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https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#1
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28427480/lessons-from-a-large-trauma-center-impact-of-blunt-chest-trauma-in-polytrauma-patients-still-a-relevant-problem
#2
REVIEW
Konstantina Chrysou, Gabriel Halat, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
BACKGROUND: Thoracic trauma is the third most common cause of death after abdominal injury and head trauma in polytrauma patients. The purpose of this study was to investigate epidemiological data, treatment and outcome of polytrauma patients with blunt chest trauma in order to help improve management, prevent complications and decrease polytrauma patients' mortality. METHODS: In this retrospective study we included all polytrauma patients with blunt chest trauma admitted to our tertiary care center emergency department for a 2-year period, from June 2012 until May 2014...
April 20, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28424818/dose-requirements-for-idarucizumab-reversal-of-dabigatran-in-a-lethal-porcine-trauma-model-with-continuous-bleeding
#3
Markus Honickel, Henri M Spronk, Rolf Rossaint, Christian Stoppe, Joanne van Ryn, Hugo Ten Cate, Oliver Grottke
Idarucizumab is licensed for emergency reversal of dabigatran. A single 5 g dose is usually sufficient, but higher doses may sometimes be required and optimum dosing has not been defined. It was the aim of this study to investigate the effect of idarucizumab, given once or as a split dose, after double trauma in pigs anticoagulated with dabigatran. Dabigatran etexilate (30 mg/kg bid) was given to 18 male pigs orally for 3 days. On day 4, animals were randomised 1:1:1 to receive idarucizumab 60+0, 60+60 or 120+0 mg/kg...
April 20, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28420542/improving-prehospital-trauma-care-in-rwanda-through-continuous-quality-improvement-an-interrupted-time-series-analysis
#4
John W Scott, Jeanne D'Arc Nyinawankusi, Samuel Enumah, Rebecca Maine, Eric Uwitonze, Yihan Hu, Ignace Kabagema, Jean Claude Byiringiro, Robert Riviello, Sudha Jayaraman
INTRODUCTION: Injury is a major cause of premature death and disability in East Africa, and high-quality pre-hospital care is essential for optimal trauma outcomes. The Rwandan pre-hospital emergency care service (SAMU) uses an electronic database to evaluate and optimize pre-hospital care through a continuous quality improvement programme (CQIP), beginning March 2014. MATERIALS AND METHODS: The SAMU database was used to assess pre-hospital quality metrics including supplementary oxygen for hypoxia (O2), intravenous fluids for hypotension (IVF), cervical collar placement for head injuries (c-collar), and either splinting (splint) or administration of pain medications (pain) for long bone fractures...
April 5, 2017: Injury
https://www.readbyqxmd.com/read/28418090/natural-mortality-and-cause-of-death-analysis-of-the-captive-chimpanzee-pan-troglodytes-a-35-year-review
#5
REVIEW
Hannah Laurence, Shyamesh Kumar, Michael A Owston, Robert E Lanford, Gene B Hubbard, Edward J Dick
We present the spontaneous causes of mortality for 137 chimpanzees (Pan troglodytes) over a 35-year period. A record review of the pathology database was performed and a primary cause of mortality was determined for each chimpanzee. The most common causes of mortality were as follows: cardiomyopathy (40% of all mortalities), stillbirth/abortion, acute myocardial necrosis, chimpanzee-induced trauma, amyloidosis, and pneumonia. Five morphologic diagnoses accounted for 61% of mortalities: cardiomyopathy, hemorrhage, acute myocardial necrosis, amyloidosis, and pneumonia...
April 18, 2017: Journal of Medical Primatology
https://www.readbyqxmd.com/read/28417338/accessibility-accountability-affordability-healthcare-policy-in-orthopedic-trauma
#6
REVIEW
Renee C Genova, Rachel L Box, James R Ficke
PURPOSE OF REVIEW: This review provides historical background on trauma care in the USA and summarizes contemporary trauma-related health policy issues. It is a primer for orthopedic surgeons who want to promote improvements in research, delivery, and cost reduction in trauma care. RECENT FINDINGS: As of 2010, funding for trauma research accounted for only 0.02% of all National Institutes of Health research funding. This is disproportionate to the societal burden of traumatic injury, which is the leading cause of death and disability among people aged 1 to 46 years in the USA...
April 18, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28416852/-first-aid-system-for-trauma-development-and-status
#7
D K Chen, W C Lin, P Zhang, S J Kuang, W Huang, T B Wang
With the great progress of the economy, the level of industrialization has been increasing year by year, which leads to an increase in accidental trauma accidents. Chinese annual death of trauma is already more than 400 000, which makes trauma the fifth most common cause of death, following malignant tumor, heart, brain and respiratory diseases. Trauma is the leading cause of the death of young adults. At the same time, trauma has become a serious social problem in peace time. Trauma throws great treats on human health and life...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28414569/elevated-levels-of-plasma-mitochondrial-dna-are-associated-with-clinical-outcome-in-intra-abdominal-infections-caused-by-severe-trauma
#8
Qiongyuan Hu, Jianan Ren, Jie Wu, Guanwei Li, Xiuwen Wu, Song Liu, Gefei Wang, Guosheng Gu, Jieshou Li
BACKGROUND: The purpose of our study was to determine prospectively relationships between plasma mitochondrial deoxyribonucleic acid (mtDNA) concentration and clinical outcome in patients with intra-abdominal infections (IAIs) induced by severe abdominal trauma. PATIENTS AND METHODS: The DNA was isolated from serum samples taken from patients with IAIs at hospital days zero, one, and two. Plasma mtDNA concentration was assessed by real-time polymerase chain reaction (PCR)...
April 17, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28407781/early-identification-of-patients-requiring-massive-transfusion-embolization-or-hemostatic-surgery-for-traumatic-hemorrhage-a-systematic-review-protocol
#9
Alexandre Tran, Maher Matar, Ewout W Steyerberg, Jacinthe Lampron, Monica Taljaard, Christian Vaillancourt
BACKGROUND: Hemorrhage is a major cause of early mortality following a traumatic injury. The progression and consequences of significant blood loss occur quickly as death from hemorrhagic shock or exsanguination often occurs within the first few hours. The mainstay of treatment therefore involves early identification of patients at risk for hemorrhagic shock in order to provide blood products and control of the bleeding source if necessary. The intended scope of this review is to identify and assess combinations of predictors informing therapeutic decision-making for clinicians during the initial trauma assessment...
April 13, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28406388/outcomes-following-traumatic-grain-elevator-injuries
#10
Sydnei Tolefree, Anthony Truong, Jeanette Ward, Fanglong Dong, Elizabeth Ablah, James Haan
OBJECTIVES: The absence of a comprehensive database of grain elevator associated injuries hinders accurate evaluation of injury prevalence and may lead to discordant information about injury frequencies. The main purpose of this study was to identify the most common mechanisms of injury related to grain elevator events. Comparisons of hospital outcomes between patients who sustained traumatic injuries associated with grain elevators at Occupational Safety and Health Administration (OSHA) regulated industrial sites versus those on OSHA exempt farming operations were also made...
April 13, 2017: Journal of Agromedicine
https://www.readbyqxmd.com/read/28403205/spontaneous-diseases-in-captive-ratites-struthioniformes-in-northwestern-germany-a-retrospective-study
#11
Aimara Bello, Samuel Frei, Martin Peters, Anne Balkema-Buschmann, Wolfgang Baumgärtner, Peter Wohlsein
A retrospective study was carried out to define the spectrum of spontaneous diseases in ostriches and few other captive ratites, order Struthioniformes, in northwestern Germany. The investigation included 71 ratites necropsied between 1968 and 2014. They consisted of 54 ostriches, 5 emus, and 12 rheas with 37 adults, 23 juveniles and 11 neonates and embryonated eggs. Necropsy reports were reviewed, histologic preparations were re-examined and additional histochemical and immunohistochemical stains were carried out in selected cases...
2017: PloS One
https://www.readbyqxmd.com/read/28400682/unplanned-intensive-care-unit-admission-following-elective-surgical-adverse-events-incidence-patient-characteristics-preventability-and-outcome
#12
Mohammed Meziane, Sidi Driss El Jaouhari, Abdelghafour ElKoundi, Mustapha Bensghir, Hicham Baba, Redouane Ahtil, Khalil Aboulaala, Hicham Balkhi, Charki Haimeur
CONTEXT: Adverse events (AEs) are a persistent and an important reason for Intensive Care Unit (ICU) admission. They lead to death, disability at the time of discharge, unplanned ICU admission (UIA), and prolonged hospital stay. They impose large financial costs on health-care systems. AIMS: This study aimed to determine the incidence, patient characteristics, type, preventability, and outcome of UIA following elective surgical AE. SETTINGS AND DESIGN: This is a single-center prospective study...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400667/epidemiology-of-lower-limb-musculoskeletal-trauma-with-associated-vascular-injuries-in-a-tertiary-care-institute-in-india
#13
Nirmal Raj Gopinathan, Siva Swaminathan Santhanam, Balaji Saibaba, Mandeep Singh Dhillon
BACKGROUND: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma. The aim of this study is to describe the epidemiology and outcome of lower extremity musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28400033/pre-hospital-policies-for-the-care-of-patients-with-acute-coronary-syndromes-in-india-a-policy-document-analysis
#14
Amisha Patel, Dorairaj Prabhakaran, Mark Berendsen, P P Mohanan, Mark D Huffman
BACKGROUND AND OBJECTIVE: Ischemic heart disease is the leading cause of death in India. In high-income countries, pre-hospital systems of care have been developed to manage acute manifestations of ischemic heart disease, such as acute coronary syndrome (ACS). However, it is unknown whether guidelines, policies, regulations, or laws exist to guide pre-hospital ACS care in India. We undertook a nation-wide document analysis to address this gap in knowledge. METHODS AND RESULTS: From November 2014 to May 2016, we searched for publicly available emergency care guidelines and legislation addressing pre-hospital ACS care in all 29 Indian states and 7 Union Territories via Internet search and direct correspondence...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28398934/pediatric-lawnmower-injuries
#15
Tina S Lee, Jan D Luhmann, Scott J Luhmann, Kimberly S Quayle
OBJECTIVE: The aim of this study was to evaluate demographics, characteristics, and mechanisms of injuries caused by lawnmowers in children. METHODS: Chart review from 1990 to 2010 at a level I pediatric trauma center identified patients younger than 18 years with lawnmower injuries. Demographics and characteristics of the injuries were analyzed by descriptive statistical analysis. RESULTS: The study identified 88 subjects, with 80% males and 42% of the subjects younger than 5 years...
April 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28398339/animal-models-to-improve-our-understanding-and-treatment-of-suicidal-behavior
#16
REVIEW
T D Gould, P Georgiou, L A Brenner, L Brundin, A Can, P Courtet, Z R Donaldson, Y Dwivedi, S Guillaume, I I Gottesman, S Kanekar, C A Lowry, P F Renshaw, D Rujescu, E G Smith, G Turecki, P Zanos, C A Zarate, P A Zunszain, T T Postolache
Worldwide, suicide is a leading cause of death. Although a sizable proportion of deaths by suicide may be preventable, it is well documented that despite major governmental and international investments in research, education and clinical practice suicide rates have not diminished and are even increasing among several at-risk populations. Although nonhuman animals do not engage in suicidal behavior amenable to translational studies, we argue that animal model systems are necessary to investigate candidate endophenotypes of suicidal behavior and the neurobiology underlying these endophenotypes...
April 11, 2017: Translational Psychiatry
https://www.readbyqxmd.com/read/28397260/influence-of-euthanasia-method-on-blood-and-gill-variables-in-normoxic-and-hypoxic-gulf-killifish-fundulus-grandis
#17
K F Larter, B B Rees
In many experiments, euthanasia, or humane killing, of animals is necessary. Some methods of euthanasia cause death through cessation of respiratory or cardiovascular systems, causing oxygen levels of blood and tissues to drop. For experiments where the goal is to measure the effects of environmental low oxygen (hypoxia), the choice of euthanasia technique, therefore, may confound the results. This study examined the effects of four euthanasia methods commonly used in fish biology (overdose of MS-222, overdose of clove oil, rapid cooling and blunt trauma to the head) on variables known to be altered during hypoxia (haematocrit, plasma cortisol, blood lactate and blood glucose) or reflecting gill damage (trypan blue exclusion) and energetic status (ATP, ADP and ATP:ADP) in Gulf killifish Fundulus grandis after 24 h exposure to well-aerated conditions (normoxia, 7·93 mg O2  l(-1) , c...
April 11, 2017: Journal of Fish Biology
https://www.readbyqxmd.com/read/28396009/molecular-mechanisms-of-brain-derived-neurotrophic-factor-in-neuro-protection-recent-developments
#18
REVIEW
Hailin Zhao, Azeem Alam, Chun-Yin San, Shiori Eguchi, Qian Chen, Qingquan Lian, Daqing Ma
Neuronal cell injury, as a consequence of acute or chronic neurological trauma, is a significant cause of mortality around the world. On a molecular level, the condition is characterized by widespread cell death and poor regeneration, which can result in severe morbidity in survivors. Potential therapeutics are of major interest, with a promising candidate being brain-derived neurotrophic factor (BDNF), a ubiquitous agent in the brain which has been associated with neural development and may facilitate protective and regenerative effects following injury...
April 7, 2017: Brain Research
https://www.readbyqxmd.com/read/28395008/derivation-and-validation-of-a-serum-biomarker-panel-to-identify-infants-with-acute-intracranial-hemorrhage
#19
Rachel Pardes Berger, Brian J Pak, Mariya D Kolesnikova, Janet Fromkin, Richard Saladino, Bruce E Herman, Mary Clyde Pierce, David Englert, Paul T Smith, Patrick M Kochanek
Importance: Abusive head trauma is the leading cause of death from physical abuse. Missing the diagnosis of abusive head trauma, particularly in its mild form, is common and contributes to increased morbidity and mortality. Serum biomarkers may have potential as quantitative point-of-care screening tools to alert physicians to the possibility of intracranial hemorrhage. Objective: To identify and validate a set of biomarkers that could be the basis of a multivariable model to identify intracranial hemorrhage in well-appearing infants using the Ziplex System...
April 10, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28389734/-intensive-care-treatment-of-traumatic-brain-injury-in-multiple-trauma-patients-decision-making-for-complex-pathophysiology
#20
H Trimmel, G Herzer, H Schöchl, W G Voelckel
Traumatic brain injury (TBI) and hemorrhagic shock due to uncontrolled bleeding are the major causes of death after severe trauma. Mortality rates are threefold higher in patients suffering from multiple injuries and additionally TBI. Factors known to impair outcome after TBI, namely hypotension, hypoxia, hypercapnia, acidosis, coagulopathy and hypothermia are aggravated by the extent and severity of extracerebral injuries. The mainstays of TBI intensive care may be, at least temporarily, contradictory to the trauma care concept for multiple trauma patients...
April 7, 2017: Der Unfallchirurg
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