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Polytrauma

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https://www.readbyqxmd.com/read/28291522/fractures-and-dislocations-of-the-hand-in-polytrauma-patients-incidence-injury-pattern-and-functional-outcome
#1
Steven Ferree, Quirine M J van der Vliet, Mark van Heijl, Roderick M Houwert, Luke P H Leenen, Falco Hietbrink
INTRODUCTION: Injuries of the hand can cause significant functional impairment, diminished quality of life and delayed return to work. However, the incidence and functional outcome of hand injuries in polytrauma patients is currently unknown. The aim of this study was to determine the incidence, distribution and functional outcome of fractures and dislocation of the hand in polytrauma patients. METHODS: A single centre retrospective cohort study was performed at a level 1 trauma centre...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28290938/postconcussive-symptoms-ptsd-and-medical-disease-burden-in-treatment-seeking-oef-oif-ond-veterans
#2
Joah L Williams, Meghan E McDevitt-Murphy, James G Murphy, Ellen M Crouse
INTRODUCTION: The most common psychological and cognitive sequelae associated with deployments to Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom) are mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). High rates of PTSD are often observed among Veterans with a history of mTBI, and persistent postconcussive symptoms commonly endorsed after mTBI are known to be associated with PTSD. Therefore, this study examined whether PTSD mediates relations between postconcussive symptoms and 2 indices of medical disease burden: 1) the number of disease categories positive for a diagnosis, or system disease burden, and 2) total number of physical diagnoses, or cumulative disease burden...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28286784/the-influence-of-metabolic-imbalances-and-oxidative-stress-on-the-outcome-of-critically-ill-polytrauma-patients-a-review
#3
REVIEW
Alexandru Florin Rogobete, Dorel Sandesc, Marius Papurica, Emil Robert Stoicescu, Sonia Elena Popovici, Lavinia Melania Bratu, Corina Vernic, Adriana Mariana Sas, Adrian Tudor Stan, Ovidiu Horea Bedreag
The critically ill polytrauma patient presents with a series of associated pathophysiologies secondary to the traumatic injuries. The most important include systemic inflammatory response syndrome (SIRS), sepsis, oxidative stress (OS), metabolic disorders, and finally multiple organ dysfunction syndrome (MODS) and death. The poor outcome of these patients is related to the association of the aforementioned pathologies. The nutrition of the critically ill polytrauma patient is a distinct challenge because of the rapid changes in terms of energetic needs associated with hypermetabolism, sepsis, SIRS, and OS...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28277439/role-of-laparoscopy-in-patients-with-abdominal-trauma-at-level-i-trauma-center
#4
Purushottam Parajuli, Subodh Kumar, Amit Gupta, Virinder Kumar Bansal, Sushma Sagar, Biplab Mishra, Maneesh Singhal, Atin Kumar, Shivanand Gamangatti, Babita Gupta, Chhavi Sawhney, Mahesh C Misra
INTRODUCTION: Abdominal trauma is one of the preventable causes of death in polytrauma patients. Decision and timing of laparotomy is a major challenge. Rate of nontherapeutic laparotomy is still high. Laparoscopy can avoid nontherapeutic laparotomy and also provide a reliable and accurate diagnosis of injury. MATERIALS AND METHODS: This ambispective observational study was conducted in the division of Trauma Surgery and Critical Care, JPN Apex Trauma Centre, All India Institute Medical Sciences, New Delhi...
March 8, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28276866/performance-validity-and-processing-speed-in-a-va-polytrauma-sample
#5
Lee Ashendorf, Erika L Clark, Michael A Sugarman
OBJECTIVE: While recognition memory has been the primary tool for the assessment of performance validity in neuropsychological evaluations, some consideration has also been given to embedded measures from other cognitive domains, including processing speed. The present study evaluated the classification accuracy of several speed-based measures in a Veterans Affairs Medical Center Polytrauma sample. METHOD: The present sample consisted of 114 military veterans (Mean age = 35...
February 10, 2017: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/28262279/major-influence-of-interobserver-reliability-on-polytrauma-identification-with-the-injury-severity-score-iss-time-for-a-centralised-coding-in-trauma-registries
#6
Roman Maduz, Patrick Kugelmeier, Severin Meili, Robert Döring, Christoph Meier, Peter Wahl
OBJECTIVE: The Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) find increasingly widespread use to assess trauma burden and to perform interhospital benchmarking through trauma registries. Since 2015, public resource allocation in Switzerland shall even be derived from such data. As every trauma centre is responsible for its own coding and data input, this study aims at evaluating interobserver reliability of AIS and ISS coding. METHODS: Interobserver reliability of the AIS and ISS is analysed from a cohort of 50 consecutive severely injured patients treated in 2012 at our institution, coded retrospectively by 3 independent and specifically trained observers...
February 21, 2017: Injury
https://www.readbyqxmd.com/read/28252351/patellar-reconstruction-following-previous-patellectomy-a-review-of-the-literature-and-a-case-series-using-distal-femoral-autograft-during-total-knee-arthroplasty
#7
D A George, A Dosani, R Morgan-Jones
During total knee arthroplasty, the reconstruction of the patella following a previous patellectomy is challenging, and is undertaken to improve functional outcomes and patient satisfaction. In this case series, we have reconstructed the patella using a femoral condyle resected during total knee arthroplasty. The resected femoral condyle with best available bone stock is selected and secured to the extensor mechanism. We reviewed the preoperative indications and postoperative outcomes of two patients who underwent the above procedure at our Institute, and compared this to the literature...
March 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28246625/endovascular-management-of-a-combined-subclavian-and-vertebral-artery-injury-in-an-unstable-polytrauma-patient-case-report-and-literature-review
#8
Christian David Weber, Philipp Kobbe, Christian Herren, Andreas H Mahnken, Frank Hildebrand, Hans-Christoph Pape
While blunt trauma of the head and neck are a common pattern of injury, significant problems related to the prompt diagnosis and optimal management of traumatic artery injuries have been reported in the literature. While patients with major artery injuries might develop hemorrhagic shock very rapidly, patients with blunt cerebrovascular injuries (BCVI) can present asymptomatic, but complications like basilar territory infarction, cortical blindness and death may occur. We report the life- and limb-saving management in a 57-year-old hemodynamically unstable trauma patient...
January 2017: Bulletin of Emergency and Trauma
https://www.readbyqxmd.com/read/28243715/volume-replacement-during-trauma-resuscitation-a-brief-synopsis-of-current-guidelines-and-recommendations
#9
REVIEW
M Maegele, M Fröhlich, M Caspers, S Kaske
INTRODUCTION: Intravascular volume and fluid replacement are still cornerstones to correct fluid deficits during early trauma resuscitation, but optimum strategies remain under debate. METHODS: A synopsis of best current knowledge with reference to the following guidelines and recommendations is presented: (1) The European Guideline on Management of Major Bleeding and Coagulopathy following Trauma (fourth edition), (2) S3 Guideline on Treatment of Patients with Severe and Multiple Injuries [English Version of the German Guideline S3 Leitlinie Polytrauma/Schwerverletzten-Behandlung/AWMF Register-Nr...
February 27, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28235981/-erratum-to-tracer-diagnosis-severe-injury-polytrauma-in-key-issue-paper-2016
#10
U Schweigkofler, S Flohé, R Hoffmann, G Matthes, T Paffrath, C Wölfl, M Fischer, E Kehrberger, H Marung, H Moecke, S Prückner, B Urban, H Trentzsch
No abstract text is available yet for this article.
February 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28228060/resuscitation-with-lyophilized-plasma-is-safe-and-improves-neurologic-recovery-in-a-long-term-survival-model-of-swine-subjected-to-traumatic-brain-injury-hemorrhagic-shock-and-polytrauma
#11
Patrick E Georgoff, Vahagn C Nikolian, Ihab Halaweish, Kiril Chtraklin, Peter J Bruhn, Hassan Eidy, Monica Rasmussen, Yongqing Li, Ashok Srinivasan, Hasan B Alam
We have previously shown that fresh frozen plasma (FFP) and lyophilized plasma decrease brain lesion size and improve neurologic recovery in a swine model of traumatic brain injury (TBI) and hemorrhagic shock (HS). In this study, we examine whether these findings can be validated in a clinically relevant model of severe TBI, HS, and polytrauma. Female Yorkshire swine were subjected to TBI (controlled cortical impact), hemorrhage (40% volume), grade III liver and splenic injuries, rib fracture, and rectus abdominis crush...
February 22, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/28224110/comparison-of-inhaled-milrinone-nitric-oxide-and-prostacyclin-in-acute-respiratory-distress-syndrome
#12
Martin Albert, Daniel Corsilli, David R Williamson, Marc Brosseau, Patrick Bellemare, Stéphane Delisle, Anne Qn Nguyen, France Varin
AIM: To evaluate the safety and efficacy of inhaled milrinone in acute respiratory distress syndrome (ARDS). METHODS: Open-label prospective cross-over pilot study where fifteen adult patients with hypoxemic failure meeting standard ARDS criteria and monitored with a pulmonary artery catheter were recruited in an academic 24-bed medico-surgical intensive care unit. Random sequential administration of iNO (20 ppm) or nebulized epoprostenol (10 μg/mL) was done in all patients...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28217583/profile-of-trauma-patients-in-the-emergency-department-of-a-tertiary-care-hospital-in-south-india
#13
Kundavaram Paul Prabhakar Abhilash, Nilanchal Chakraborthy, Gautham Raja Pandian, Vineet Subodh Dhanawade, Thomas Kurien Bhanu, Krishna Priya
BACKGROUND: Trauma is an increasing cause of morbidity and mortality in India. This study was done to improve the understanding of the mode of trauma, severity of injuries, and outcome of trauma victims in our hospital. MATERIALS AND METHODS: This was a retrospective observational study of all adult trauma patients more than 18-year-old presenting to our emergency department (ED). Details of the incident, injuries, and outcome were noted. RESULTS: The ED attended to 16,169 patients during the 3-month study period with 10% (1624/16,169) being adult trauma incidents...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28206801/burden-and-mental-health-among-caregivers-of-veterans-with-traumatic-brain-injury-polytrauma
#14
Joan M Griffin, Minji K Lee, Lauren R Bangerter, Courtney Harold Van Houtven, Greta Friedemann-Sánchez, Sean M Phelan, Kathleen F Carlson, Laura A Meis
Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28206800/perspectives-of-veterans-with-mild-traumatic-brain-injury-on-community-reintegration-making-sense-of-unplanned-separation-from-service
#15
Alexander V Libin, Manon Maitland Schladen, Ellen Danford, Samantha Cichon, Dwan Bruner, Joel Scholten, Maria Llorente, Slavomir Zapata, Alexander W Dromerick, Marc R Blackman, Kathryn M Magruder
For veterans separated from the military as a result of acquired mild traumatic brain injury (mTBI), the transition from a military identity to a civilian one is complicated by health, cognitive, and psychosocial factors. We conducted in-depth interviews with 8 veterans with mTBI to understand how they perceived the experience of departure from the military, rehabilitation services provided at a Department of Veterans Affairs (VA) Polytrauma Network Site, and reentry into civilian life. Two distinct patterns of thinking about community reintegration emerged...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28195958/rehospitalization-in-the-first-year-following-veteran-and-service-member-tbi-a-va-tbi-model-systems-study
#16
Johanna Tran, Flora Hammond, Kristen Dams-OʼConnor, Xinyu Tang, Blessen Eapen, Marissa McCarthy, Risa Nakase-Richardson
OBJECTIVE: To determine the incidence and causes of rehospitalization following military or Veteran traumatic brain injury (TBI). SETTING: Department of Veterans Affairs (VA) Veterans Health Administration Polytrauma Rehabilitation Centers (VHA PRCs). PARTICIPANTS: Consecutive sample of VHA TBI Model System participants (N = 401). DESIGN: Prospective observational cohort study. MAIN MEASURES: Number and type of rehospitalizations in first year post-TBI...
February 10, 2017: Journal of Head Trauma Rehabilitation
https://www.readbyqxmd.com/read/28195897/base-of-skull-blocks-for-open-reduction-and-internal-fixation-of-faciomaxillary-fractures
#17
Sandeep Mehrotra, Sunil Anand
INTRODUCTION: Faciomaxillary fractures (FMF) occur in a significant proportion of trauma patients. Nearly all polytrauma patients and even those with isolated FMF are managed under general anesthesia for definitive management. We propose the use of regional nerve blocks as a safe and effective means for open reduction and fixation of isolated FMF. AIM AND OBJECTIVES: The aim is to evaluate the feasibility, effectiveness and safety of base of skull maxillomandibular and distal trigeminal nerve blocks in the management of FMF...
February 14, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28190439/neurologic-complications-of-polytrauma
#18
R M Jha, L Shutter
Neurologic complications in polytrauma can be classified by etiology and clinical manifestations: neurovascular, delirium, and spinal or neuromuscular problems. Neurovascular complications include ischemic strokes, intracranial hemorrhage, or the development of traumatic arteriovenous fistulae. Delirium and encephalopathy have a reported incidence of 67-92% in mechanically ventilated polytrauma patients. Causes include sedation, analgesia/pain, medications, sleep deprivation, postoperative state, toxic ingestions, withdrawal syndromes, organ system dysfunction, electrolyte/metabolic abnormalities, and infections...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28187475/concomitant-sternal-fracture-in-flail-chest-an-analysis-of-21-741-polytrauma-patients-from-the-traumaregister-dgu%C3%A2
#19
Stefan Schulz-Drost, Sebastian Krinner, Andreas Langenbach, Pascal Oppel, Rolf Lefering, Dominic Taylor, Friedrich F Hennig, Andreas Mauerer
Background Isolated sternal fractures (SFs) rarely show complications, but their influence in a thorax trauma of the seriously injured still remains unclear. Methods A retrospective analysis of the TraumaRegister DGU(®) was performed involving the years 2009 to 2013 (Injury Severity Score [ISS] ≥ 16, primary admission to a trauma center). Cohort formation: Unilateral and bilateral flail chest (FC) injuries with and without a concomitant SF, respectively. Results In total, 21,741 patients (25% female) met the inclusion criteria, with 3,492 (16...
February 10, 2017: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/28164622/using-the-expression-of-mirnas-as-biomarkers-for-the-evaluation-acute-respiratory-distress-syndrome-in-the-critically-ill-polytrauma-patient
#20
REVIEW
Marius Papurica, Alexandru F Rogobete, Carmen A Cradigati, Mirela Sarandan, Raluca Dumache, Lavinia M Bratu, Sonia E Popovici, Dorel Sandesc, Corina Vernic, Ovidiu H Bedreag
BACKGROUND: A high percentage of critically ill polytrauma patients develop acute respiratory distress syndrome (ARDS), both because of the primary traumatic injuries and because of the secondary post-traumatic injuries. For adequate management of these patients, new complex evaluation and monitoring methods are needed, methods that could answer as many questions as possible regarding the pathophysiological changes associated with ARDS. Currently, a series of clinical and biochemical markers are being used which unfortunately do not respond to the needs of an intensive care clinician...
August 1, 2016: Clinical Laboratory
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