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https://www.readbyqxmd.com/read/28105481/-thoracic-injuries-in-severely-injured-children-association-with-increased-injury-severity-and-a-higher-number-of-complications
#1
Philipp Störmann, Julia Nadine Weber, Heike Jakob, Ingo Marzi, Dorien Schneidmueller
BACKGROUND: Severely injured children and adolescents in clinical practice are rare. For adequate treatment of these patients, detailed knowledge of anatomical and physiological peculiarities, as well as abundant injury patterns, are indispensable. Traumatic brain injuries are known to lead to an unfavorable outcome. In addition, thoracic trauma is regarded as prognostically unfavorable. OBJECTIVES: This study depicts epidemiology and injury patterns of severely injured children and adolescents focusing on peculiarities in the severely injured with associated thoracic injuries...
January 19, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28103119/iatrogenic-spinal-cord-injury-in-a-trauma-patient-with-ankylosing-spondylitis
#2
Ahmad Maarouf, Colleen M McQuown, Jennifer A Frey, Rami A Ahmed, Lisa Derrick
BACKGROUND: The recommended practice for over 30 years has been to routinely immobilize patients with unstable cervical spinal injuries using cervical spinal collars. It is shown that patients with Ankylosing spondylitis (AS) are four times more likely to suffer a spinal fracture compared to the general population and have an eleven-fold greater risk of spinal cord injury. Current protocols of spinal immobilization were responsible for secondary neurologic deterioration in some of these patients...
January 19, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28102159/x-rays-for-acute-knee-injuries-pre-and-post-pittsburgh-decision-rules-implementation-a-district-general-hospital-experience
#3
Saad R El Ashry, Tarek A El Gamal, Sudhakar R Challagundla, Chara A Ntala, Ahmed M Nagy, Evan O Crane
BACKGROUND: We wanted to assess the number of unnecessary radiographs done for acute knee injury patients and the accuracy of the Pittsburgh decision rules. MATERIAL AND METHODS: A retrospective observational study was done to look at the acute knee injury patients presented to a district general hospital Accident and Emergency Department from August 2011 till August 2013. We assessed the following parameters: sex, age, mechanism of injury, weight-bearing status and incidence of fractures in patients subjected to plain radiograph...
October 28, 2016: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/28097413/when-surgical-resources-are-severely-constrained-who-receives-care-determinants-of-access-to-orthopaedic-trauma-surgery-in-uganda
#4
Trina Stephens, Alexander Mezei, Nathan N O'Hara, Jeffrey Potter, Rodney Mugarura, Piotr A Blachut, Peter J O'Brien, Tito Beyeza, Gerard P Slobogean
BACKGROUND: In low- and middle-income countries, the volume of traumatic injuries requiring orthopaedic intervention routinely exceeds the capacity of available surgical resources. The objective of this study was to identify predictors of surgical care for lower extremity fracture patients at a high-demand, resource-limited public hospital in Uganda. METHODS: Skeletally mature patients admitted with the intention of definitive surgical treatment of an isolated tibia or femur fractures to the national referral hospital in Uganda were recruited to participate in this study...
January 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28096018/understanding-the-distribution-of-a-e-attendances-and-hospital-admissions-for-the-case-managed-population-a-single-case-cross-sectional-study
#5
Eloise Phillips, Sarahjane Jones, Jessica Runacres, Maxine Lintern, Mark Radford
AIM: To describe the characteristics of case-managed patients presenting at accident and emergency (A & E) and to explore the distribution of their attendances and admissions. BACKGROUND: Recently, the UK Government announced extended-hours primary care provision in an effort to reduce the growing utilization of A & E. No evidence is available to understand the use of acute services by this high-risk patient group. METHOD: A cross-sectional design utilising routinely collected anonymsed A & E attendance and hospital admission data from 2010 to 2015...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095031/the-role-of-drug-and-alcohol-use-and-the-risk-of-motor-vehicle-crashes-in-shiraz-iran-2014-a-case-crossover-study
#6
Narges Khanjani, Masoomeh Mousavi, Amirreza Dehghanian, Yunes Jahani, Hamid Souri
BACKGROUND: Traffic accidents and traffic-related injuries and mortality have become a major public health concern over the current years in Iran. This study aimed to examine the role of drug and alcohol use in motor vehicle accidents in Iran. METHODS: This case-crossover study was conducted on 441 drivers who survived from a road traffic crash and were taken to the emergency department of Shahid Rajaee trauma hospital in Shiraz, southern Iran. Data were collected using checklists which included demographic characteristics and drug and alcohol use prior to driving...
January 17, 2017: Traffic Injury Prevention
https://www.readbyqxmd.com/read/28094079/a-stroke-mimic-methotrexate-induced-neurotoxicity-in-the-emergency-department
#7
Patrick Rogers, Wilbur J Pan, Richard A Drachtman, Christopher Haines
BACKGROUND: Acute lymphoblastic leukemia (ALL) is the most common form of childhood leukemia. The treatment of ALL involves multimodality therapy, and methotrexate (MTX) remains a mainstay of treatment. A complication of MTX therapy includes acute, subacute, and chronic neurotoxocity. Signs and symptoms may range from headaches, dizziness, and mood disorders to seizures and stroke-like symptoms. CASE REPORT: An 18-year-old woman with a history of ALL presented to the emergency department with acute onset of right-sided facial paralysis, right upper extremity flaccid paralysis, and right lower extremity weakness after receiving MTX therapy 3 days earlier...
January 13, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28092242/-prehospital-emergency-care-injuries-from-external-causes-in-a-region-of-venezuela
#8
Rafael Herrera, Daniel Bastidas, Everilda Arteaga, Gilberto Bastidas
BACKGROUND: Worldwide, approximately 3 500 000 people die every year as a result of injuries from external causes, in Venezuela these arte the third leading cause of overall morbidity. Nevertheless, in the country there are no records of the defining aspects of prehospital emergency care as a tool to address this socio-health problem, the aim of this investigation. METHODS: A descriptive, transversal, field study based on the information recorded daily for a year paramedics was performed...
January 2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28091758/-deaths-from-propofol-abuse-survey-of-institutes-of-forensic-medicine-in-germany-austria-and-switzerland
#9
C Maier, J Iwunna, M Tsokos, F Mußhoff
Previous references suggesting a high mortality of propofol addiction in medical personnel were mostly based on surveys of the heads of medical departments or case reports; therefore, a questionnaire was sent to 48 forensic medicine departments in Germany, Austria and Switzerland concerning the number of autopsies carried out between 2002-2112 on medical personnel with the suspicion of abuse of propofol or other analgesics. The response rate was 67%. In 16 out of the 32 responding departments 39 deaths (27 males) were observed with previous connections to anesthesiology, intensive care or emergency departments of which 22 were physicians, 13 nurses, 2 other personnel and 2 were unknown...
January 13, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28089281/features-of-public-healthcare-services-provided-to-migrant-patients-in-the-eastern-macedonia-and-thrace-region-greece
#10
Christos A Tsitsakis, Anastasios Karasavvoglou, Efstathios Tsaridis, Georgia Ramantani, Giannoula Florou, Persefoni Polychronidou, Stamatios Stamatakis
BACKGROUND: The influx of migrants, refugees and asylum-seekers into European Union (EU) countries, especially into Greece, in the last 20 years is an issue of growing concern and requires a rational approach. The aim of this study is to chart the use of public health services by the migrants of the Eastern Macedonia and Thrace Region, which forms the northeastern border of Greece. METHODS: We collected data from five of the six public hospitals in the specified region, and we carried out a per clinic cross tabulation analysis of admission diagnosis and citizenship variables in order to establish the frequency at which the various diagnoses emerge per distinct group of migrant and non-migrant patients in each clinic...
December 27, 2016: Health Policy
https://www.readbyqxmd.com/read/28087958/the-teaching-of-trauma-management-in-undergraduate-medical-education
#11
S K Lum, T Subramaniam
BACKGROUND: The teaching of trauma in medical schools faces many educational and logistic challenges. Issues on what to teach, how to teach, when to teach, who will teach and whether medical students with insufficient exposure to clinical medicine can benefit from a trauma course are unclear. MATERIALS AND METHODS: A well-designed one day intensive trauma course concentrating on the primary survey was taught to semester seven and semester eight students by a multi-disciplinary team comprising of surgeons, anaesthetists, emergency physicians and trained medical officers...
December 2016: Medical Journal of Malaysia
https://www.readbyqxmd.com/read/28087128/intranasal-oxytocin-to-prevent-posttraumatic-stress-disorder-symptoms-a-randomized-controlled-trial-in-emergency-department-patients
#12
Mirjam van Zuiden, Jessie L Frijling, Laura Nawijn, Saskia B J Koch, J Carel Goslings, Jan S Luitse, Tessa H Biesheuvel, Adriaan Honig, Dick J Veltman, Miranda Olff
BACKGROUND: There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms...
December 8, 2016: Biological Psychiatry
https://www.readbyqxmd.com/read/28079306/open-dislocation-of-ankle-without-fracture-treated-with-an-external-fixator
#13
Emrah Sayit, Asli Tanrivermis Sayit, Elcin Zan
Ankle dislocations are orthopedic emergencies that require immediate treatment to avoid neurovascular impairment. They are usually accompanied by one or more comminuted fractures of the ankle mortis. In rare circumstances, such as high-energy trauma, the ankle dislocations may not be accompanied by concomitant malleolar fractures and, thus, are named "pure ankle dislocations". We presented a very rare and interesting case of an open medial dislocation of the ankle without associated fracture in an 18-year-old man with no known predisposing risk factors...
January 12, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28078473/traumatic-atlantoaxial-rotatory-fixation-in-an-adult-patient
#14
María A García-Pallero, Cristina V Torres, Juan Delgado-Fernández, R G Sola
INTRODUCTION: Atlantoaxial rotational fixation (AARF) is a rare entity in adults, with only a few cases reported in the English literature and often associated with a traumatic mechanism. It is an underdiagnosed condition that must be taken into account in the initial assessment of all craniocervical trauma. Both diagnostic and therapeutic delay may be a potential cause of severe neurological damage or even death of the patient. The therapeutic management is controversial given the difficulty of achieving optimum stability and permanent reduction...
January 11, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28074723/-a-woman-with-excessive-dynamic-airway-collapse
#15
R L T N Salden, S Postma
BACKGROUND: 'Excessive dynamic airway collapse' (EDAC) is a form of tracheamalacia, that does not affect the rings of cartilage on the anterior side of the trachea, but in which the posterior wall of the trachea collapses during inspiration and expiration. CASE DESCRIPTION: An 80 year-old woman presented to the accident and emergency department with dyspnoea and severe inspiratory and expiratory stridor, with sudden onset a few hours previously. Following a series of investigations, she was shown to have a narrowing of the trachea, radiating from the posterior wall...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28074458/endovascular-treatment-of-peripheral-and-visceral-arterial-injuries-in-patients-with-acute-trauma
#16
Aysun Erbahçeci Salık, Filiz Saçan İslim, Barbaros Erhan Çil
BACKGROUND: The present study is an evaluation of the efficacy of endovascular treatment in emergency setting for patients with acute peripheral and visceral arterial injury secondary to penetrating or blunt trauma. METHODS: Twelve patients (11 men) aged 35.8±11.3 years (range: 18-56 years) with penetrating or blunt trauma who underwent endovascular treatment in our department between March 2010 and June 2014 for peripheral and visceral arterial injury were retrospectively reviewed...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#17
Amir Reza Vosoughi, Pascal F Rippstein
Traumatic lateral dislocations of the first metatarsophalangeal (MTP) joint are very rare. A 44-year-old male was referred after a motorcycle to car accident because of an exposed head of the left first metatarsal through a laceration on the medial aspect of the first MTP joint. Radiographs showed a lateral dislocation of the first MTP joint, with concomitant fractures of the neck of the second metatarsal and the base of the third and fourth metatarsal bones. The dislocation was reduced in the emergency department with the patient under conscious sedation after thorough irrigation...
January 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#18
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28067089/metabolomic-applications-in-radiation-biodosimetry-exploring-radiation-effects-through-small-molecules
#19
Evan L Pannkuk, Albert J Fornace, Evagelia C Laiakis
PURPOSE: Exposure of the general population to ionizing radiation has increased in the past decades, primarily due to long distance travel and medical procedures. On the other hand, accidental exposures, nuclear accidents, and elevated threats of terrorism with the potential detonation of a radiological dispersal device or improvised nuclear device in a major city, all have led to increased needs for rapid biodosimetry and assessment of exposure to different radiation qualities and scenarios...
January 9, 2017: International Journal of Radiation Biology
https://www.readbyqxmd.com/read/28056502/environmental-occurrence-of-perfluoroalkyl-acids-and-novel-fluorotelomer-surfactants-in-the-freshwater-fish-catostomus-commersonii-and-sediments-following-firefighting-foam-deployment-at-the-lac-m%C3%A3-gantic-railway-accident
#20
Gabriel Munoz, Mélanie Desrosiers, Sung Vo Duy, Pierre Labadie, Helene Budzinski, Jinxia Liu, Sébastien Sauvé
: On July 6(th) 2013, an unmanned train laden with almost 8 million liters of crude oil careened off the rails downtown Lac-Mégantic (Québec, Canada). In the aftermath of the derailment accident, the emergency response entailed the deployment of 33,000 L of aqueous film forming foam (AFFF) concentrate that contained proprietary fluorosurfactants. The present study examines the environmental occurrence of perfluoroalkyl acids (PFAAs) and newly-identified per and polyfluoroalkyl substances (PFASs) in the benthic fish white sucker (Catostomus commersonii) and sediments from Lake Mégantic and Chaudière River...
January 6, 2017: Environmental Science & Technology
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