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vascular surgery; general surgery; trauma

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https://www.readbyqxmd.com/read/28273299/association-between-ratio-of-fresh-frozen-plasma-to-red-blood-cells-during-massive-transfusion-and-survival-among-patients-without-traumatic-injury
#1
Tomaz Mesar, Andreas Larentzakis, Walter Dzik, Yuchiao Chang, George Velmahos, Daniel Dante Yeh
Importance: Hemostatic resuscitation has been shown to be beneficial for patients with trauma, but there is little evidence that it is equally beneficial for bleeding patients without trauma. The practice of a high transfusion ratio of fresh frozen plasma (FFP) to red blood cells (RBCs) has spread to other surgical and medical fields. Objective: To identify whether ratio-based resuscitation in patients without trauma is associated with improved survival. Design, Setting, and Participants: This study is a retrospective review of all massive transfusions provided in an urban academic hospital from January 1, 2009, through December 31, 2012...
March 8, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28205467/a-rare-type-of-upper-extremity-injury-penetrating-injuries-caused-by-blunt-edged-items
#2
Hakan Şirinoğlu, Furkan Certel, Nebil Yeşïloğlu, Gökhan Temïz, Kübra Ece Kalafatlar, Murat Sarici, Özhan Çelebïler
BACKGROUND: Penetrating upper extremity injury is a common encountered cause of significant loss of labor force and it is generally caused by sharp items. This article presents five rare cases of penetrating hand and forearm injury caused by blunt-edged items in conjunction with a detailed discussion of the mechanism and management of the injury. METHODS: Five patients with a mean age of 37.6 were treated for upper extremity trauma caused by "blunt-edged items" such as corrugated iron fence, garden wires, iron stick or iron safety fence between 2009 to 2014...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28198023/patient-outcomes-and-amotosalen-uva-treated-platelet-utilization-in-massively-transfused-patients
#3
W Nussbaumer, M Amato, H Schennach, M Astl, C Y Chen, J-S Lin, L Corash, R J Benjamin
BACKGROUND: Amotosalen/UVA-treated platelet concentrates (PCs) have demonstrated efficacy for treating and preventing bleeding in clinical trials and in routine use; however, most studies were performed in haematology/oncology patients. We investigated efficacy during massive transfusion (MT) in general hospitalized patients. METHODS: Universal amotosalen/UVA treatment (INTERCEPT Blood System) of platelets was introduced at a large Austrian medical centre. We performed a retrospective cohort analysis comparing component use, in-hospital mortality and length of stay after MT that included platelet transfusion, for two periods (21 months each) before and after implementation...
February 15, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28151094/spontaneous-resolution-of-ruptured-intracranial-pial-arteriovenous-fistula-following-spinal-surgery
#4
Mark K Lyons, Joseph M Hoxworth, Jamal McClendon, Chandan X Krishna, Naresh P Patel
Pial arteriovenous fistulae (AVFs) are rare vascular abnormalities that are distinct from arteriovenous malformations and dural AVFs. These vascular lesions have been linked with trauma, ischemic syndromes, venous thrombotic diseases, and intracranial surgical procedures. In this report we describe a case of an intracranial ruptured pial AVF immediately following uneventful spinal surgery in an elderly patient with subsequent spontaneous resolution. He was a previous heavy smoker with a 60-pack-year history and alcohol abuse...
January 1, 2017: Neuroradiology Journal
https://www.readbyqxmd.com/read/28121362/anatomy-pathophysiology-and-classification-of-posterior-tibial-tendon-dysfunction
#5
M Guelfi, A Pantalone, R M Mirapeix, D Vanni, F G Usuelli, M Guelfi, V Salini
OBJECTIVE: Adult acquired flatfoot deformity is generally associated with a collapsing medial longitudinal arch and a progressive loss of strength of the posterior tibial tendon (PTT). This condition is commonly associated with PTT dysfunction or rupture, which can have an arthritic or a traumatic etiology. Several causes have been proposed to explain the clinical evidence of tendon degeneration observed at the time of surgery including trauma, anatomical, mechanical, inflammatory and ischemic factors...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#6
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care, and the trend toward nonoperative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
March 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27923680/the-100-most-cited-manuscripts-in-emergency-abdominal-surgery-a-bibliometric-analysis
#7
Thomas Ellul, Nicholas Bullock, Tarig Abdelrahman, Arfon G M T Powell, Jolene Witherspoon, Wyn G Lewis
BACKGROUND: The number of citations a scientific article receives provides a good indication of its impact within any given field. This bibliometric analysis aimed to identify the 100 most cited articles in Emergency Abdominal Surgery (EAS), to highlight key areas of interest and identify those that have most significantly shaped contemporary clinical practice in this newly evolving surgical specialty. This is of increasing relevance as concerns grow regarding the variable and suboptimal outcomes in Emergency General Surgery...
January 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27911067/-vascular-interventional-radiology-a-fundamental-procedure-for-the-management-of-paediatric-trauma
#8
E Bordón Cabrera, A Laín, R Gander, M Pérez Lafuente, I Díez Miranda, C G Fontecha, L Seidler, I Delgado, S Cañadas Palazón, J Lloret
INTRODUCTION: The management of active bleeding with haemodinamic lability in the paediatric trauma patient is difficult and generally leads to damage control surgery. Vascular Interventional Radiology (VIR) techniques are useful for the diagnosis as for the definitive treatment. AIM: The aim of our study was to describe our experience and evaluate effectiveness of VIR in the management of the paediatric trauma patient with active bleeding signs. METHODS: Retrospective analysis (2003-2014) of politraumatic patients who showed contrast blush on computed tomography and then treated by VIR techniques...
January 25, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/27811349/prevalence-and-characteristics-of-surgical-site-infections-caused-by-gram-negative-rod-shaped-bacteria-from-the-family-enterobacteriacae-and-gram-positive-cocci-from-the-genus-staphylococcus-in-patients-who-underwent-surgical-procedures-on-selected-surgical
#9
Małgorzata Tomaszewska-Kowalska, Krzysztof Kołomecki, Maria Wieloch-Torzecka
Surgical site infections on surgical wards are the most common cause of postoperative complications. Prevalence of surgical site infections depends on the surgical specialization. Analysis of the causes of surgical site infections allows to conclude that microorganisms from the patient's own microbiota - Gram-negative rod-shaped bacteria from the family Enterobacteriacae and from the patient's skin microbiota - Gram-positive cocci - Staphylococcus are the most common agents inducing surgical site infections...
October 1, 2016: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/27724088/advances-in-military-resuscitation
#10
Sharon Edwards, Jason Smith
Trauma is a leading cause of death and disability worldwide, in civilian environments and on the battlefield. Trauma-induced haemorrhage is the principal cause of potentially preventable death, which is generally attributable to a combination of vascular injury and coagulopathy. Survival rates following severe traumatic injury have increased due to advanced trauma management initiatives and treatment protocols, influenced by lessons learned from recent conflicts in Iraq and Afghanistan. The use of tourniquets and intraosseous needles, early blood and blood product transfusion, administration of tranexamic acid in pre-hospital settings, and consultant-led damage control resuscitation incorporating damage control surgery have all played their part...
October 6, 2016: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/27621021/trends-in-open-vascular-surgery-for-trauma-implications-for-the-future-of-acute-care-surgery
#11
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David Spain, Kristan Staudenmayer
BACKGROUND: Trauma patients with vascular injuries have historically been within a general surgeon's operative ability. Changes in training and decline in operative trauma have decreased trainees' exposure to these injuries. We sought to determine how frequently vascular procedures are performed at US trauma centers to quantify the need for general surgeons trained to manage vascular injuries. METHODS: We conducted a retrospective analysis of the National Trauma Data Base (NTDB) from 2012 compared with 2002...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27566811/management-of-bleeding-in-vascular-surgery
#12
REVIEW
Y E Chee, S E Liu, M G Irwin
Management of acute coagulopathy and blood loss during major vascular procedures poses a significant haemostatic challenge to anaesthetists. The acute coagulopathy is multifactorial in origin with tissue injury and hypotension as the precipitating factors, followed by dilution, hypothermia, acidemia, hyperfibrinolysis and systemic inflammatory response, all acting as a self-perpetuating spiral of events. The problem is confounded by the high prevalence of antithrombotic agent use in these patients and intraoperative heparin administration...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27516036/the-interdisciplinary-approach-of-an-aggressive-giant-cell-tumor-of-bone-complicated-with-a-fracture-of-the-distal-femur
#13
Iulian Daniel Vîlcioiu, Dragoş George Zamfirescu, Ioan Cristescu, Andrei Ursache, Şerban Arghir Popescu, Cosmin Antoniu Creangă, Ioan Lascăr
Giant cell tumor of bone (GCTB) represents one of the commonest bone tumors encountered by an orthopedic surgeon. The giant-cell tumor is generally classified as benign but the fast growing rhythm and the aggressive soft-tissue invasion may in some cases demonstrate a malign potential of the tumor. We present the case of an aggressive giant cell tumor in a young patient that was first diagnosed in our emergency department with a fracture of the distal femur after a low energy trauma. With further examinations, we discovered that the tumor was invading the both femoral condyles and was vascularized by three major arterial pedicles...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27365740/damage-control-philosophy-in-polytrauma
#14
U S Dadhwal, N Pathak
Severe traumatic injury is a public health care problem; with injuries accounting for 12% of the global mortality. Continued improvement in the survival of severely injured trauma patients is a paramount goal. Bailout/damage control surgery following trauma has developed as a major advance in surgical practice in the last twenty years. The principles of damage control surgery defied the traditional surgical teaching of definitive operative intervention and were slow to be adopted. Currently, damage control surgery has been successfully utilized to manage traumatic thoracic, abdominal, extremity, and peripheral vascular injuries...
October 2010: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/27265210/surgical-resident-radiation-knowledge-attitudes-practices-and-exposures
#15
Richard A Sidwell, Hayden L Smith, James P Halsey, Matthew J McFarlane
OBJECTIVE: To investigate the level of ionizing radiation exposure among surgical residents and to evaluate resident knowledge, attitudes, and practices regarding exposures. DESIGN: An observational study was conducted using radiation exposure data for surgical residents who wore film badge dosimeters. A cross-sectional survey was electronically administered at the end of the year, examining resident knowledge, attitudes, and practices concerning radiation exposures...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27211878/repaying-in-kind-examination-of-the-reciprocity-effect-in-faculty-and-resident-evaluations
#16
REVIEW
Aimee K Gardner, Daniel J Scott
BACKGROUND: Although the reciprocity hypothesis (that trainees have a tendency to modify evaluations based on the grades they receive from instructors) has been documented in other fields, very little work has examined this phenomenon in the surgical residency environment. The purpose of this study was to investigate the extent to which lenient-grading faculty receive higher evaluations from surgery residents. METHODS: Evaluation data from 2 consecutive academic years were collected retrospectively at a large university-based General Surgery residency program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27209033/third-degree-open-fractures-and-traumatic-sub-total-amputations-of-the-upper-extremity-outcome-and-relevance-of-the-mangled-extremity-severity-score
#17
A Fochtmann, H Binder, G Rettl, J Starlinger, O Aszmann, K Sarahrudi, S Hajdu
INTRODUCTION: Third degree open fractures and traumatic sub-/total amputations of the upper extremity represent severe injuries and are associated with a high rate of functional impairment of the affected extremity. More than 20 years ago, the Mangled Extremity Severity Score (MESS) was introduced to predict amputation following severe lower extremity trauma. However, there have been few studies evaluating MESS in connection with the mangled upper limb. MATERIAL AND METHODS: A retrospective medical chart review was performed of all patients diagnosed with the aforementioned fractures of the upper extremity treated at the Department of trauma surgery (level I trauma center) and the Clinical division of plastic and reconstructive surgery at the general hospital of Vienna between 1994 and 2014...
October 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27179226/clinical-strategies-for-the-management-of-intestinal-obstruction-and-pseudo-obstruction-a-delphi-consensus-study-of-sicut-societ%C3%A3-italiana-di-chirurgia-d-urgenza-e-del-trauma
#18
Gianluca Costa, Paolo Ruscelli, Genoveffa Balducci, Francesco Buccoliero, Laura Lorenzon, Barbara Frezza, Piero Chirletti, Franco Stagnitti, Stefano Miniello, Francesco Stella
BACKGROUND: Intestinal obstructions/pseudo-obstruction of the small/large bowel are frequent conditions but their management could be challenging. Moreover, a general agreement in this field is currently lacking, thus SICUT Society designed a consensus study aimed to define their optimal workout. METHODS: The Delphi methodology was used to reach consensus among 47 Italian surgical experts in two study rounds. Consensus was defined as an agreement of 75.0% or greater...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27148160/public-knowledge-and-attitude-toward-essential-tremor-a-questionnaire-survey
#19
Sherif Shalaby, Jeffrey Indes, Benison Keung, Christopher H Gottschalk, Duarte Machado, Amar Patel, Daphne Robakis, Elan D Louis
BACKGROUND: Public awareness of and attitude toward disease is an important issue for patients. Public awareness of essential tremor (ET) has never been studied. METHODS: We administered a 10-min, 31-item questionnaire to 250 consecutive enrollees. These included three samples carefully chosen to have a potential range of awareness of ET: 100 individuals ascertained from a vascular disease clinic, 100 individuals from a general neurology clinic, and 50 Parkinson's disease (PD) patients...
2016: Frontiers in Neurology
https://www.readbyqxmd.com/read/27100954/a-penetrating-dorsal-thoracic-injury-that-is-lucky-from-every-aspect-a-case-report
#20
Mehmet İlhan, Ali Fuat Kaan Gök, Gizem Öner, Kayıhan Günay, Cemalettin Ertekin
INTRODUCTION: Penetrating thoracic trauma management represents a major problem for emergency department staff. In these cases, we reported a patient, who can be deemed very lucky, because of both the trauma mechanism and the provided first aid at scene. PRESENTATION OF CASE: A 30-year-old man was transported to the emergency surgery outpatient clinic after being stabbed from his back. A knife entered thorax from the dorsal region paravertebrally between two scapulae...
2016: International Journal of Surgery Case Reports
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