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"Trauma" AND ("Blunt" OR "Penetrating")

Tamara Merz, Britta Lukaschewski, Daniela Wigger, Aileen Rupprecht, Martin Wepler, Michael Gröger, Clair Hartmann, Matthew Whiteman, Csaba Szabo, Rui Wang, Christiane Waller, Peter Radermacher, Oscar McCook
BACKGROUND: Both the hydrogen sulfide/cystathionine-γ-lyase (H2 S/CSE) and oxytocin/oxytocin receptor (OT/OTR) systems have been reported to be cardioprotective. H2 S can stimulate OT release, thereby affecting blood volume and pressure regulation. Systemic hyper-inflammation after blunt chest trauma is enhanced in cigarette smoke (CS)-exposed CSE-/- mice compared to wildtype (WT). CS increases myometrial OTR expression, but to this point, no data are available on the effects CS exposure on the cardiac OT/OTR system...
October 19, 2018: Intensive Care Medicine Experimental
Reinier B Beks, David Reetz, Mirjam B de Jong, Rolf H H Groenwold, Falco Hietbrink, Michael J R Edwards, Luke P H Leenen, Roderick Marijn Houwert, Jan Paul M Frölke
BACKGROUND: Over the years, a trend has evolved towards operative treatment of flail chest although evidence is limited. Furthermore, little is known about operative treatment for patients with multiple rib fractures without a flail chest. The aim of this study was to compare rib fixation based on a clinical treatment algorithm with nonoperative treatment for both patients with a flail chest or multiple rib fractures. METHODS: All patients with ≥ 3 rib fractures admitted to one of the two contributing hospitals between January 2014 and January 2017 were retrospectively included in this multicenter cohort study...
October 19, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Adel Elkbuli, Rudy Flores, Brianna Dowd, Shaikh Hai, Dessy Boneva, Mark McKenney
BACKGROUND: Cardio Pulmonary Resuscitation (CPR) for traumatized patients in the field portends poor survival but the outcome of trauma patients who arrive in-extremis and undergo CPR shortly after arrival has not been well studied. The purpose of our review is to evaluate survival to discharge for trauma patients with CPR from 1 to 120 minutes (min) after arrival. METHODS: The NTDB Research Data Set (RDS) was reviewed. Patients with vitals in the field who underwent CPR from 1 to 120 min after arrival were divided according to injury type and Injury Severity Score (ISS)...
September 19, 2018: American Journal of Emergency Medicine
Sarah Maki, Joshua H Hou
SIGNIFICANCE: As the prevalence of post-laser-assisted in situ keratomileusis (LASIK) patients rises, recognition of possible traumatic complications and their management in this population becomes increasingly relevant. Penetrating injuries and intraocular foreign bodies are possible in post-LASIK corneas despite an intact anterior corneal surface. However, with prompt recognition and treatment, excellent visual recovery can be achieved. PURPOSE: The purpose of this study was to report an interesting case of a penetrating foreign body through an intact LASIK flap...
October 18, 2018: Optometry and Vision Science: Official Publication of the American Academy of Optometry
Jeffrey W Shupp, Kathleen E Brummel-Ziedins, Mitchell J Cohen, Kalev Freeman, Rasha Hammamieh, Uma S Mudunuri, Thomas Orfeo, Lauren T Moffatt, Bernard H Brownstein, Kenneth G Mann, Marti Jett, Anthony E Pusateri
INTRODUCTION: Provisioning care for traumatically injured patients makes conducting research very proximal to injury difficult. These studies also inherently have regulatory barriers to overcome. Here we outline a protocol for acute-phase enrollment of traumatically injured patients into a prospective observational clinical trial with precise and comprehensive sample acquisition in support of a systems biology approach to a research study. METHODS: Experts in trauma, burn, blood coagulation, computational biology, and integrative systems biology developed a prospective study that would capture the natural history of coagulation pathology after traumatic injury...
October 18, 2018: Shock
Darko Aleksa Golic, Dragan Svraka, Nataša Keleman, Snjezana Petrovic
Flail chest, often defined as the fracture of three or more ribs in two or more places, represents the most severe form of rib fractures. Conservative treatment, consisting of respiratory assistance with endotracheal intubation and mechanical ventilation (internal pneumatic stabilization) and pain control, are the current treatments of choice in the majority of patients with multiple rib fractures. However, the use of mechanical ventilation may create complications. In selected patients, operative fixation of fractured ribs within 72 h post injury may lead to better outcomes...
2018: Frontiers in Medicine
Manpreet Singh, Natasha Gautam, Zoramthara Zadeng, Manpreet Kaur, Pankaj Gupta
PURPOSE: To study the clinical findings, imaging features, and treatment outcomes in children diagnosed with traumatic orbital subperiosteal hematoma (OSpH). METHODS: The medical records of eligible OSpH children treated either via needle aspiration or open surgical drainage were reviewed retrospectively. Three anatomical factors (inferior globe displacement, superior orbital sulcus fullness, extraocular movements) and two functional parameters (visual acuity, pupillary reactions) were used to determine overall success...
October 15, 2018: Journal of AAPOS: the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
Lindsey L Perea, Joshua P Hazelton, Nicole Fox, John P Gaughan, John Porter, Anna Goldenberg
OBJECTIVES: Vascular injury in pediatric trauma patients is uncommon but associated with a reported mortality greater than 19% in some series. The purpose of this study was to characterize pediatric major vascular injuries (MVIs) and analyze mortality at a high-volume combined adult and pediatric trauma center. METHODS: A retrospective review (January 2000 to May 2016) was conducted of all pediatric (<18 years old) trauma patients who presented with a vascular injury...
October 17, 2018: Pediatric Emergency Care
Aliakbar Sabermoghaddam, Mahsa Sardabi, Mohammad Yaser Kiarudi, Saeed Shokoohi-Rad
Subperiosteal hematoma of the orbit is a rare complication that may occur in different situations. The most common cause is blunt trauma to the head region. The victims are usually young boys and the common site is usually orbital roof. There is no uniform approach in the literature in the management of subperiosteal hematoma. Conservative management has been recommended in cases with intact visual function. If conservative management is planned, complete resorption of hematoma may last several months, and the patients must tolerate diplopia and varying degrees of proptosis in this relatively long period of time...
October 18, 2018: Orbit
Guilherme Gozzoli Podolsky-Gondim, Luciano Lopes Furlanetti, Dinark Conceição Viana, Matheus Fernando Manzolli Ballestero, Ricardo Santos de Oliveira
INTRODUCTION: Head injury is a significant economic, social, and medical problem in developing countries and remains one of the leading causes of pediatric morbidity and mortality. The association of traumatic brain injury and coagulopathy in children is linked with an increase in mortality and poor functional outcomes. However, its impact on long-term outcome has not been discussed in the literature so far. OBJECTIVES: The aim of this paper was to investigate the effect of coagulopathy diagnosed by routine laboratory tests on neurological outcome following traumatic brain injury in children...
October 18, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Katrin Brodbeck, Stefanie Kern, Sylvia Schick, Arnd Steinbrück, Michael Schwerer, Birgit Bayer, Katja Anslinger, Steffen Peldschus
INTRODUCTION: Cell-free DNA (cfDNA) elevations were remarked in the blood of trauma patients. Published increases refer to comparative values of a healthy control group, ignoring thereby inter- and intra-individual differences under normal conditions. The aim of this study was to quantify cfDNA in patients in the time course of a planned orthopedic surgery, which constitutes the advantage of obtaining individual pre- and post-trauma values for each patient. By this approach, a basis should be established for the potential future application of cfDNA as biomarker for the detection of mild injuries related to volunteer experiments in forensic biomechanics...
October 16, 2018: International Journal of Legal Medicine
Michelle C Accardi-Ravid, Joshua R Dyer, Sam R Sharar, Shelley Wiechman, Mark P Jensen, Hunter G Hoffman, David R Patterson
BACKGROUND: Nearly 2.8 million people are hospitalized in the USA annually for traumatic injuries, which include orthopedic and internal organ injuries. Early post-injury pain is predictive of poor outcomes, including inability to eventually return to work, and long-term psychological distress. The goal of the present study was to improve our scientific understanding of trauma-related pain by examining (1) the nature and frequency of inpatient trauma pain and (2) the associations between inpatient trauma pain, education, opioid analgesic equivalent use, pain catastrophizing, and sleep quality...
October 15, 2018: International Journal of Behavioral Medicine
Paola Fugazzola, Lucia Morganti, Federico Coccolini, Stefano Magnone, Giulia Montori, Marco Ceresoli, Matteo Tomasoni, Dario Piazzalunga, Stefano Maccatrozzo, Niccolò Allievi, Savino Occhionorelli, Luca Ansaloni
INTRODUCTION: The majority of patients with splenic trauma undergo non-operative management (NOM); around 15% of these cases fail NOM and require surgery. The aim of the current study is to assess whether the hemodynamic status of the patient represents a risk factor for failure of NOM (fNOM) and if this may be considered a relevant factor in the decision-making process, especially in Centers where AE (angioembolization), intensive monitoring and 24-h-operating room are not available...
October 15, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
M Rosa Cozcolluela-Cabrejas, Luis Alberto Sanz-Salanova, John Jairo Jerez Oliveros, José Miguel Madrid Pérez, Laura Romina Zalazar, Felicidad Pérez Omeñaca
INTRODUCTION: To identify the different types of injuries occurred during activities for the general public involving bulls. We analyze the conditions in which these injuries occurred, radiological examinations performed, treatment and complications. METHOD: We present a 10-year retrospective study examining 107 patients who came to the Emergency Department of our hospital with pathologies associated with bulls or bull calves over a period of 10years. We evaluated patient age and sex, exposure to toxic substances, period of the year in which the lesions occurred, type of injury (open, closed or mixed lesions), hospital stay, transfer to another hospital, treatment and complications...
October 12, 2018: Cirugía Española
Marina Kawaguchi, Hirotsugu Yamamoto, Taihei Yamada, Tetsuya Yumoto, Toshiyuki Aokage, Hiromi Ihoriya, Koki Eto, Takanori Suezawa, Hiromichi Naito, Atsunori Nakao
INTRODUCTION: Penetrating thoracic traumas have a wide spectrum, ranging from mild traumas to life-threatening injuries. PRESENTATION OF CASE: This paper illustrates a 40-year-old male with a penetrating pulmonary artery injury that was successfully treated with emergency surgery. The patient visited local hospital by foot complaining of moving object on his chest and was found that an ice pick was penetrating the man's left chest. An ambulance took the patient to our emergency department...
October 8, 2018: International Journal of Surgery Case Reports
Krishan Kumar, Rick Figurasin, Swati Kumar, Muhammad Waseem
Open globe injury (OGI) is a severe form of eye trauma. It is an important cause of monocular blindness worldwide. Ruptures from blunt trauma are most common at the sites where the sclera is thinnest, at the insertions of the extraocular muscles, and at the limbus. Most often, rupture is equatorial. We present a unique case of open globe injury due to blunt ocular trauma from a thrown rock that resulted in a meridional rupture of the eye. The pertinent literature is reviewed.
2018: Case Reports in Emergency Medicine
Christopher Melinosky, Shiming Yang, Peter Hu, HsiaoChi Li, Catriona H T Miller, Imad Khan, Colin Mackenzie, Wan-Tsu Chang, Gunjan Parikh, Deborah Stein, Neeraj Badjatia
Background: In the acute resuscitation period after traumatic brain injury (TBI), one of the goals is to identify those at risk for secondary neurological decline (ND), represented by a constellation of clinical signs that can be identified as objective events related to secondary brain injury and independently impact outcome. We investigated whether continuous vital sign variability and waveform analysis of the electrocardiogram (ECG) or photoplethysmogram (PPG) within the first hour of resuscitation may enhance the ability to predict ND in the initial 48 hours after traumatic brain injury (TBI)...
2018: Frontiers in Neurology
Arjun Desai, Mrinalini A Yadav, Viney Gupta, Shikha Gupta
A 15-year-old male patient presented with vision loss after blunt trauma to the right eye and with clinical evidence of posterior lenticonus. The posttraumatic lenticonus was eccentric (superotemporal). Irregular astigmatism with high myopia on dilated retinoscopy within the lenticonus, localized posterior convexity of peripheral capsule on ultrasound biomicroscopy, and increased higher-order aberrations (HOAs) on wavefront aberrometry compared with fellow-eye findings confirmed the diagnosis. To our knowledge, acquired peripheral posterior lenticonus representing dialysis of Weigert ligament after acute blunt trauma is a new finding...
October 9, 2018: Journal of Cataract and Refractive Surgery
Ting Hway Wong, Yu Jie Wong, Zheng Yi Lau, Nivedita Nadkarni, Gek Hsiang Lim, Dennis Chuen Chai Seow, Marcus Eng Hock Ong, Kelvin Bryan Tan, Hai V Nguyen, Chek Hooi Wong
OBJECTIVES: Readmission after acute care is a significant contributor to health care costs, and has been proposed as a quality indicator. Our earlier studies showed that patients aged ≥55 years who are injured by falls from heights of ≤0.5 m were at increased risk for long-term mortality, compared to patients by high-velocity blunt trauma (higher fall heights, road injuries, and other blunt trauma). We hypothesized that these patients are also at higher risk of readmission, compared to patients injured by high-velocity mechanisms...
October 9, 2018: Journal of the American Medical Directors Association
Xinpu Tang, Hongxu Chen, Chaoyue Chen, Jianguo Xu
INTRODUCTION: Impalement injury is an uncommon presentation, and penetrating chest injuries account for 1% to 13% of thoracic trauma hospital admissions. The vast majority of patients with penetrating thoracic trauma who survive to reach the hospital alive can be managed nonoperatively. Nevertheless, in 10% to 15% of cases, emergency operation is necessary due to the associated hemorrhagic shock and visceral injury. CASE PRESENTATION: Here, we report on a 39-year-old male, a construction worker, who fell down from a height of a construction site, landing ventrally on a clump of iron rods with 4 projecting heavy metallic rods penetrating into his thorax and head (scalp pierced only)...
October 2018: Medicine (Baltimore)
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