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https://www.readbyqxmd.com/read/28719459/coagulation-management-in-patients-undergoing-neurosurgical-procedures
#1
Chiara Robba, Rita Bertuetti, Frank Rasulo, Alessando Bertuccio, Basil Matta
PURPOSE OF REVIEW: Management of coagulation in neurosurgical procedures is challenging. In this contest, it is imperative to avoid further intracranial bleeding. Perioperative bleeding can be associated with a number of factors, including anticoagulant drugs and coagulation status but is also linked to the characteristic and the site of the intracranial disorder. The aim of this review will be to focus primarily on the new evidence regarding the management of coagulation in patients undergoing craniotomy for neurosurgical procedures...
July 14, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28719428/blood-product-utilization-among-trauma-and-nontrauma-massive-transfusion-protocols-at-an-urban-academic-medical-center
#2
Eshan U Patel, Paul M Ness, Christi E Marshall, Thomas Gniadek, David T Efron, Peter M Miller, Joseph A Zeitouni, Karen E King, Evan M Bloch, Aaron A R Tobian
BACKGROUND: Hospital-wide massive transfusion protocols (MTPs) primarily designed for trauma patients may lead to excess blood products being prepared for nontrauma patients. This study characterized blood product utilization among distinct trauma and nontrauma MTPs at a large, urban academic medical center. METHODS: A retrospective study of blood product utilization was conducted in patients who required an MTP activation between January 2011 and December 2015 at an urban academic medical center...
July 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28717978/-treatment-strategy-and-planning-for-pilon-fractures
#3
REVIEW
Thomas Mittlmeier, Alice Wichelhaus
BACKGROUND: Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. GOALS/MATERIAL AND METHODS: Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#4
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28716784/protocol-for-a-prospective-observational-study-to-improve-prehospital-notification-of-injured-patients-presenting-to-trauma-centres-in-india
#5
Biswadev Mitra, Joseph Mathew, Amit Gupta, Peter Cameron, Gerard O'Reilly, Kapil Dev Soni, Gaurav Kaushik, Teresa Howard, Madonna Fahey, Michael Stephenson, Vineet Kumar, Sharad Vyas, Satish Dharap, Pankaj Patel, Advait Thakor, Naveen Sharma, Tony Walker, Mahesh Chandra Misra, Russell Gruen, Mark Fitzgerald
INTRODUCTION: Prehospital notification of injured patients enables prompt and timely care in hospital through adequate preparation of trauma teams, space, equipment and consumables necessary for resuscitation, and may improve outcomes. In India, anecdotal reports suggest that prehospital notification, in those few places where it occurs, is unstructured and not linked to a well-defined hospital response. The aim of this manuscript is to describe, in detail, a study protocol for the evaluation of a formalised approach to prehospital notification...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#6
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28715116/delayed-transplantation-may-affect-intellectual-ability-in-children
#7
Jiwon M Lee, Yeon Kyung Jung, Jeong-Hoon Bae, Sun Ah Yoon, Ju Hee Kim, YoungRok Choi, Hyeyoung Kim, Kwang-Woong Lee, Hye Young Ahn, Jae Won Kim, Min-Sup Shin, Kyung-Suk Suh, Il-Soo Ha, Hae Il Cheong, Hee Gyung Kang, Nam-Joon Yi
BACKGROUND: Decline in neurocognitive function is a reported complication in children with chronic illness. Concerns have been increasing that exposure to a major surgery or trauma may negatively impact cognitive performance in children. This study has evaluated cognitive function in 43 Korean children who received organ transplantation, and sought to identify associated clinical factors. METHODS: Pediatric recipients of kidney (KT) or liver transplantation (LT) from years 1999 to 2011 were recruited for cognitive tests...
July 17, 2017: Pediatrics International: Official Journal of the Japan Pediatric Society
https://www.readbyqxmd.com/read/28714778/how-clients-change-emotion-with-emotion-a-programme-of-research-on-emotional-processing
#8
Antonio Pascual-Leone
This paper reviews a body of research that has examined Pascual-Leone and Greenberg's sequential model of emotional processing or used its accompanying measure (the Classification of Affective Meaning States). Research from 24 studies using a plurality of methods examined process-outcome relationships from micro to macro levels of observation and builds support for emotional transformation as a possible causal mechanism of change in psychotherapy. A pooled sample of 310 clinical and 130 sub-clinical cases have been studied, reflecting the process of 7 different treatment approaches in addressing over 5 different presenting clinical problems (including depression, anxiety, relational trauma, and personality disorders)...
July 17, 2017: Psychotherapy Research: Journal of the Society for Psychotherapy Research
https://www.readbyqxmd.com/read/28713688/childhood-trauma-and-factors-associated-with-depression-among-inpatients-with-cardiovascular-disease
#9
Felipe José Nascimento Barreto, Frederico Duarte Garcia, Paulo Henrique Teixeira Prado, Paulo Marcos Brasil Rocha, Nádia Souza Las Casas, Felipe Barbosa Vallt, Humberto Correa, Maila Castro Lourenço Neves
AIM: To identify factors associated with depressive symptoms among inpatients with cardiovascular disease (CVD). METHODS: This is a cross-sectional study performed in a subsample of a large cross-sectional research that investigated affective disorders and suicide behaviour among inpatients hospitalized in non-surgical wards of the University Hospital of the Federal University of Minas Gerais from November 2013 to October 2015. Sociodemographic and clinical data were obtained through a structured interview and medical record review...
June 22, 2017: World Journal of Psychiatry
https://www.readbyqxmd.com/read/28711170/early-selenium-treatment-for-traumatic-brain-injury-does-it-improve-survival-and-functional-outcome
#10
Hosseinali Khalili, Rebecka Ahl, Yang Cao, Shahram Paydar, Gabriel Sjölin, Amin Niakan, Gholamreza Dabiri, Shahin Mohseni
BACKGROUND: Traumatic brain injury (TBI) is a major cause of death and debility following trauma. The initial brain tissue insult is worsened by secondary reactive responses including oxidative stress reactions, inflammatory changes and subsequent permanent neurologic deficits. Effective agents to improve functional outcome and survival following TBI are scarce. Selenium is an antioxidant which has shown to reduce oxidative stress. This study examines the effect of intravenous selenium (Selenase(®)) treatment in patients with severe TBI on functional outcome and survival in a prospective study design...
July 8, 2017: Injury
https://www.readbyqxmd.com/read/28710974/predictors-of-recovery-in-cyclists-hospitalised-for-orthopaedic-trauma-following-an-on-road-crash
#11
Ben Beck, Christina L Ekegren, Peter Cameron, Elton R Edwards, Andrew Bucknill, Rodney Judson, Richard Page, Raphael Hau, Mark Stevenson, Belinda J Gabbe
BACKGROUND: As cycling-related injury rates are on the rise, there is a need to understand the long term outcomes of these patients in order to quantify the burden of injury and to inform injury prevention strategies. This study aimed to investigate predictors of return to work and functional recovery in a cohort of cyclists hospitalised for orthopaedic trauma from crashes occurring on-road. METHODS: A retrospective analysis of data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) was conducted for patients who were hospitalised for orthopaedic trauma following a cycling crash that occurred on-road between July 2007 and June 2015...
July 12, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28709791/molecular-biology-of-flexor-tendon-healing-in-relation-to-reduction-of-tendon-adhesions
#12
REVIEW
Anais Legrand, Yoav Kaufman, Chao Long, Paige M Fox
Tendon injuries are encountered after major and minor hand trauma. Despite meticulous repair technique, adhesion formation can occur, limiting recovery. Although a great deal of progress has been made toward understanding the mechanism of tendon healing and adhesions, clinically applicable solutions to prevent adhesions remain elusive. The goal of this paper is to review the most recent literature relating to the tendon healing and adhesion prevention.
July 11, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#13
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28706106/detailed-assessment-of-benefits-and-risks-of-retrievable-inferior-vena-cava-filters-on-patients-with-complicated-injuries-the-da-vinci-multicentre-randomised-controlled-trial-study-protocol
#14
Kwok M Ho, Sudhakar Rao, Stephen Honeybul, Rene Zellweger, Bradley Wibrow, Jeffrey Lipman, Anthony Holley, Alan Kop, Elizabeth Geelhoed, Tomas Corcoran
INTRODUCTION: Retrievable inferior vena cava (IVC) filters have been increasingly used in patients with major trauma who have contraindications to anticoagulant prophylaxis as a primary prophylactic measure against venous thromboembolism (VTE). The benefits, risks and cost-effectiveness of such strategy are uncertain. METHODS AND ANALYSIS: Patients with major trauma, defined by an estimated Injury Severity Score >15, who have contraindications to anticoagulant VTE prophylaxis within 72 hours of hospitalisation to the study centre will be eligible for this randomised multicentre controlled trial...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#15
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704709/protective-role-of-surface-toll-like-receptor-9-expressing-neutrophils-in-local-inflammation-during-systemic-inflammatory-response-syndrome-in-mice
#16
Xiuping Meng, Wei Sun, Yunjia Ren, Yue Xiao, Peiyan Zhao, Wenting Lu, Li Hua, Luowei Wang, Liying Wang, Yongli Yu
Clinically, systemic inflammatory response syndrome (SIRS) occurs after serious trauma or sepsis. In sepsis, neutrophils are the major effector cells responsible for eliminating pathogens. However, the role of neutrophils in development of SIRS, especially in local inflammatory area, is controversial. In this study, we established a SIRS mouse model characterized with cytokine-mediated lethal shock by intraperitoneal injection of oligodexynucleotides containing CpG motifs (CpG ODN) in D-galactosamine (D-GalN) sensitized mice based on our previous work and found that abundant neutrophils were rapidly recruited into the peritoneal cavity, where some neutrophils expressed surface TLR9 (sTLR9), defined as sTLR9(+) neutrophils...
July 10, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28703089/a-traumatic-tale-of-two-cities-a-comparison-of-outcomes-for-adults-with-major-trauma-who-present-to-differing-trauma-centres-in-neighbouring-canadian-provinces
#17
Jefferson Hayre, Colin Rouse, James French, Jacqueline Fraser, Ian Watson, Sue Benjamin, Allison Chisholm, George Stoica, Beth Sealy, Mete Erdogan, Robert Green, Paul Atkinson
OBJECTIVES: While the use of formal trauma teams is widely promoted, the literature is not clear that this structure provides improved outcomes over emergency physician delivered trauma care. The goal of this investigation was to examine if a trauma team model with a formalized, specialty-based trauma team, with specific activation criteria and staff composition, performs differently than an emergency physician delivered model. Our primary outcome was survival to discharge or 30 days...
July 13, 2017: CJEM
https://www.readbyqxmd.com/read/28703082/dental-injuries-in-younger-emergency-department-patients
#18
Vigil James, Yona R Vandersluis, Evangeline W J Zhang, Dennis Scolnik
BACKGROUND: Dental trauma is a relatively common occurrence in childhood, with an impact exceeding that of periodontal diseases. It places a significant burden on the public health system because of its high frequency, impact on quality of life and consumption of resources. OBJECTIVES: To identify changing trends of dental injury in patients between 0-18 years of age in Canada and provide a detailed assessment of dental injury patterns in patients attending a large pediatric tertiary care hospital...
July 13, 2017: CJEM
https://www.readbyqxmd.com/read/28703070/when-disaster-strikes-how-the-emergency-services-provide-a-rapid-response
#19
Erin Dean
As the major trauma centre for north west London, St Mary's Hospital cared for casualties from the two terrorist attacks in the capital - in Westminster and Borough Market - as well as victims of the fire at Grenfell Tower (pictured).
July 13, 2017: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
https://www.readbyqxmd.com/read/28702382/epidemiology-of-pelvic-ring-fractures-and-injuries
#20
Gilberto José Cação Pereira, Erick Ribeiro Damasceno, Daniel Innocenti Dinhane, Francisco Marques Bueno, Jaqueline Bartelega Rodrigues Leite, Bruno da Costa Ancheschi
OBJECTIVE: This study evaluated the pelvic ring fractures and injuries in patients admitted to and treated at this ward between August, 2012 and January, 2014. METHODS: 66 patients were submitted to treatment protocols according to their age, gender, skin color, injury mechanism, location of the trauma, classification of their injuries, emergency intervention, associated injuries, injured side of the body, treatment, and mortality. The most relevant data were classified according to statistic procedures, such as Goodman's association test...
May 2017: Revista Brasileira de Ortopedia
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