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Polytrauma

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https://www.readbyqxmd.com/read/28538596/acute-and-hyper-acute-thoracolumbar-corpectomy-for-traumatic-burst-fractures-using-a-mini-open-lateral-approach
#1
William D Smith, Nick Ghazarian, Ginger Christian
STUDY DESIGN: Retrospective chart review. OBJECTIVE: The study purpose was to examine the feasibility of acute (<24 hours) and hyper-acute (<8 hours) treatment of thoracolumbar burst fractures to maintain or improve spinal injury scores. SUMMARY OF BACKGROUND DATA: Historically, treatment of spinal burst fractures within 24 hours from injury was considered an "acute" treatment timeframe. Patient polytrauma triage, multiple surgical specialty and hospital resource coordination affect time to treatment...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28538398/simultaneous-bilateral-midshaft-clavicle-fractures-with-unilateral-dislocation-of-the-acromioclavicular-joint-a-case-report
#2
Dong Dong, Mingyang Yu, Guishan Gu
RATIONALE: Simultaneous bilateral mid-clavicle fracture with unilateral dislocation of the acromioclavicular (AC) joint is an extremely rare injury combination. PATIENT CONCERNS: Herein, we report a case of polytrauma in a 42 years old female following a road traffic accident. DIAGNOSES: The radiographs showed the fractures in bilateral middle third of the clavicle and AC joint dislocation of left shoulder. INTERVENTIONS: The patient was treated with a 5-hole locking hook plate to stabilize the left AC joint and a shortly reconstruction plate to fix the left clavicle...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28537413/two-stage-surgical-treatment-of-inferior-vena-cava-traumatic-rupture-including-urgent-transport-to-a-specialized-unit
#3
J Kristek, P Hromádka, M Konarik, J Froněk
Inferior vena cava injury as well as major liver injury remains a formidable treatment challenge. The most imminent danger is life-threatening bleeding. In this report, we present a case of polytrauma (Injury Severity Score 35) with arupture of the juxtahepatic inferior vena cava which was successfully treated using two-stage approach. The first part of the treatment consisted of damage control laparotomy at a level I trauma center. After stabilization, the patient was air-transported to receive the definitive treatment at a tertiary care facility experienced in hepatopancreatobiliary and transplantation surgery...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28535476/examination-of-polytrauma-typologies-a-latent-class-analysis-approach
#4
Erin Sullivan, Ateka A Contractor, Monica M Gerber, Craig Neumann
Potentially traumatizing events (PTE) are highly prevalent, and are associated with detrimental effects on psychological health, including increased risk of posttraumatic stress disorder (PTSD). Multiple endorsed PTEs (polytraumatization) may have even greater effects on a person's health than the impact of a single index event. To better understand patterns of polytraumatization, person-centered analytic techniques such as Latent class analysis (LCA) are recommended. The current study used LCA to explore latent subgroupings of people based on their endorsement of PTEs, thus defining patterns in PTE exposure...
May 17, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28520674/relationship-stability-after-traumatic-brain-injury-among-veterans-and-service-members-a-va-tbi-model-systems-study
#5
Lillian Flores Stevens, Yanna Lapis, Xinyu Tang, Angelle M Sander, Laura E Dreer, Flora M Hammond, Jeffrey S Kreutzer, Therese M OʼNeil-Pirozzi, Risa Nakase-Richardson
OBJECTIVE: To explore stability of relationships and predictors of change in relationship status 2 years following TBI/polytrauma. SETTING: Five Department of Veterans Affairs Polytrauma Rehabilitation Centers (VA PRCs). PARTICIPANTS: A total of 357 active duty service members and Veterans enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers Traumatic Brain Injury Model Systems database with complete marital status information at 2 years postinjury...
May 17, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28520667/supervision-needs-following-veteran-and-service-member-moderate-to-severe-traumatic-brain-injury-a-va-tbi-model-systems-study
#6
Erin K Bailey, Risa Nakase-Richardson, Nitin Patel, Christina Dillahunt-Aspillaga, Susan A Ropacki, Angelle M Sander, Lillian Stevens, Xinyu Tang
OBJECTIVE: To characterize supervision levels across residential settings at 1 year post-TBI and explore predictors of supervision in a Veteran and Service-member population. SETTING: Five VA Polytrauma Rehabilitation Centers. PARTICIPANTS: A total of 302 individuals enrolled in the VA TBI Model Systems (TBIMS) research program. DESIGN: Prospective, longitudinal, multisite. MAIN MEASURES: Primary residence and supervision levels measured via scores on the Supervision Rating Scale...
May 17, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28520659/predictors-of-satisfaction-with-life-in-veterans-after-traumatic-brain-injury-a-va-tbi-model-systems-study
#7
Leah R Gause, Jacob A Finn, Greg J Lamberty, Xinyu Tang, Lillian Flores Stevens, Blessen C Eapen, Risa Nakase-Richardson
OBJECTIVE: To identify predictors of satisfaction with life in Veterans 1 year after traumatic brain injury (TBI). SETTING: The VA TBI Model Systems (TBIMS) project includes 5 Veterans Affairs (VA) Polytrauma Rehabilitation Centers. PARTICIPANTS: Veterans enrolled in the VA TBIMS study who completed the Satisfaction With Life Scale at year 1 follow-up. The sample is largely male (96%) and Caucasian (72%), with a median age of 27 years upon enrollment...
May 17, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28513412/-multidisciplinary-approach-of-facial-injuries
#8
L Dubois, R Schreurs, O Lapid, P Saeed, G F Adriaensen, F M Hoefnagels, V M de Jong
BACKGROUND: Approximately one quarter of polytrauma patients has facial injuries, which usually lead to loss of form and function. Several specialties are involved in the acute and reconstructive phases of facial injuries, such as oral and maxillofacial surgery, otorhinolaryngology, plastic surgery, ophthalmology and dentistry. CASE DESCRIPTION: A 25-year-old man with severe facial injuries was brought to the shock room after sustaining high-energy trauma. He had a panfacial fracture that required reconstruction...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28504994/preoperative-low-dose-aspirin-exposure-and-outcomes-after-emergency-neurosurgery-for-traumatic-intracranial-hemorrhage-in-elderly-patients
#9
Alex T Lee, Arni Gagnidze, Sharon R Pan, Pimwan Sookplung, Bala Nair, Shu-Fang Newman, Alon Ben-Ari, Ahmed Zaky, Kevin Cain, Monica S Vavilala, Irene Rozet
BACKGROUND: Antiplatelet medications are usually discontinued before elective neurosurgery, but this is not an option for emergent neurosurgery. We performed a retrospective cohort study to examine whether preoperative aspirin use was associated with worse outcomes after emergency neurosurgery in elderly patients. METHODS: We analyzed all cases of emergency neurosurgical procedures for traumatic intracranial hemorrhage from 2008 to 2012 at a level 1 trauma center...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28501568/polytrauma-induced-hepatic-stress-response-and-the-development-of-liver-insulin-resistance
#10
Robert M Akscyn, J Lee Franklin, Tatyana A Gavrikova, Joseph L Messina
Insulin resistance and metabolic dysfunction are common following injury. Polytrauma is defined as combined injuries to more than one body part or organ system, and is common in modern warfare, as well as automobile and industrial accidents. Polytrauma can include any combination of burn injury, fracture, hemorrhage, trauma to the extremities, and blunt or penetrating trauma. Multiple minor injuries are often more deleterious than a more severe single injury. To investigate the mechanisms of development of insulin resistance following injury, we have developed a rat model of polytrauma which combined soft tissue trauma with burn injury and penetrating gastrointestinal (GI) trauma...
May 10, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28495862/the-diagnosis-wide-landscape-of-hospital-acquired-aki
#11
Anne-Sophie Jannot, Anita Burgun, Eric Thervet, Nicolas Pallet
BACKGROUND AND OBJECTIVES: The exploration of electronic hospital records offers a unique opportunity to describe in-depth the prevalence of conditions associated with diagnoses at an unprecedented level of comprehensiveness. We used a diagnosis-wide approach, adapted from phenome-wide association studies (PheWAS), to perform an exhaustive analysis of all diagnoses associated with hospital-acquired AKI (HA-AKI) in a French urban tertiary academic hospital over a period of 10 years. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We retrospectively extracted all diagnoses from an i2b2 (Informatics for Integrating Biology and the Bedside) clinical data warehouse for patients who stayed in this hospital between 2006 and 2015 and had at least two plasma creatinine measurements performed during the first week of their stay...
May 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28495203/treatment-of-air-leak-in-polytrauma-patients-with-blunt-chest-injury
#12
Gabriel Halat, Lukas L Negrin, Konstantina Chrysou, Beatrix Hoksch, Ralph A Schmid, Gregor J Kocher
INTRODUCTION: Precise diagnostics and an adequate therapeutic approach are mandatory in the treatment of air leak in polytrauma patients with blunt chest trauma. The aim of this study was to evaluate the incidence, characteristics, and management of air leak following this injury pattern. PATIENTS AND METHODS: Data from 110 polytrauma patients was collected retrospectively. Fifty-four patients received initial treatment by chest tube placement for pneumothorax. These patients were classified into two groups, one with severe air leak and one with minor air leak...
May 1, 2017: Injury
https://www.readbyqxmd.com/read/28495021/damage-control-and-intramedullary-nailing-for-long-bone-fractures-in-polytrauma-patients
#13
Peter Patka
The early fracture treatment in patients with multiple injuries should be focused on damage control. The fracture type and its location, local soft tissue condition as well as the patient's physiological condition shall determine the time and type of fracture treatment. Prevention of local and systemic complications must be immediately considered and included in the treatment planning. The use of external fixator (ExFix), which will be replaced by IM-implants in most cases at a later stage, provides adequate temporary fracture stabilization with less collateral damage...
May 7, 2017: Injury
https://www.readbyqxmd.com/read/28493077/lung-protective-effects-of-low-volume-resuscitation-and-pharmacologic-treatment-of-swine-subjected-to-polytrauma-and-hemorrhagic-shock
#14
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/28491210/-surgical-treatment-of-the-humeral-pallet-fractures-in-adults
#15
Redouane Hani, Mustapha Nekkaoui, Mohammed Kharmaz, Mohamed El Ouadghiri, Abdou Lahlou, Mly Omar Lamrani, Ahmed El Bardouni, Mustapha Mahfoud, Mohamed Saleh Berrada
The treatment of humeral pallet fractures is mainly based on reconstruction surgery with osteosynthesis. We collected the data of 40 patients with humeral pallet fracture from our archives in the Department of Orthopaedics and Traumatology at the Ibn Sina University Hospital, Rabat from january 2012 to december 2014. The aim of our study was to highlight the clinical, therapeutic and evolutionary features of these fractures as well as the challenges in managing these complex fractures and in evaluating the results...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28487103/the-high-risk-polytrauma-patient-and-inferior-vena-cava-filter-use
#16
Onur Berber, Aswin Vasireddy, Obi Nzeako, Adel Tavakkolizadeh
OBJECTIVES: The aim of this study was to assess the impact on practice of vena cava filter insertion guidelines (Eastern Association for the Surgery of Trauma: practice management guidelines). DESIGN: The study was performed at a level 1 trauma centre with data from the 'Trauma Audit and Research Network' cross-referenced to hospital data. RESULTS: A total of 1138 specific 'high-risk' major trauma patients were identified over a 6-year period...
April 20, 2017: Injury
https://www.readbyqxmd.com/read/28484529/secondary-communicating-hydrocephalus-management-by-implantation-of-external-ventricular-shunt-and-minimal-gradual-increase-of-cerebrospinal-fluid-pressure
#17
Keyvan Mostofi, Madjid Samii
BACKGROUND: This paper presents a new management strategy explaining the process used by implantation of external ventricular drainage (EVD) and very gradual increase of intracranial pressure for treatment of acute hydrocephalus. During the last 30 years' experience in professional practice, the senior author (M.S.) discovered that there are some options of regulations between cerebral spinal fluid (CSF) production and resorption. This theory shows that minimal continuous increase of the CSF pressure as long as the patient general neurological condition is unchanged and appears as normal can lead to definitive treatment of hydrocephalus without needing to set a shunt...
April 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28471371/the-reversal-of-direct-oral-anticoagulants-in-animal-models
#18
Markus Honickel, Necib Akman, Oliver Grottke
Several direct oral anticoagulants (DOACs), including direct thrombin and factor Xa inhibitors, have been approved as alternatives to vitamin K antagonist (VKA) anticoagulants. As with any anticoagulant, DOAC use carries a risk of bleeding. In patients with major bleeding or needing urgent surgery, reversal of DOAC anticoagulation may be required, presenting a clinical challenge. The optimal strategy for DOAC reversal is being refined, and may include use of hemostatic agents such as prothrombin complex concentrates (PCCs; a source of concentrated clotting factors), or DOAC-specific antidotes (which bind their target DOAC to abrogate its activity)...
April 4, 2017: Shock
https://www.readbyqxmd.com/read/28467584/the-geriatric-polytrauma-risk-profile-and-prognostic-factors
#19
Holger Rupprecht, Hans Jürgen Heppner, Kristina Wohlfart, Alp Türkoglu
BACKGROUND: In the German population, the percentage of elderly patients is increasing, and consequently there are more elderly patients among trauma cases, and particularly cases of polytrauma. The aim of this study was to present clinical results and a risk profile for geriatric polytrauma patients. METHODS: Review of 140 geriatric (over 65 years of age) polytrauma patients who received prehospital treatment was performed. Severity of trauma was retrospectively assessed with Hannover Polytrauma Score (HPTS)...
March 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28452884/the-effect-of-reboa-partial-aortic-occlusion-and-aggressive-blood-transfusion-on-traumatic-brain-injury-in-a-swine-polytrauma-model
#20
M Austin Johnson, Timothy K Williams, Sarah-Ashley E Ferencz, Anders J Davidson, Rachel M Russo, William T O'Brien, Joseph M Galante, J Kevin Grayson, Lucas P Neff
OBJECTIVES: Despite clinical reports of poor outcomes, the degree to which REBOA exacerbates traumatic brain injury (TBI) is not known. We hypothesized that combined effects of increased proximal mean arterial pressure (pMAP), carotid blood flow (Qcarotid), and intracranial pressure (ICP) from REBOA would lead to TBI progression compared to partial aortic occlusion (PAO) or no intervention. METHODS: 21 swine underwent a standardized TBI via computer Controlled cortical impact followed by 25% total blood volume rapid hemorrhage...
April 27, 2017: Journal of Trauma and Acute Care Surgery
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