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https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#1
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28529911/severe-trauma-in-the-geriatric-population
#2
REVIEW
Juan Antonio Llompart-Pou, Jon Pérez-Bárcena, Mario Chico-Fernández, Marcelino Sánchez-Casado, Joan Maria Raurich
Geriatric trauma constitutes an increasingly recognized problem. Aging results in a progressive decline in cellular function which leads to a loose of their capacity to respond to injury. Some medications commonly used in this population can mask or blunt the response to injury. Falls constitute the most common cause of trauma and the leading cause of trauma-related deaths in this population. Falls are complicated by the widespread use of antiplatelets and anticoagulants, especially in patients with brain injury...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28515606/gender-based-assessment-of-survival-in-trauma-hemorrhagic-shock-a-retrospective-analysis-of-indian-population
#3
Pankaj Verma, Sanjeev Bhoi, Upendra Baitha, Tej Prakash Sinha, Prakash Ranjan Mishra
INTRODUCTION: Trauma-hemorrhagic shock (THS) is a leading cause of death. Female rats and women experience better outcomes in terms of survival after major trauma as compared to males. There are limited data in Indian population. Authors studied the gender-based outcome of patients with Class IV hemorrhagic shock due to blunt trauma and the distribution of factors among males and females which are known to affect outcome. MATERIALS AND METHODS: It was a retrospective study with data of trauma victims between January 2008 and July 2013...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28509685/modelling-acute-traumatic-haemorrhagic-shock-injury-challenges-and-guidelines-for-preclinical-studies
#4
Jordi L Tremoleda, Sarah A Watts, Penny S Reynolds, Christoph Thiemermann, Karim Brohi
Trauma is responsible for a large proportion of the world's burden of disease, and is by far the biggest killer of young adults. Haemorrhage is the leading cause of preventable death and its effects are directly correlated with the incidence multi-organ failure in survivors. Trauma research is challenging due to patient heterogeneity, limited randomised controlled trials, and in vitro studies that fail to mimic the systemic injury response. Preclinical research remains essential for mechanistic and therapeutic discovery...
May 15, 2017: Shock
https://www.readbyqxmd.com/read/28507366/over-a-decade-of-changing-trends-in-surgical-mortality-audit-from-a-tertiary-care-hospital
#5
Hassaan Bari, Khawaja Mohammad Inam Pal, Akbar Jaleel Zubairi
OBJECTIVE: A retrospective audit of the trend of mortality in the general surgery service at our hospital over the last decade was conducted to reflect the complexity of cases being seen. METHODS: Mortalities of 8 separate years, a decade apart, namely 1997, 1998, 1999, and 2000 as initial years (Group-I) and 2011, 2012, 2013 and 2014 as recent years (Group-II) were reviewed. RESULTS: Total number of admissions in the service and surgeries performed during these two periods experienced an increase of 50...
May 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28499862/successful-revascularization-of-aortic-arch-in-a-39-year-old-blunt-trauma-patient-with-acute-diffuse-axonal-injury-without-the-use-of-systemic-anticoagulation
#6
Andrew M Abi-Chaker, Keith M Jones, Priscilla Sanchez, Jordan Sasson, Xiaoyi Li, Jorge Rey
BACKGROUND: Blunt traumatic aortic injury is the second leading cause of death in trauma patients age 4 to 34. Of the patients that are able to receive treatment, mortality rates as high as 40% have been reported. Endovascular repair options have allowed for more expeditious repairs with reduced iatrogenic trauma; however, when the injury involves the ascending aorta or arch, current endografts lack fenestrations needed for cerebral blood flow. Traditionally, on pump cardiopulmonary bypass with systemic anticoagulation has been used to repair these injuries...
May 9, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28499787/motocross-associated-head-and-spine-injuries-in-adult-patients-evaluated-in-an-emergency-department
#7
Lucas Oliveira J E Silva, M Fernanda Bellolio, Elisa M Smith, David J Daniels, Christine M Lohse, Ronna L Campbell
BACKGROUND: Motor vehicle-related injuries (including off-road) are the leading cause of traumatic brain injury (TBI) and acute traumatic spinal cord injury in the United States. OBJECTIVES: To describe motocross-related head and spine injuries of adult patients presenting to an academic emergency department (ED). METHODS: We performed an observational cohort study of adult ED patients evaluated for motocross-related injuries from 2010 through 2015...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28495265/continuous-positive-airway-pressure-for-children-with-undifferentiated-respiratory-distress-in-ghana-an-open-label-cluster-crossover-trial
#8
Patrick T Wilson, Frank Baiden, Joshua C Brooks, Marilyn C Morris, Katie Giessler, Damien Punguyire, Gavin Apio, Akua Agyeman-Ampromfi, Sara Lopez-Pintado, Justice Sylverken, Kwadwo Nyarko-Jectey, Harry Tagbor, Rachel T Moresky
BACKGROUND: In low-income and middle-income countries, invasive mechanical ventilation is often not available for children at risk of death from respiratory failure. We aimed to determine if continuous positive airway pressure (CPAP), a form of non-invasive ventilation, decreases all-cause mortality in children with undifferentiated respiratory distress in Ghana. METHODS: This open-label, cluster, crossover trial was done in two Ghanaian non-tertiary hospitals where invasive mechanical ventilation is not routinely available...
June 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28493974/serum-%C3%AE-1-antitrypsin-aat-antagonizes-intrinsic-apoptosis-induction-in-neutrophils-from-patients-with-systemic-inflammatory-response-syndrome
#9
Theresia Sarabhai, Christoph Peter, Anne-Kathrin Bär, Joachim Windolf, Borna Relja, Sebastian Wesselborg, Thorsten Wahlers, Adnana Paunel-Görgülü
Excessive neutrophil activation accompanied by delayed apoptotic cell death in inflammatory conditions causes progressive damage of cells and tissues, leading to life-threatening multiple organ dysfunction syndrome. Previous work suggested that circulating serum factors during inflammation are critically involved in the suppression of neutrophil cell death although the identity of these antiapoptotic mediators remained elusive. In this study, we identified the acute phase protein α-1 Antitrypsin (AAT) as a potent suppressor of staurosporine (STS)-induced apoptosis in human neutrophils through a mechanism implicating caspases-independent pathways...
2017: PloS One
https://www.readbyqxmd.com/read/28493077/lung-protective-effects-of-low-volume-resuscitation-and-pharmacologic-treatment-of-swine-subjected-to-polytrauma-and-hemorrhagic-shock
#10
Vahagn C Nikolian, Baihong Pan, Tomaz Mesar, Isabel S Dennahy, Patrick E Georgoff, Xiuzhen Duan, Baoling Liu, Xizi Wu, Michael J Duggan, Hasan B Alam, Yongqing Li
Hemorrhage is a common cause of death in the battlefield. Valproic acid (VPA) has been associated with improved outcomes in multiple models of trauma, when combined with isotonic fluid resuscitation. However, isotonic fluid administered in this setting is logistically impractical and may be associated with complications. In this study, we sought to evaluate the feasibility and immunologic impact of combining VPA treatment with low-volume hypertonic saline (HTS). In vivo: female Yorkshire swine were subjected to hemorrhage (40% total blood volume) and polytrauma (rib fracture and delayed liver injury)...
May 10, 2017: Inflammation
https://www.readbyqxmd.com/read/28492546/cold-inducible-rna-binding-protein-through-tlr4-signaling-induces-mitochondrial-dna-fragmentation-and-regulates-macrophage-cell-death-after-trauma
#11
Zhigang Li, Erica K Fan, Jinghua Liu, Melanie J Scott, Yuehua Li, Song Li, Wen Xie, Timothy R Billiar, Mark A Wilson, Yong Jiang, Ping Wang, Jie Fan
Trauma is a major cause of systemic inflammatory response syndrome and multiple organ dysfunction syndrome. Macrophages (Mφ) direct trauma-induced inflammation, and Mφ death critically influences the progression of the inflammatory response. In the current study, we explored an important role of trauma in inducing mitochondrial DNA (mtDNA) damage in Mφ and the subsequent regulation of Mφ death. Using an animal pseudo-fracture trauma model, we demonstrated that tissue damage induced NADPH oxidase activation and increased the release of reactive oxygen species via cold-inducible RNA-binding protein (CIRP)-TLR4-MyD88 signaling...
May 11, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28486327/tourniquets-in-trauma-care-a-review-of-application
#12
Brian Cornelius, Ryan Campbell, Pat McGauly
Traumatic hemorrhage has been identified as the leading cause of battlefield death in recent conflicts. Although injury patterns are not directly reproducible to the civilian world, treatment advancements can be used to provide care to patients worldwide. Long-standing dogma regarding the use of tourniquets has been disproved, and there is now recognition of the critical role that tourniquets play in trauma care. The history and evolution of tourniquets, including the identification of previous faults in application, will lead to an examination of the current devices in use along with evidence-based recommendations for use...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28484665/retrospective-review-of-pediatric-blunt-renal-trauma-a-single-institution-s-five-year-experience
#13
Carly R Richards, Margaret E Clark, Ronald S Sutherland, Russell K Woo
Children are at higher risk of renal injury from blunt trauma than adults due to a variety of anatomic factors such as decreased perirenal fat, weaker abdominal muscles, and a less ossified thoracic cage. Non-operative management is gaining in popularity for even major injuries, although there are no universally accepted guidelines. We present a retrospective review of pediatric major blunt renal injuries (grade 3 or higher) at a children's hospital in Hawai'i over a 5-year period. Medical records were examined between January 2009 and September 2014 from Kapi'olani Medical Center for Women and Children in Honolulu, Hawai'i...
May 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28481839/high-ratio-plasma-resuscitation-does-not-improve-survival-in-pediatric-trauma-patients
#14
Jeremy W Cannon, Michael A Johnson, Robert C Caskey, Matthew A Borgman, Lucas P Neff
BACKGROUND: Damage control resuscitation (DCR) including balanced resuscitation with high ratios of plasma (PLAS) and platelets (PLT) to packed red blood cells (PRBC) improves survival in adult patients. We sought to evaluate the effect of a high ratio PLAS to PRBC resuscitation strategy in massively transfused pediatric patients with combat injuries. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried from 2001-2013 for pediatric trauma patients (<18 years)...
May 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28481163/body-temperature-after-ems-transport-association-with-traumatic-brain-injury-outcomes
#15
Joshua B Gaither, Vatsal Chikani, Uwe Stolz, Chad Viscusi, Kurt Denninghoff, Bruce Barnhart, Terry Mullins, Amber D Rice, Moses Mhayamaguru, Jennifer J Smith, Samuel M Keim, Bentley J Bobrow, Daniel W Spaite
INTRODUCTION: Low body temperatures following prehospital transport are associated with poor outcomes in patients with traumatic brain injury (TBI). However, a minimal amount is known about potential associations across a range of temperatures obtained immediately after prehospital transport. Furthermore, a minimal amount is known about the influence of body temperature on non-mortality outcomes. The purpose of this study was to assess the correlation between temperatures obtained immediately following prehospital transport and TBI outcomes across the entire range of temperatures...
May 8, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28480093/the-public-health-threat-of-road-traffic-accidents-in-nigeria-a-call-to-action
#16
REVIEW
Noc Onyemaechi, U R Ofoma
Public health experts worldwide concede that there is a global epidemic of road traffic accidents (RTA). Globally, RTA is the leading cause of injury-related deaths. In Nigeria, injuries and deaths resulting from RTA are on the rise and are Nigeria's third-leading cause of overall deaths, the leading cause of trauma-related deaths and the most common cause of disability. Do RTA constitute a public health problem in Nigeria? If so, is there a pragmatic approach to combat this problem? A systematic literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google, and directory of open access journals was carried out using the key words " RTA, public health problem, government response, Nigeria...
July 2016: Annals of Medical and Health Sciences Research
https://www.readbyqxmd.com/read/28475653/a-long-term-retrospective-study-on-rehabilitation-of-seabirds-in-gran-canaria-island-spain-2003-2013
#17
Natalia Montesdeoca, Pascual Calabuig, Juan A Corbera, Jorge Orós
AIMS: The aims of this study were to analyze the causes of morbidity and mortality in a large population of seabirds admitted to the Tafira Wildlife Rehabilitation Center (TWRC) in Gran Canaria Island, Spain, from 2003 to 2013, and to analyze the outcomes of the rehabilitation process. METHODS: We included 1,956 seabirds (133 dead on admission and 1,823 admitted alive) in this study. Causes of morbidity were classified into nine categories: light pollution (fallout), fishing gear interaction, crude oil, poisoning/intoxication, other traumas, metabolic/nutritional disorder, orphaned young birds, other causes, and unknown/undetermined...
2017: PloS One
https://www.readbyqxmd.com/read/28474980/risk-of-deep-venous-thrombosis-in-elective-neurosurgical-procedures-a-prospective-doppler-ultrasound-based-study-in-children-12-years-of-age-or-younger
#18
Andrea G Scherer, Ian K White, Kashif A Shaikh, Jodi L Smith, Laurie L Ackerman, Daniel H Fulkerson
OBJECTIVE The risk of venous thromboembolism (VTE) from deep venous thrombosis (DVT) is significant in neurosurgical patients. VTE is considered a leading cause of preventable hospital deaths and preventing DVT is a closely monitored quality metric, often tied to accreditation, hospital ratings, and reimbursement. Adult protocols include prophylaxis with anticoagulant medications. Children's hospitals may adopt adult protocols, although the incidence of DVT and the risk or efficacy of treatment is not well defined...
May 5, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28463097/road-traffic-injury-in-lagos-nigeria-assessing-prehospital-care
#19
Nasiru A Ibrahim, Abdul Wahab O Ajani, Ibrahim A Mustafa, Rufai A Balogun, Mobolaji A Oludara, Olufemi E Idowu, Babatunde A Solagberu
Introduction Injuries are the third most important cause of overall deaths globally with one-quarter resulting from road traffic crashes. Majority of these deaths occur before arrival in the hospital and can be reduced with prompt and efficient prehospital care. The aim of this study was to highlight the burden of road traffic injury (RTI) in Lagos, Nigeria and assess the effectiveness of prehospital care, especially the role of Lagos State Ambulance Service (LASAMBUS) in providing initial care and transportation of the injured to the hospital...
May 2, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28458343/protection-of-the-blood-brain-barrier-as-a-therapeutic-strategy-for-brain-damage
#20
Shotaro Michinaga, Yutaka Koyama
Severe brain damage by trauma, ischemia, and hemorrhage lead to fatal conditions including sudden death, subsequent complications of the extremities and cognitive dysfunctions. Despite the urgent need for treatments for these complications, currently available therapeutic drugs are limited. Blood-brain barrier (BBB) disruption is a common pathogenic feature in many types of brain damage. The characteristic pathophysiological conditions caused by BBB disruption are brain edema resulting from an excessive increase of brain water content, inflammatory damage caused by infiltrating immune cells, and hemorrhage caused by the breakdown of microvessel structures...
2017: Biological & Pharmaceutical Bulletin
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