-nearly-come-full-circle-nonoperative-management-of-high-grade-iv-v-blunt-splenic-trauma-is-safe-utilizing-a-protocol-with-routine-angioembolization
#2
Indermeet S Bhullar, Joseph J Tepas, Daniel Siragusa, Todd Loper, Andrew Kerwin, Eric R Frykberg
INTRODUCTION: Nonoperative management (NOM) of hemodynamically stable high grade (IV-V) blunt splenic trauma (BST) remains controversial given the high failure rates (19%) that persist despite angioembolization (AE) protocols. The NOM protocol was modified in 2011 to include mandatory AE of all grade (IV-V) injuries without CB along with selective AE of grade (I-V) with CB. The purpose of this study was to determine if this new AE protocol significantly lowered the failure rates for grade (IV-V) injuries allowing for safe observation without surgery and if the exclusion of grade III injuries allowed for the prevention of unnecessary angiograms without affecting the overall failure rates...
January 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#3
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28092169/national-athletic-trainers-association-position-statement-management-of-acute-skin-trauma
#4
Joel W Beam, Bernadette Buckley, William R Holcomb, Mario Ciocca
OBJECTIVE:   To present recommendations for the cleansing, debridement, dressing, and monitoring of acute skin trauma in patients. BACKGROUND:   Acute skin trauma is common during participation in athletic and recreational activities. Clinical decisions and intervention protocols after injury vary among athletic trainers and are often based on ritualistic practices. An understanding of cleansing, debridement, and dressing techniques; clinical features of infection and adverse reactions; and monitoring of acute skin trauma is critical for certified athletic trainers and other allied health and medical professionals to create a local wound environment that promotes healing and lessens the risk of complications...
December 2016: Journal of Athletic Training
https://www.readbyqxmd.com/read/28078377/advances-in-imaging-and-management-trends-of-traumatic-aortic-injuries
#5
Prashant Nagpal, Brian F Mullan, Indrani Sen, Sachin S Saboo, Ashish Khandelwal
Acute traumatic aortic injury (ATAI) is a life-threatening injury. CT is the imaging tool of choice, and the knowledge of direct and indirect signs of injury, grading system, and current management protocol helps the emergency radiologist to better identify and classify the injury and provide additional details that can impact management options. Newer dual-source CT technology with ultrafast acquisition speed has also influenced the appropriate protocol for imaging in patients with suspected ATAI. This review highlights the imaging protocol in patients with blunt trauma, CT appearance and grading systems of ATAI, management options, and the role of the multidisciplinary team in the management of these patients...
January 11, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28072649/is-early-definitive-fixation-of-bicondylar-tibial-plateau-fractures-safe-an-observational-cohort-study
#6
Florence Unno, Kelly A Lefaivre, Georg Osterhoff, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Peter O'Brien
OBJECTIVES: The optimal treatment protocol for bicondylar plateau fractures remains controversial. Contrary to popular practice which favors a staged protocol in many high-energy fracture patterns, we have used early single-stage open reduction and internal fixation (ORIF) to treat these injuries whenever possible. The purpose of this study was to determine the complication rate as well as the functional and radiographic outcomes of this strategy. DESIGN: Retrospective Cohort study and prospective data collection...
December 28, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28059586/resource-document-coordination-of-pediatric-emergency-care-in-ems-systems
#7
Katherine Remick, Toni Gross, Kathleen Adelgais, Manish I Shah, Julie C Leonard, Marianne Gausche-Hill
BACKGROUND: Citing numerous pediatric-specific deficiencies within Emergency Medical Services (EMS) systems, the Institute of Medicine (IOM) recommended that EMS systems appoint a pediatric emergency care coordinator (PECC) to provide oversight of EMS activities related to care of children, to promote the integration of pediatric elements into day-to-day services as well as local and/or regional disaster planning, and to promote pediatric education across all levels of EMS providers. METHODS: A systematic review of the literature was undertaken to describe the evidence for pediatric coordination across the emergency care continuum...
January 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28042430/experimental-protocol-of-dental-procedures-in-patients-with-hereditary-angioedema-the-role-of-anxiety-and-the-use-of-nitrogen-oxide
#8
A Rosa, M Miranda, R Franco, M G Guarino, A Barlattani, P Bollero
Hereditary angioedema (HAE) is a rare disease, little known to the medical and dental community, but with a growing rate of hospitalization over the years. HAE is due to a deficit/dysfunction of C1 esterase inhibitor which leads to an increase in vascular permeability and the appearance of edemas widespread in all body areas. The airways are the most affected and laryngeal swelling, which can occur, it is dangerous for the patient's life, is also a sensitive spot in our daily practice, therefore, it is also important to be aware of all the signs of this disease...
April 2016: Oral & Implantology
https://www.readbyqxmd.com/read/28028561/management-of-paediatric-liver-trauma
#9
REVIEW
A B van As, Alastair J W Millar
Of all the intra-abdominal solid organs, the liver is the most vulnerable to blunt abdominal trauma. The majority of liver ruptures present in combination with other abdominal or extra-abdominal injuries. Over the last three decades, the management of blunt liver trauma has evolved from obligatory operative to non-operative management in over 90% of cases. Penetrating liver injuries more often require operative intervention and are managed according to adult protocols. The greatest clinical challenge remains the timely identification of the severely damaged liver with immediate and aggressive resuscitation and expedition to laparotomy...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27998319/leading-indicators-of-community-based-violent-events-among-adults-with-mental-illness
#10
R A Van Dorn, K J Grimm, S L Desmarais, S J Tueller, K L Johnson, M S Swartz
BACKGROUND: The public health, public safety and clinical implications of violent events among adults with mental illness are significant; however, the causes and consequences of violence and victimization among adults with mental illness are complex and not well understood, which limits the effectiveness of clinical interventions and risk management strategies. This study examined interrelationships between violence, victimization, psychiatric symptoms, substance use, homelessness and in-patient treatment over time...
December 21, 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27997463/outcomes-of-endoscopic-dacryocystorhinostomy-in-secondary-acquired-nasolacrimal-duct-obstruction-a-case-control-study
#11
Adam R Sweeney, Greg E Davis, Shu-Hong Chang, Arash J Amadi
INTRODUCTION: Secondary acquired nasolacrimal duct obstruction (SANDO), where the obstruction is caused by a known process, is becoming more commonly treated by endoscopic dacryocystorhinostomy (endoDCR). This study evaluates outcomes of endoDCR for cases of SANDO in comparison to endoDCR outcomes treating primary acquired nasolacrimal duct obstruction (PANDO). METHODS: All patients undergoing endoDCR from 2006 to 2015 at a tertiary referral center were reviewed for etiology of nasolacrimal duct obstruction (NLDO) and success of procedure...
December 16, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27920244/are-the-registry-data-reliable-an-audit-of-a-regional-trauma-registry-in-the-netherlands
#12
E E Horton, P Krijnen, H M Molenaar, I B Schipper
OBJECTIVE: Data in trauma registries need to be reliable when used for evaluation of injury management, trauma protocols and hospital statistics. The aim of this audit was to analyse the reliability of the data in the Trauma Centre West Netherlands (TCWN) region. DESIGN: Routinely registered trauma patients from all nine hospitals in the TCWN region were re-registered by a registrar for analysis. SETTING: Nine hospitals in the TCWN region in the Netherlands...
December 4, 2016: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/27906845/an-algorithmic-approach-using-ultrasonography-in-the-diagnosis-of-pediatric-nasal-bone-fracture
#13
Ikkei Tamada, Takaaki Mori, Nobuaki Inoue, Hirokazu Shido, Marie Aoki, Yukie Nakamura, Ruri Kamogawa
BACKGROUND: Ultrasonography (US) was recently reported as a reliable modality for diagnosing nasal bone fractures. However, whether US is reliable as a screening tool in the pediatric emergency department (ED) remains unknown. This prospective cohort study had a 2-fold aim: to assess the utility of US in the diagnosis of pediatric nasal bone fracture, and to evaluate the validity of our protocol for managing pediatric nasal bone fractures (Fuchu-Kids algorithm). PATIENTS AND METHODS: Among the patients who presented at the ED with facial trauma, those with a suspected nasal bone fracture were enrolled in the study...
November 30, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27893505/rib-fracture-protocol-advancing-the-care-of-the-elderly-patient
#14
Susan Leininger
This article discusses unique factors associated with rib fractures in the elderly patient population and explains the process used in one facility to develop a revised protocol for the management of elderly patients with a rib fracture. The goals were to eliminate gaps in early trauma care management and employ a care routine that would improve outcomes for this vulnerable group of patients with fracture.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27884333/c-spine-injury-and-mandibular-fractures-lifesaver-broken-in-two-spots
#15
Michael W Chu, Tahereh Soleimani, Tyler A Evans, Sarah I Fernandez, Leigh Spera, Carrie Klene, Ben L Zarzaur, Sunil S Tholpady
BACKGROUND: Trauma is a leading cause of injury and mortality and may involve mandibular fractures and cervical spine injuries. Manipulation of the spine during trauma protocols and operative treatment has the potential to cause serious spinal cord injuries. The purpose of this study was to identify risk factors associated with cervical spine injury (CSI) in patients with mandibular fractures. METHODS: The National Trauma Databank (2007-2010) was used to identify patients with mandibular fractures...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27871539/liberal-or-restrictive-fluid-management-during-elective-surgery-a-systematic-review-and-meta-analysis
#16
REVIEW
Pim B B Schol, Ivon M Terink, Marcus D Lancé, Hubertina C J Scheepers
This article reviews if a restrictive fluid management policy reduces the complication rate if compared to liberal fluid management policy during elective surgery. The PubMed database was explored by 2 independent researchers. We used the following search terms: "Blood transfusion (MESH); transfusion need; fluid therapy (MESH); permissive hypotension; fluid management; resuscitation; restrictive fluid management; liberal fluid management; elective surgery; damage control resuscitation; surgical procedures, operative (MESH); wounds (MESH); injuries (MESH); surgery; trauma patients...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27870668/cost-savings-opportunities-in-perioperative-management-of-the-patients-with-orthopaedic-trauma
#17
Alastair E Moody, Catriona E Moody, Peter L Althausen
Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27864669/subaxial-cervical-spine-trauma
#18
REVIEW
Eric Feuchtbaum, Jacob Buchowski, Lukas Zebala
Subaxial cervical spine trauma is common and an often missed diagnosis. Accurate and efficient diagnosis and management is necessary to avoid devastating complications such as spinal cord injury. Several classification schemes have been devised to help categorize fractures of the subaxial spine and define treatment algorithms. The Subaxial Cervical Spine Injury Classification System (SLIC) is widely used and evaluates not only fracture morphology but also considers ligamentous injury and neurological status in surgical decision making...
December 2016: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/27857503/comprehensive-review-of-challenges-associated-with-management-of-lower-limb-fractures-in-poliomyelitis-patients
#19
REVIEW
Mayank Gupta, Vijay Kumar Jain, Gaurav Kumar Upadhyaya, Rajendra Kumar Arya
Poliomyelitis is on the verge of eradication. But the survivors of polio are still living with its consequences in different parts of the world and so will continue to be seen for almost a century. Fractures in the polio-affected limb are a common entity in these patients and are difficult to manage using the common fracture management protocols. This article gives a comprehensive review of the challenges faced in fixation of fractures in polio affected limbs and possible solutions to overcome them. Knowledge of treating these fractures is important to a trauma surgeon as such scenarios are not uncommon in daily practice...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27855275/epidemiology-and-aetiology-of-traumatic-cardiac-arrest-in-england-and-wales-a-retrospective-database-analysis
#20
Ed Barnard, David Yates, Antoinette Edwards, Marisol Fragoso-Iñiguez, Tom Jenks, Jason E Smith
BACKGROUND: Historically, reported survival from traumatic cardiac arrest (TCA) was extremely low. More recent publications have recorded survival to discharge of up to 8%. This improvement is likely to be multi-factorial; however, there are currently no published data describing the epidemiology or aetiology of TCA in England and Wales to guide future practice improvement. METHODS: Population-based analysis of 2009-2015 Trauma Audit and Research Network (TARN) data...
January 2017: Resuscitation
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