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https://www.readbyqxmd.com/read/29194318/non-compliance-with-acs-cot-recommended-criteria-for-full-trauma-team-activation-is-associated-with-undertriage-deaths
#1
Christopher J Tignanelli, Wayne E Vander Kolk, Judy N Mikhail, Matthew J Delano, Mark R Hemmila
BACKGROUND: The appropriate triage of acutely injured patients within a trauma system is associated with improved rates of mortality and optimal resource utilization. The American College of Surgeons Committee on Trauma (ACS-COT) put forward six minimum criteria (ACS-6) for full trauma team activation (TTA). We hypothesized that ACS-COT verified trauma center compliance with these criteria is associated with low under-triage rates and improved overall mortality. METHODS: Data from a state-wide collaborative quality initiative was utilized...
November 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29091466/micro-mechanical-properties-of-different-sites-on-woodpecker-s-skull
#2
Yikun Ni, Lizhen Wang, Xiaoyu Liu, Hongquan Zhang, Chia-Ying Lin, Yubo Fan
The uneven distributed microstructure featured with plate-like spongy bone in woodpecker's skull has been found to further help reduce the impact during woodpecker's pecking behavior. Therefore, this work was to investigate the micro-mechanical properties and composition on different sites of Great Spotted woodpecker's (GSW) skull. Different sites were selected on forehead, tempus and occiput, which were also compared with those of Eurasian Hoopoe (EH) and Lark birds (LB). Micro structural parameters assessed from micro computed tomography (μCT) occurred significantly difference between GSW, EH and LB...
November 1, 2017: Computer Methods in Biomechanics and Biomedical Engineering
https://www.readbyqxmd.com/read/29025455/the-burden-of-gunshot-injuries-on-orthopaedic-healthcare-resources-in-south-africa
#3
Case Martin, Gerhard Thiart, Graham McCollum, Stephen Roche, Sithombo Maqungo
BACKGROUND: Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective...
June 30, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/29019403/tertiary-interactions-in-the-unbound-guanine-sensing-riboswitch-focus-functional-conformational-variability-on-the-binding-site
#4
Christian Hanke, Holger Gohlke
Riboswitches are genetic regulatory elements mainly found in bacteria, which regulate gene expression based on the availability of a ligand. Purine-sensing riboswitches, including the guanine-sensing riboswitch (Gsw), possess tertiary interactions connecting the L2 and L3 loops. These interactions are important for ligand binding to the aptamer. However, atomic-level structural knowledge about the unbound state and how the tertiary interactions influence the conformational heterogeneity of the aptamer is still scarce...
October 11, 2017: Journal of Chemical Information and Modeling
https://www.readbyqxmd.com/read/28985608/the-role-of-neutrophil-gelatinase-associated-lipocalin-ngal-in-the-detection-of-blast-lung-injury-in-a-military-population
#5
Andrew Lumley, Erik Osborn, Adrian Mellor, Elise LaCroix, George Johnson, Mary Wallace, Mike Stacey, Jason E Smith, David Woods
PURPOSE: To study the relationship between serum neutrophil gelatinase-associated lipocalin (NGAL) and military blast and gunshot wound (GSW) to establish whether potential exists for NGAL as a biomarker for blast lung injury (BLI). METHOD: Patients from the intensive care unit (ICU) of the Role 3 Medical Treatment Facility at Camp Bastion, Helmand Province, Afghanistan were studied over a five month period commencing in 2012. Age, mechanism, trauma injury severity score (TRISS) and serum NGAL were recorded on ICU admission (NGAL1)...
September 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28931325/outcomes-of-talus-fractures-associated-with-high-energy-combat-trauma
#6
Travis Junge, Jaime Bellamy, Thomas Dowd, Patrick Osborn
BACKGROUND: Talus fractures are infrequent injuries that are often associated with poor clinical outcomes. Literature reviewing talus fractures is limited to a civilian population, with few studies characterizing these injuries sustained in active duty personnel. The aim of this study was to characterize talus fractures sustained in combat trauma by reporting their surgical outcomes. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried to identify US service members who sustained talus fractures in battle conditions between 2001 and 2014...
December 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28928592/the-journey-of-harmless-bullet-the-perioperative-care-of-penetrating-cardiac-injury
#7
Ahmad Abou-Leila, Gennadiy Voronov
Traumatic injuries to the heart contribute significantly to trauma are associated with high mortality. Cardiac gunshot wounds (GSW) are considered more lethal compared to other injuries and present several unique challenges to the anesthesia management and perioperative care. We are reporting a rare case of a trauma victim who survived a GSW to the heart. We will discuss the perioperative care of penetrating cardiac injuries, the role of the anesthesia team in resuscitation, safe anesthesia induction, cardiopulmonary bypass management, and the essential role of intraoperative transesophageal echocardiogram imaging...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28910475/chest-seal-placement-for-penetrating-chest-wounds-by-prehospital-ground-forces-in-afghanistan
#8
Steven G Schauer, Michael D April, Jason F Naylor, Erica M Simon, Andrew D Fisher, Cord W Cunningham, Daniel M Morissette, Jessie Renee D Fernandez, Kathy L Ryan
BACKGROUND: Thoracic trauma represents 5% of all battlefield injuries. Communicating pneumothoraces resulting in tension physiology remain an important etiology of prehospital mortality. In addressing penetrating chest trauma, current Tactical Combat Casualty Care (TCCC) guidelines advocate the immediate placement of a vented chest seal device. Although the Committee on TCCC (CoTCCC) has approved numerous chest seal devices for battlefield use, few data exist regarding their use in a combat zone setting...
December 0: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28900668/validation-of-the-baragwanath-mortality-prediction-score-for-cerebral-gunshot-wounds-the-pietermaritzburg-experience
#9
V Y Kong, G V Oosthuizen, B Sartorious, J L Bruce, G L Laing, R Weale, D L Clarke
INTRODUCTION: Cerebral gunshot wounds (GSW) are highly lethal injuries. To date, only one clinical scoring system to predict mortality in a developing world setting has been described. This is the Baragwanath mortality prediction score ("ABC": admission blood pressure, brain matter spillage and consciousness level). MATERIALS AND METHODS: We performed a retrospective review of prospectively entered data for a cohort of patients with isolated cerebral GSWs over a 5-year period (January 2010-December 2014) in our institution...
September 12, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28893848/a-review-of-10-years-of-scapula-injuries-sustained-by-uk-military-personnel-on-operations
#10
Darren C Roberts, D M Power, S A Stapley
BACKGROUND: Scapula fractures are relatively uncommon injuries, mostly occurring due to the effects of high-energy trauma. Rates of scapula fractures are unknown in the military setting. The aim of this study is to analyse the incidence, aetiology, associated injuries, treatment and complications of these fractures occurring in deployed military personnel. METHODS: All UK military personnel returning with upper limb injuries from Afghanistan and Iraq were retrospectively reviewed using the Royal Centre for Defence Medicine database and case notes (2004-2014)...
September 11, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28876672/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#11
V M Meijering, A T Hattam, P H Navsaria, A J Nicol, S Edu
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres in South Africa. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876666/civilian-gunshot-wounds-to-the-chest-a-clinicopathological-analysis-of-an-annual-caseload-at-a-level-1-trauma-centre
#12
V M Meijering, A T Hattam
BACKGROUND: Gunshot wounds (GSW) to the chest are common presentations to trauma centres both in South Africa and internationally. The clinical management and outcome of GSW to the chest are significantly altered by missile trajectory and the associated anatomical structures injured making them challenging injuries to treat. Currently, the management of GSW chest is based on scant evidence and treatment is typically according to algorithms based largely on the anecdotal experience of high volume institutions and experienced clinicians...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28807080/a-descriptive-analysis-of-traction-splint-utilization-and-iv-analgesia-by-emergency-medical-services
#13
Joshua Nackenson, Amado A Baez, Jonathan P Meizoso
Study Objectives Traction splinting has been the prehospital treatment of midshaft femur fracture as early as the battlefield of the First World War (1914-1918). This study is the assessment of these injuries and the utilization of a traction splint (TS) in blunt and penetrating trauma, as well as intravenous (IV) analgesia utilization by Emergency Medical Services (EMS) in Miami, Florida (USA). METHODS: This is a retrospective study of patients who sustained a midshaft femur fracture in the absence of multiple other severe injuries or severe physiologic derangement, as defined by an injury severity score (ISS) <20 and a triage revised trauma score (T-RTS)≥10, who presented to an urban, Level 1 trauma center between September 2008 and September 2013...
December 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28705774/american-spinal-injury-association-a-sensory-and-motor-complete-is-not-different-from-american-spinal-injury-association-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#14
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
BACKGROUND CONTEXT: We receive a large number of patients with spinal cord injury (SCI) due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Although many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete because of sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from patients labeled ASIA A complete. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28697021/injuries-sustained-during-contact-with-law-enforcement-an-analysis-from-us-trauma-centers
#15
Morgan Schellenberg, Kenji Inaba, Jayun Cho, James M Tatum, Galinos Barmparas, Aaron Strumwasser, Daniel Grabo, Cynthia Bir, Alexander Eastman, Demetrios Demetriades
BACKGROUND: Injuries sustained by civilians from interaction with police are a polarizing contemporary sociopolitical issue. Few comprehensive studies have been published using national hospital-based data. The aim of this study was to examine the epidemiology of these injuries to better understand this mechanism of injury. METHODS: Patients entered into the NTDB (01/2007 - 12/2012) with E-codes E970.0-E976.0 (ICD-9-CM), identifying injuries associated with law enforcement in the course of legal action, were enrolled...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640851/ligand-mediated-and-tertiary-interactions-cooperatively-stabilize-the-p1-region-in-the-guanine-sensing-riboswitch
#16
Christian A Hanke, Holger Gohlke
Riboswitches are genetic regulatory elements that control gene expression depending on ligand binding. The guanine-sensing riboswitch (Gsw) binds ligands at a three-way junction formed by paired regions P1, P2, and P3. Loops L2 and L3 cap the P2 and P3 helices and form tertiary interactions. Part of P1 belongs to the switching sequence dictating the fate of the mRNA. Previous studies revealed an intricate relationship between ligand binding and presence of the tertiary interactions, and between ligand binding and influence on the P1 region...
2017: PloS One
https://www.readbyqxmd.com/read/28612168/civilian-cerebral-gunshot-wounds-in-rural-south-african-patients-are-associated-with-significantly-higher-mortality-rates-than-in-urban-patients
#17
V Y Kong, J L Bruce, B Sartorius, G L Laing, J Odendaal, P Brysiewicz, D L Clarke
INTRODUCTION: This study focuses on a specific and often dramatic injury, namely gunshot wounds (GSW) of the head in order to determine whether there is a discrepancy in outcome between patients who sustain their injury in a rural setting and those who sustain it in an urban setting. MATERIALS AND METHODS: This study involves a retrospective review of our prospectively maintained regional electronic trauma registry. All patients who sustained a cerebral GSW from January 2010 to December 2014 were reviewed...
June 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28610778/a-comparison-between-non-powder-gun-and-powder-gun-injuries-in-a-young-pediatric-population
#18
Jennifer J Freeman, Marielena Bachier-Rodriguez, Jessica Staszak, Alexander Feliz
INTRODUCTION: Non-powder guns (NPG) are viewed as toys for children by the general public. Literature on firearm injuries in the pediatric population is increasing, however there are still large gaps in the published literature regarding NPG. We intended to identify and compare the epidemiology, circumstances of injury and outcomes of children with NPG versus powder-gun injuries (GSW). PATIENTS AND METHODS: We performed a 6-year retrospective analysis of children 0-14 years old treated for NPG and GSW injuries at our level one pediatric trauma center...
September 2017: Injury
https://www.readbyqxmd.com/read/28585791/-pediatric-traumatic-brain-injury-due-to-civil-gunshot-wounds-at-a-general-hospital-in-cali-colombia
#19
L Parrado Sánchez, C Gómez, J A Valderrama Chaparro, L D Beltrán Osorio, M Sierra Ruiz, A Enríquez Marulanda, J Lobato Polo
OBJECTIVES: Traumatic brain injury (TBI) due to gunshot-wounds (GSW) is a critical situation in the pediatric population. The aim of this study is to characterize TBI in this population since there are few reports that describe it especially in Colombia where its incidence is high, also to determine which were the main mortality predictor within our population. MATERIAL AND METHODS: We conducted a retrospective cross-sectional study in which we reviewed pediatric medical records of patients that had consulted at the Fundacion Valle del Lili pediatric Emergency Room between January of 2011 and December of 2015 because of TBI due to GSW...
January 25, 2017: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28578468/penetrating-cardiac-injuries-predictive-model-for-outcomes-based-on-2016-patients-from-the-national-trauma-data-bank
#20
J A Asensio, O A Ogun, P Petrone, A J Perez-Alonso, M Wagner, R Bertellotti, B Phillips, D L Cornell, A O Udekwu
BACKGROUND: Penetrating cardiac injuries are uncommon and lethal. The objectives of this study are to examine the national profile of cardiac injuries, identify independent predictors of outcome, generate, compare and validate previous predictive models for outcomes. We hypothesized that National Trauma Data Bank (NTDB) given its large number of patients, would validate these models. METHODS: The NTDB was queried for data on cardiac injuries, using survival as the main outcome measure...
June 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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