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Polytrauma

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https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#1
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
BACKGROUND: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications. METHODS: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29156155/leukotriene-b4-indicates-lung-injury-and-on-going-inflammatory-changes-after-severe-trauma-in-a-porcine-long-term-model
#2
Philipp Störmann, Birgit Auner, Lukas Schimunek, Rafael Serve, Klemens Horst, Tim-P Simon, Roman Pfeifer, Kernt Köhler, Frank Hildebrand, Sebastian Wutzler, Hans-Christoph Pape, Ingo Marzi, Borna Relja
BACKGROUND: Recognizing patients at risk for pulmonary complications (PC) is of high clinical relevance. Migration of polymorphonuclear leukocytes (PMN) to inflammatory sites plays an important role in PC, and is tightly regulated by specific chemokines including interleukin (IL)-8 and other mediators such as leukotriene (LT)B4. Previously, we have reported that LTB4 indicated early patients at risk for PC after trauma. Here, the relevance of LTB4 to indicating lung integrity in a newly established long-term porcine severe trauma model (polytrauma, PT) was explored...
December 2017: Prostaglandins, Leukotrienes, and Essential Fatty Acids
https://www.readbyqxmd.com/read/29149362/-traumatic-brain-injury-in-polytrauma-patients
#3
EDITORIAL
T Neubauer
No abstract text is available yet for this article.
September 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/29138874/using-il-6-concentrations-in-the-first-24%C3%A2-h-following-trauma-to-predict-immunological-complications-and-mortality-in-trauma-patients-a-meta-analysis
#4
REVIEW
Zhi Qiao, Weikang Wang, Luxu Yin, Peng Luo, Johannes Greven, Klemens Horst, Frank Hildebrand
PURPOSE: In previous studies, interleukin-6 (IL-6) has been shown to have a high predictive value for the development of complications and mortality after trauma; however, there is some uncertainty around these results. The aim of this meta-analysis was to assess the value of early IL-6 levels (within the first 24 h after trauma) for predicting post-traumatic complications [acute respiratory distress syndrome (ARDS), systemic inflammatory response syndrome (SIRS), sepsis, multiple organ failure (MOF), and multiple organ dysfunction syndrome (MODS)] and mortality...
November 14, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29132582/airway-management-in-trauma
#5
REVIEW
George Kovacs, Nicholas Sowers
Airway management in the trauma patient presents numerous unique challenges beyond placement of an endotracheal tube and outcomes are dependent on the provider's ability to anticipate difficulty. Airway management strategies for the care of the polytrauma patient are reviewed, with specific considerations for those presenting with traumatic brain injury, suspected c-spine injury, the contaminated airway, the agitated trauma patient, maxillofacial trauma, and the traumatized airway. An approach to airway management that considers the potential anatomic and physiologic challenges in caring for these complicated trauma patients is presented...
February 2018: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/29128858/relation-between-lifespan-polytrauma-typologies-and-post-trauma-mental-health
#6
Ateka A Contractor, Lily A Brown, Nicole H Weiss
BACKGROUND: Most individuals experience more than one trauma. Hence, it is important to consider the count and types of traumas (polytraumatization) in relation to post-trauma mental health. METHOD: The current study examined the relation of polytraumatization patterns to PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]), depression, and impulsivity facets (lack of perseverance, lack of premeditation, negative urgency, sensation seeking) using a web-based sample of 346 participants...
October 16, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/29125848/early-decreased-tlr2-expression-on-monocytes-is-associated-with-their-reduced-phagocytic-activity-and-impaired-maturation-in-a-porcine-polytrauma-model
#7
Lukas Schimunek, Rafael Serve, Michel P J Teuben, Philipp Störmann, Birgit Auner, Mathias Woschek, Roman Pfeifer, Klemens Horst, Tim-P Simon, Miriam Kalbitz, Ramona Sturm, Hans-C Pape, Frank Hildebrand, Ingo Marzi, Borna Relja
In their post-traumatic course, trauma patients suffering from multiple injuries have a high risk for immune dysregulation, which may contribute to post-injury complications and late mortality. Monocytes as specific effector cells of the innate immunity play a crucial role in inflammation. Using their Pattern Recognition Receptors (PRRs), notably Toll-Like Receptors (TLR), the monocytes recognize pathogens and/or pathogen-associated molecular patterns (PAMPs) and organize their clearance. TLR2 is the major receptor for particles of gram-positive bacteria, and initiates their phagocytosis...
2017: PloS One
https://www.readbyqxmd.com/read/29122114/frequency-and-perforin-expression-of-different-lymphocyte-subpopulations-in-patients-with-lower-limb-fracture-and-thoracic-injury
#8
Nikola Grzalja, Tedi Cicvaric, Danijel Knezevic, Janja Kuharic, Alan Sustic, Bore Bakota, Simona Komen, Vlatka Sotosek Tokmadzic
INTRODUCTION: Trauma with multiple injuries is associated with a high risk of complications, which may be related to excessive stimulation of inflammatory and anti-inflammatory responses. Although the effects of polytrauma on the immune response have been well established at the cellular and molecular levels, there is little information about the changes in the cytolytic potential of immunocompetent cells, including expression of cytotoxic molecules such as perforin. Therefore, the objective of the present study was to analyse and compare differences in the frequency and perforin expression of leukocyte subpopulations in the peripheral blood of patients with lower limb fracture, thoracic injury, and simultaneous lower limb fracture and thoracic injury...
November 2017: Injury
https://www.readbyqxmd.com/read/29114277/contributing-factors-for-coagulopathy-in-traumatic-brain-injury
#9
Ajit Shrestha, Ramesh Man Joshi, Upendra Prasad Devkota
Context: In traumatic brain injury patients, coagulation disorder causes secondary brain injury, thereby increasing mortality and morbidity. Aims: The aim of this study is to identify the factors responsible for coagulopathy in traumatic brain injury. Settings and Design: This prospective longitudinal study from June 2012 included 100 patients with moderate and severe head injury presenting to National Institute of Neurological and Allied Sciences, Kathmandu, over 1-year period...
October 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29110832/thromboelastometric-profile-and-acute-coagulopathy-of-the-polytraumatized-patient-clinical-and-prognostic-implications
#10
Antònia Bonet, Zoilo Madrazo, Maylin Koo, Israel Otero, Montserrat Mallol, Irene Macia, Luciano Ramirez, Antoni Sabaté
INTRODUCTION: About 25-35% of polytraumatized patients have a profound alteration of hemostasis on arrival at the hospital (acute traumatic coagulopathy [CAT]). Viscoelastic tests (ROTEM(®)) measure the hemostatic capacity and provide an early detection of CAT. The objectives of this study are to describe the initial thromboelastogram of these patients and to determine the prevalence of CAT according to predefined thromboelastographic profiles. METHODS: Single-center, observational, prospective study in polytraumatic patients...
October 27, 2017: Cirugía Española
https://www.readbyqxmd.com/read/29098965/orthopedic-injuries-in-pediatric-trauma
#11
Eman Loubani, Rodrick Lim, Debra Bartley
Trauma remains the leading cause of death in children, of which the majority of patients have orthopedic injuries. The range of injured bones is various, each requiring knowledge and expertise to appropriately manage in a timely fashion. The importance of a systematic approach to the pediatric polytrauma patient is paramount. This chapter will highlight orthopedic issues important to the pediatric polytrauma patient including the unique anatomy and properties of pediatric bone. A systematic approach to the pediatric polytrauma patient will also be discussed...
September 11, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29097180/student-veterans-reintegrating-from-the-military-to-the-university-with-traumatic-injuries-how-does-service-use-relate-to-health-status
#12
Christine A Elnitsky, Cara Blevins, Jan Warren Findlow, Tabitha Alverio, Dennis Wiese
OBJECTIVE: To examine the effects of campus services on the health of veterans with traumatic injuries and comorbidities as they return from military service and enter college. DESIGN: Cross-sectional internet survey using a mixed-methods analysis approach. SETTING: A four-year urban research university in the southeastern United States. PARTICIPANTS: We conducted a survey of 127 veterans returning from active military duty...
October 30, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29088951/update-on-critical-care-for-acute-spinal-cord-injury-in-the-setting-of-polytrauma
#13
John K Yue, Ethan A Winkler, Jonathan W Rick, Hansen Deng, Carlene P Partow, Pavan S Upadhyayula, Harjus S Birk, Andrew K Chan, Sanjay S Dhall
Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29084268/early-structural-changes-of-the-heart-after-experimental-polytrauma-and-hemorrhagic-shock
#14
Christian K Braun, Miriam Kalbitz, Rebecca Halbgebauer, Philipp Eisele, David A C Messerer, Sebastian Weckbach, Anke Schultze, Sonja Braumüller, Florian Gebhard, Markus S Huber-Lang
Evidence is emerging that systemic inflammation after trauma drives structural and functional impairment of cardiomyocytes and leads to cardiac dysfunction, thus worsening the outcome of polytrauma patients. This study investigates the structural and molecular changes in heart tissue 4 h after multiple injuries with additional hemorrhagic shock using a clinically relevant rodent model of polytrauma. We determined mediators of systemic inflammation (keratinocyte chemoattractant, macrophage chemotactic protein 1), activated complement component C3a and cardiac troponin I in plasma and assessed histological specimen of the mouse heart via standard histomorphology and immunohistochemistry for cellular and subcellular damage and ongoing apoptosis...
2017: PloS One
https://www.readbyqxmd.com/read/29084107/postrehabilitation-mental-health-treatment-utilization-in-veterans-with-traumatic-brain-injury-a-va-tbi-model-systems-study
#15
Jacob A Finn, Greg J Lamberty, Xinyu Tang, Marie E Saylors, Lillian Flores Stevens, Tracy Kretzmer
OBJECTIVE: To identify preinjury variables related to mental health treatment utilization at 2 years post-traumatic brain injury (TBI). SETTING: Veterans Affairs (VA) TBI Model Systems includes 5 VA Polytrauma Rehabilitation Centers. PARTICIPANTS: Veterans and service members enrolled in TBI Model Systems who completed the year 2 follow-up assessment and provided mental health information. Sample was largely male (97%) and White (72%), with median age of 30 years...
October 27, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/29063224/predictors-and-time-based-hospital-mortality-in-patients-with-isolated-and-polytrauma-brain-injuries
#16
Ayman El-Menyar, Rafael Consunji, Husham Abdelrahman, Rifat Latifi, Bianca M Wahlen, Hassan Al-Thani
BACKGROUND: Traumatic brain injury (TBI) is a major cause of morbidity and mortality worldwide. We studied the predictors and time-based mortality in patients with isolated and polytrauma brain injuries in a rapidly developing country. We hypothesized that TBI-related 30-day mortality is decreasing over time. METHODS: A retrospective analysis was conducted for all patients with moderate-to-severe TBI who were admitted directly to a level 1 trauma center between 2010 and 2014...
October 23, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29062816/fat-embolism-syndrome-in-femoral-shaft-fractures-does-the-initial-treatment-make-a-difference
#17
Jânio José Alves Bezerra Silva, Diogo de Almeida Diana, Victor Eduardo Roman Salas, Caio Zamboni, José Soares Hungria Neto, Ralph Walter Christian
OBJECTIVE: To identify the risk factors correlated with the initial treatment performed. METHODS: This is a retrospective study involving a total of 272 patients diagnosed with femoral shaft fractures. Of the patients, 14% were kept at rest until the surgical treatment, 52% underwent external fixation, 10% received immediate definitive treatment, and 23% remained in skeletal traction (23%) until definitive treatment. RESULTS: There were six cases of fat embolism syndrome (FES), which showed that polytrauma is the main risk factor for its development and that initial therapy was not important...
September 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29054228/novel-airway-and-ventilator-management-of-tracheobronchial-disruption-after-blunt-trauma
#18
Nitin Mehdiratta, Michael Archer, Melissa Stewart, Bradley Dennis, Eric Grogan
Tracheobronchial injuries can be difficult to diagnose and manage, especially in the presence of polytrauma. A 50-year-old woman presented as a Level I trauma activation after being struck by a motor vehicle. Initial evaluation demonstrated intracranial hemorrhage and multiple chest injuries, including multilevel bilateral rib fractures, pneumomediastinum, and concern for tracheobronchial injury. After initial stabilization, bronchoscopy was performed and demonstrated an injury to the carina. We report a novel airway and ventilation strategy in the setting of concomitant tracheobronchial injury after severe blunt chest trauma in which extracorporeal support is contraindicated...
November 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29050055/-polytrauma-management-treatment-of-severely-injured-patients-in-er-and-or
#19
Christian von Rüden, Volker Bühren, Mario Perl
The adequate treatment of severely injured patients is challenging and can only be successfully executed when it starts at the accident site and is continued in all treatment phases including the early rehabilitation phase. Treatment should be performed by an interdisciplinary team guided by a trauma surgeon in order to adequately manage the severe injuries some of which are life-threatening. Treatment of polytrauma patients is a key task of certified trauma centers and must follow standardized guidelines. For a successful therapy of severely injured patients lifetime training at regular intervals in well-established polytrauma concepts is a mandatory requirement...
October 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29040811/mobile-emergency-simulation-training-for-rural-health-providers
#20
Douglas Martin, Brent Bekiaris, Gregory Hansen
INTRODUCTION: Mobile emergency simulation offers innovative continuing medical educational support to regions that may lack access to such opportunities. Furthermore, satisfaction is a critical element for active learning. Together, the authors evaluated Canadian rural healthcare providers' satisfaction from high fidelity emergency simulation training using a modified motorhome as a mobile education unit (MEU). METHODS: Over a 5-month period, data was collected during 14 educational sessions in nine different southern Manitoban communities...
July 2017: Rural and Remote Health
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