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https://www.readbyqxmd.com/read/27921017/factors-impacting-mortality-in-the-pre-hospital-period-after-road-traffic-accidents-in-urban-india
#1
Ananthnarayan Chandrasekharan, Aditya J Nanavati, Sandhya Prabhakar, Subramaniam Prabhakar
BACKGROUND: India currently has the dubious distinction of experiencing the highest number of road traffic accidents in the world. OBJECTIVES: We believe that this study on road traffic accidents may help to identify factors in the pre-hospital setting that may influence mortality rates. PATIENTS AND METHODS: A prospective observational study was carried out in a metro area in India over a period of one year. The study included consecutive patients admitted to the trauma service after road traffic accidents...
July 2016: Trauma Monthly
https://www.readbyqxmd.com/read/27918852/anomaly-detection-outperforms-logistic-regression-in-predicting-outcomes-in-trauma-patients
#2
Zachary D W Dezman, Chen Gao, Shiming Yang, Peter Hu, Li Yao, Hsiao-Chi Li, Chein-I Chang, Colin Mackenzie
OBJECTIVE: Recent advancements in trauma resuscitation have shown a great benefit of early identification and control of hemorrhage, which is the most common cause of death in injured patients. We introduce a new analytical approach, anomaly detection (AD), as an alternative method to the traditional logistic regression (LR) method in predicting which injured patients receive transfusions, intensive care, and other interventions. METHODS: We abstracted routinely collected prehospital vital sign data from patient records (adult patients who survived more than 15 minutes after being directly admitted to a level 1 trauma center)...
December 5, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27914759/fluid-management-in-patients-with-trauma-restrictive-versus-liberal-approach
#3
REVIEW
Lee Palmer
Massive hemorrhage remains a major cause of traumatic deaths. The ideal fluid resuscitative strategy is much debated. Research has provided inconsistent results regarding which fluid strategy is ideal; the optimum fluid type, timing, and volume remains elusive. Aggressive large-volume resuscitation has been the mainstay based on controlled hemorrhage animal models. For uncontrolled hemorrhagic shock, liberal fluid resuscitative strategies exacerbate the lethal triad, invoke resuscitative injury, and increase mortality while more restrictive fluid strategies tend to ameliorate trauma-induced coagulopathy and favor a greater chance of survival...
December 1, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27912037/avalanche-accidents-causing-fatalities-are-they-any-different-in-the-summer
#4
Mathieu Pasquier, Olivier Hugli, Alexandre Kottmann, Frank Techel
: Pasquier, Mathieu, Olivier Hugli, Alexandre Kottmann, and Frank Techel. Avalanche accidents causing fatalities: are they any different in the summer? High Alt Med Biol. 16:000-000, 2016. AIMS: This retrospective study investigated the epidemiology of summer avalanche accidents that occurred in Switzerland and caused at least one fatality between 1984 and 2014. Summer avalanche accidents were defined as those that occurred between June 1st and October 31st. RESULTS: Summer avalanches caused 21 (4%) of the 482 avalanches with at least one fatality occurring during the study period, and 40 (6%) of the 655 fatalities...
December 2, 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27911370/integrated-compensatory-responses-in-a-human-model-of-hemorrhage
#5
Victor A Convertino, Carmen Hinojosa-Laborde, Gary W Muniz, Robert Carter
Hemorrhage is the leading cause of trauma-related deaths, partly because early diagnosis of the severity of blood loss is difficult. Assessment of hemorrhaging patients is difficult because current clinical tools provide measures of vital signs that remain stable during the early stages of bleeding due to compensatory mechanisms. Consequently, there is a need to understand and measure the total integration of mechanisms that compensate for reduced circulating blood volume and how they change during ongoing progressive hemorrhage...
November 20, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27904474/poly-adp-ribose-polymerase-inhibition-reveals-a-potential-mechanism-to-promote-neuroprotection-and-treat-neuropathic-pain
#6
REVIEW
Prashanth Komirishetty, Aparna Areti, Ranadeep Gogoi, Ramakrishna Sistla, Ashutosh Kumar
Neuropathic pain is triggered by the lesions to peripheral nerves which alter their structure and function. Neuroprotective approaches that limit the pathological changes and improve the behavioral outcome have been well explained in different experimental models of neuropathy but translation of such strategies to clinics has been disappointing. Experimental evidences revealed the role of free radicals, especially peroxynitrite after the nerve injury. They provoke oxidative DNA damage and consequent over-activation of the poly(ADP-ribose) polymerase (PARP) upregulates pro-inflammatory pathways, causing bioenergetic crisis and neuronal death...
October 2016: Neural Regeneration Research
https://www.readbyqxmd.com/read/27898998/nutritional-supplementation-for-hip-fracture-aftercare-in-older-people
#7
REVIEW
Alison Avenell, Toby O Smith, James P Curtain, Jenson Cs Mak, Phyo K Myint
BACKGROUND: Older people with hip fractures are often malnourished at the time of fracture, and subsequently have poor food intake. This is an update of a Cochrane review first published in 2000, and previously updated in 2010. OBJECTIVES: To review the effects (benefits and harms) of nutritional interventions in older people recovering from hip fracture. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL, MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Embase, CAB Abstracts, CINAHL, trial registers and reference lists...
November 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27895932/coagulation-complications-following-trauma
#8
REVIEW
Wenjun Z Martini
Traumatic injury is one of the leading causes of death, with uncontrolled hemorrhage from coagulation dysfunction as one of the main potentially preventable causes of the mortality. Hypothermia, acidosis, and resuscitative hemodilution have been considered as the significant contributors to coagulation manifestations following trauma, known as the lethal triad. Over the past decade, clinical observations showed that coagulopathy may be present as early as hospital admission in some severely injured trauma patients...
2016: Military Medical Research
https://www.readbyqxmd.com/read/27894500/prediction-of-massive-transfusion-in-trauma
#9
REVIEW
Paul M Cantle, Bryan A Cotton
Hemorrhage is the leading cause of preventable death in trauma. Damage control resuscitation relies on permissive hypotension, minimizing crystalloid use, and early implementation of massive transfusion protocols with established blood component ratios. These protocols improve the survival of the severely injured patient. Trauma physicians must quickly and accurately predict when a massive transfusion protocol should be activated. Several validated transfusion scores have been developed for this purpose. Many of these scores are useful for resuscitation research...
January 2017: Critical Care Clinics
https://www.readbyqxmd.com/read/27893619/substituting-systolic-blood-pressure-with-shock-index-in-the-national-trauma-triage-protocol
#10
Ansab A Haider, Asad Azim, Peter Rhee, Narong Kulvatunyou, Kareem Ibraheem, Andrew Tang, Terence O'Keeffe, Hajira Iftikhar, Gary Vercruysse, Bellal Joseph
INTRODUCTION: The National Trauma Triage Protocol (NTTP) is an algorithm that guides emergency medical services providers through four decision steps to identify the patients that would benefit from trauma center care. The NTTP defines a systolic blood pressure (SBP) of less than 90 mm Hg as one of the criteria for trauma center need. The aim of our study was to determine the impact of substituting SBP of less than 90 mm Hg with shock index (SI) on triage performance. METHODS: A 2-year (2011-2012) retrospective analysis of all trauma patients 18 years or older in the National Trauma Databank was performed...
December 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893507/case-study-obstetrical-trauma-with-maternal-death-and-fetal-survival
#11
Matthew Mowry
Trauma during pregnancy is the leading cause of non-obstetric-related maternal and fetal death. This article summarizes obstetric physiology and outlines the assessment and treatment of traumatic injuries of the pregnant patient. A case is presented in which a pregnant woman with blunt abdominal trauma was managed efficiently in a trauma center within a hospital that does not have in-house obstetric services.
January 2017: Critical Care Nursing Quarterly
https://www.readbyqxmd.com/read/27881180/polypharmacy-and-adverse-outcomes-after-hip-fracture-surgery
#12
Maria Härstedt, Cecilia Rogmark, Richard Sutton, Olle Melander, Artur Fedorowski
BACKGROUND: We aimed to explore the effects of polypharmacy and specific drug classes on readmissions and mortality after hip surgery. METHODS: We analyzed data on 272 consecutive hip fracture patients (72.1% females; age 82 ± 9 years) who underwent acute hip replacement. We collected detailed data on the pharmacological treatment upon admission and discharge. Patients were followed up over a period of 6 months after discharge using the Swedish National Hospital Discharge Register and the Swedish National Cause of Death Register...
November 24, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27873009/systematic-review-and-need-assessment-of-pediatric-trauma-outcome-benchmarking-tools-for-low-resource-settings
#13
REVIEW
Etienne St-Louis, Jade Séguin, Daniel Roizblatt, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Trauma is a leading cause of mortality and disability in children worldwide. The World Health Organization reports that 95% of all childhood injury deaths occur in Low-Middle-Income Countries (LMIC). Injury scores have been developed to facilitate risk stratification, clinical decision making, and research. Trauma registries in LMIC depend on adapted trauma scores that do not rely on investigations that require unavailable material or human resources. We sought to review and assess the existing trauma scores used in pediatric patients...
November 21, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/27868190/intensive-care-medicine-in-rural-sub-saharan-africa
#14
M W Dünser, R M Towey, J Amito, M Mer
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2...
November 21, 2016: Anaesthesia
https://www.readbyqxmd.com/read/27862246/a-retrospective-analysis-of-mortality-in-captive-pygmy-hippopotamus-choeropsis-liberiensis-from-1912-to-2014
#15
Gabriella L Flacke, Suzana Tkalčić, Beatrice Steck, Kristin Warren, Graeme B Martin
The pygmy hippopotamus (Choeropsis liberiensis) is an IUCN Red List Endangered species (CITES Appendix II) that has been housed in zoological collections since 1912. As wild populations continue to decline throughout the species' range, successful ex situ breeding and management, including an understanding of morbidity and mortality, are of utmost importance. This study is the first comprehensive review of mortality data from the captive population since 1982 and significantly expands on previous analyses. We solicited necropsy reports from 129/187 zoological institutions worldwide that currently or previously held pygmy hippos and received data for 404 animals (177 ♂, 220 ♀, 7 undermined sex), representing 43% of pygmy hippos that have died in captivity...
November 2016: Zoo Biology
https://www.readbyqxmd.com/read/27857504/impaired-hematopoietic-progenitor-cells-in-trauma-hemorrhagic-shock
#16
REVIEW
Manoj Kumar, Sanjeev Bhoi
Hemorrhagic shock (HS) is the major cause of death during trauma. Mortality due to HS is about 50%. Dysfunction of hematopoietic progenitor cells (HPCs) has been observed during severe trauma and HS. HS induces the elevation of cytokines, granulocyte-colony stimulating factor (G-CSF), peripheral blood HPCs, and circulating catecholamines, and decreases the expression of erythropoietin receptor connected with suppression of HPCs. Impaired HPCs may lead to persistent anemia and risk of susceptibility to infection, sepsis, and MOF...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27855427/anger-in-adulthood-in-participants-who-lost-their-father-during-the-war-in-croatia-when-they-were-in-their-formative-age
#17
Ivana Lončar, Mladen Lončar
BACKGROUND: Loss of parents in early childhood can have serious long-term psychological consequences. Abandoned by a close figure of attachment, many persons have developed the emotion of anger, even though the separation was caused by death. The traumatic experience of the loss of a parent is particularly hard in war, because most often it does not occur as an individual trauma. Our aim is to research anger as a personality trait in persons whose father had died in war at a time when they were children, and to compare it with an appropriate civilian control group of subjects...
December 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27852461/the-development-of-intensive-care-in-the-military-environment
#18
REVIEW
Matthew J Roberts
If the history of critical care is to be addressed, the starting point must be the fundamental and defining qualities of intensive care units. These are the concentration of the sickest patients in a defined area of the hospital, staffed by the personnel most able to care for them (by virtue of specialist training), and the application of the most advanced monitoring or therapeutic techniques available at the time. In the military environment, the ability to provide critical care to ill or injured servicemen has developed in tandem with the civilian experience, but the pressures of the austere environment of the battlefield have, at times, held back military medical services from providing the highest level of care that servicemen might deserve and, indeed, expect in civilian life...
October 2016: Journal of Anesthesia History
https://www.readbyqxmd.com/read/27848415/learning-lessons-from-war-to-treat-people-with-trauma
#19
(no author information available yet)
Trauma is a leading cause of death and disability in civilian environments, and on the battlefield, and trauma-induced haemorrhage is the main cause of potentially preventable death.
November 9, 2016: Nursing Standard
https://www.readbyqxmd.com/read/27847192/trends-in-1029-trauma-deaths-at-a-level-1-trauma-center-impact-of-a-bleeding-control-bundle-of-care
#20
Blessing T Oyeniyi, Erin E Fox, Michelle Scerbo, Jeffrey S Tomasek, Charles E Wade, John B Holcomb
BACKGROUND: Over the last decade the age of trauma patients and injury mortality has increased. At the same time, many centers have implemented multiple interventions focused on improved hemorrhage control, effectively resulting in a bleeding control bundle of care. The objective of our study was to analyze the temporal distribution of trauma-related deaths, the factors that characterize that distribution and how those factors have changed over time at our urban level 1 trauma center...
November 3, 2016: Injury
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