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Whole body trauma ct

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https://www.readbyqxmd.com/read/29201849/concurrent-surgery-of-craniectomy-and-splenectomy-as-initial-treatment-in-severe-traumatic-head-injury-a-case-report
#1
Hyeong Rae Lee, Nam Kyu You, Sook Jin Seo, Mi Sun Choi
It is not a common case for neurosurgery department and the other departments to perform joint operation at the same time. Patients with severe head injury are a condition in which vital signs are unstable due to severe brain swelling and increased intracranial pressure, and emergency surgery is required. A 44-year-old man visited the trauma center with a motorcycle accident. The Glasgow Coma Scale score at the time of emergency department was 3 points, and the pupil was fixed at 6 mm on both sides. His medical history was unknown...
October 2017: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29170332/35%C3%A2-to-pan-scan-or-not-to-pan-scan-further-analysis-of-the-tarn-database-2012-2017
#2
Paul Hunt, Fiona Lecky, Omar Bouamra
BACKGROUND: A 'whole body' or 'pan-scan' computed tomography (CT) imaging approach is now becoming the standard of care during the early management of adult patients with suspected severe blunt multitrauma. A number of studies have variously reported a mortality benefit or no benefit from a pan-scan approach compared to that of carrying out body region-focused CT and/or plain radiographs or a mixture of imaging modalities. However, unanswered questions still remain due to the significant heterogeneity in practice between institutions, and the limitations of published studies...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29170300/3%C3%A2-derivation-and-internal-validation-of-a-clinical-decision-rule-to-guide-whole-body-computed-tomography-scanning-in-trauma
#3
Hridesh Chatha, Ian Sammy, Rick Body, Abdo Sattout, John Hollingsworth
BACKGROUND: There are no widely accepted validated clinical decision rules for the use of WBCT in trauma. Given the potential risks and costs, there is a clear need for a clinical decision rule (CDR) to safely guide targeted use of WBCT. We aimed to derive a CDR to guide clinical decisions on WBCT utilisation by detecting patients at high and low risk of multi-region trauma. METHODS: We retrospectively identified consecutive patients who had presented to a major trauma centre with suspected major trauma...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29140964/whole-body-computed-tomography-in-severely-injured-patients
#4
Stefan Huber-Wagner, Karl-Georg Kanz, Marc Hanschen, Martijn van Griensven, Peter Biberthaler, Rolf Lefering
PURPOSE OF REVIEW: To provide an update on the relevant and recent studies on whole-body computed tomography (WBCT) imaging of severely injured patients. RECENT FINDINGS: The advantages of WBCT in time saving, diagnostic accuracy and even in survival have been proven in numerous studies. WBCT can also be beneficial in haemodynamically unstable major trauma patients. The CT scanner should be located close to the emergency department or even in the trauma room. The issue of radiation is still quite important, however, iterative as well as split-bolus protocols can nowadays reduce radiation significantly...
November 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29101416/changes-in-trauma-management-following-the-implementation-of-the-whole-body-computed-tomography-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu%C3%A2
#5
H-G Palm, M Kulla, M Wettberg, R Lefering, B Friemert, P Lang
OBJECTIVES: Whole-body computed tomography (WBCT) plays an increasingly important role in the diagnostic assessment of trauma room patients. It is still unclear whether its use has led to changes of trauma room procedures and patient outcomes. METHODS: In a retrospective multi-centric study based on the trauma registry of the German Trauma Society (TraumaRegister DGU®), we analysed patients with an ISS ≥ 9 between 2002 and 2013. Two periods of time, i.e. up to 3 years preceding (pre-WBCT) and up to 3 years following the introduction of the WBCT (WBCT-group), were assessed separately for every hospital (TR-DGU Project ID 2014-020)...
November 3, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29095676/incidence-and-imaging-findings-of-costal-cartilage-fractures-in-patients-with-blunt-chest-trauma-a-retrospective-review-of-1461-consecutive-whole-body-ct-examinations-for-trauma
#6
Mari T Nummela, Frank V Bensch, Tuomo T Pyhältö, Seppo K Koskinen
Purpose To assess the incidence of costal cartilage (CC) fractures in whole-body computed tomographic (CT) examinations for blunt trauma and to evaluate distribution of CC fractures, concomitant injuries, mechanism of injury, accuracy of reporting, and the effect on 30-day mortality. Materials and Methods Institutional review board approval was obtained for this retrospective study. All whole-body CT examinations for blunt trauma over 36 months were reviewed retrospectively and chest trauma CT studies were evaluated by a second reader...
November 2, 2017: Radiology
https://www.readbyqxmd.com/read/29049422/thoracic-trauma-now-and-then-a-10-year-experience-from-16-773-severely-injured-patients
#7
Klemens Horst, Hagen Andruszkow, Christian D Weber, Miguel Pishnamaz, Christian Herren, Qiao Zhi, Matthias Knobe, Rolf Lefering, Frank Hildebrand, Hans-Christoph Pape
BACKGROUND AND PURPOSE: Thoracic trauma remains to be a relevant injury to the polytraumatised patient. However, literature regarding how far changes in clinical guidelines for pre- and in-hospital trauma management and diagnostic procedures affect the outcome of multiple injured patients with severe chest injury during a long-term observation period is sparse. METHODS: Multiple traumatised patients (age≥16y) documented in the TraumaRegister DGU® (TR-DGU) from January 1st 2005 to December 31st 2014 with severe chest trauma (AIS≥3) were included in this study...
2017: PloS One
https://www.readbyqxmd.com/read/29049218/cardiovascular-findings-on-computed-tomography-in-patients-with-unclear-finding-situation-and-trauma-of-unknown-origin
#8
Hans-Jonas Meyer, Dominik Schramm, Andreas Gunter Bach, Anne Beeskow, Alexey Surov
Incidental cardiovascular findings are common and can be found in up to 70% of patients. Previously, several reports about incidental findings (IFs) on whole body computed tomography (CT) were published. However, no previous study investigated cardiovascular IFs in patients with unclear finding situation and trauma of unknown origin on whole body CT.The radiological database of 2 university hospitals was screened for patients with trauma of unknown origin and unclear finding situation investigated by whole body CT...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28953551/the-survival-benefit-of-a-novel-trauma-workflow-that-includes-immediate-whole-body-computed-tomography-surgery-and-interventional-radiology-all-in-one-trauma-resuscitation-room-a-retrospective-historical-control-study
#9
Takahiro Kinoshita, Kazuma Yamakawa, Hiroki Matsuda, Yoshiaki Yoshikawa, Daiki Wada, Toshimitsu Hamasaki, Kota Ono, Yasushi Nakamori, Satoshi Fujimi
OBJECTIVE: The aim of this study was to evaluate the impact of a novel trauma workflow, using an interventional radiology (IVR)-computed tomography (CT) system in severe trauma. BACKGROUND: In August 2011, we installed an IVR-CT system in our trauma resuscitation room. We named it the Hybrid emergency room (ER), as it enabled us to perform all examinations and treatments required for trauma in a single place. METHODS: This retrospective historical control study conducted in Japan included consecutive severe (injury severity score ≥16) blunt trauma patients...
September 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28835284/maintaining-immobilisation-devices-on-trauma-patients-during-ct-a-feasibility-study
#10
Pål Johan Stokkeland, Erlend Andersen, Maria Myhre Bjørndal, Arne Morten Mikalsen, Sindre Aslaksen, Per Kristian Hyldmo
BACKGROUND: To reduce the possibility of secondary deterioration of spinal injuries, it is desirable to maintain the spinal immobilisation that is applied in the prehospital setting throughout computed tomography (CT) scanning. A previous study found that metallic components within the inflation valve of the vacuum mattresses caused CT artefacts. The aim of our study was to investigate the effect of vacuum mattresses with plastic valves on CT artefacts, the radiation dose, and noise compared to a trauma transfer board and the spine boards currently used in our trauma system...
August 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28810921/the-role-of-whole-body-computed-tomography-in-the-diagnosis-of-thoracic-injuries-in-severely-injured-patients-a-retrospective-multi-centre-study-based-on-the-trauma-registry-of-the-german-trauma-society-traumaregister-dgu-%C3%A2
#11
Patricia Lang, Martin Kulla, Fabian Kerwagen, Rolf Lefering, Benedikt Friemert, Hans-Georg Palm
BACKGROUND: Thoracic injuries are a leading cause of death in polytrauma patients. Early diagnosis and treatment are of paramount importance. Whole-body computed tomography (WBCT) has largely replaced traditional imaging techniques such as conventional radiographs and focused computed tomography (CT) as diagnostic tools in severely injured patients. It is still unclear whether WBCT has led to higher rates of diagnosis of thoracic injuries and thus to a change in outcomes. METHODS: In a retrospective study based on the trauma registry of the German Trauma Society (TraumaRegister DGU(®)), we analysed data from 16,545 patients who underwent treatment in 59 hospitals between 2002 and 2012 (ISS ≥ 9)...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28730296/early-computed-tomography-or-focused-assessment-with-sonography-in-abdominal-trauma-what-are-the-leading-opinions
#12
L Grünherz, K O Jensen, V Neuhaus, L Mica, C M L Werner, B Ciritsis, C Michelitsch, G Osterhoff, H-P Simmen, K Sprengel
PURPOSE: The initial assessment of severely injured patients in the resuscitation room requires a systematic and quickly performed survey. Whereas the Advanced Trauma Life Support (ATLS(®))-based algorithm recommends focused assessment with sonography in trauma (FAST) among others, recent studies report a survival advantage of early whole-body computed tomography (WBCT) in haemodynamically stable as well as unstable patients. This study assessed the opinions of trauma surgeons about the early use of WBCT in severely injured patients with abdominal trauma, and abdominal CT in patients with isolated abdominal trauma, during resuscitation room treatment...
July 20, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28707527/diagnostic-usefulness-%C3%A2-of-low-dose-lumbar-multi-detector-ct-with-iterative-reconstruction-in-trauma-patients-acomparison-with-standard-dose-ct
#13
COMPARATIVE STUDY
Sun Hwa Lee, Seong Jong Yun, Dong Hyeon Kim, Hyeon Hwan Jo, Jae Gwang Song, Yong Sung Park
OBJECTIVE: To compare the image quality (IQ), radiation dose and diagnostic reliability of standard-dose and low-dose lumbar spine (L-spine) multi-detector CT (SDCT and LDCT, respectively) with iterative reconstruction (IR) in trauma patients. METHODS: We retrospectively analysed the data of 263 consecutive patients (male:female, 133:130; mean age, 44.3 years) who underwent SDCT (200-300mAs; 120 kVp) with IR (n = 126) or LDCT (80-150mAs; 120kVp) with IR (n = 137) for suspected L-spine fractures between November 2015 and September 2016...
August 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28651263/quality-and-dose-optimized-ct-trauma-protocol-recommendation-from-a-university-level-i-trauma-center
#14
Johannes Kahn, David Kaul, Georg Böning, Roman Rotzinger, Patrick Freyhardt, Philipp Schwabe, Martin H Maurer, Diane Miriam Renz, Florian Streitparth
Purpose As a supra-regional level-I trauma center, we evaluated computed tomography (CT) acquisitions of polytraumatized patients for quality and dose optimization purposes. Adapted statistical iterative reconstruction [(AS)IR] levels, tube voltage reduction as well as a split-bolus contrast agent (CA) protocol were applied. Materials and Methods 61 patients were split into 3 different groups that differed with respect to tube voltage (120 - 140 kVp) and level of applied ASIR reconstruction (ASIR 20 - 50 %)...
September 2017: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/28646272/rhesus-cochlear-and-vestibular-functions-are-preserved-after-inner-ear-injection-of-saline-volume-sufficient-for-gene-therapy-delivery
#15
Chenkai Dai, Mohamed Lehar, Daniel Q Sun, Lani Swarthout Rvt, John P Carey, Tim MacLachlan, Doug Brough, Hinrich Staecker, Alexandra M Della Santina, Timothy E Hullar, Charles C Della Santina
Sensorineural losses of hearing and vestibular sensation due to hair cell dysfunction are among the most common disabilities. Recent preclinical research demonstrates that treatment of the inner ear with a variety of compounds, including gene therapy agents, may elicit regeneration and/or repair of hair cells in animals exposed to ototoxic medications or other insults to the inner ear. Delivery of gene therapy may also offer a means for treatment of hereditary hearing loss. However, injection of a fluid volume sufficient to deliver an adequate dose of a pharmacologic agent could, in theory, cause inner ear trauma that compromises functional outcome...
August 2017: Journal of the Association for Research in Otolaryngology: JARO
https://www.readbyqxmd.com/read/28644901/vascular-geometry-as-a-risk-factor-for-non-penetrating-traumatic-injuries-of-the-aortic-arch
#16
Andreas Schicho, Lukas Luerken, Christian Stroszczynski, Ramona Meier, Andreas G Schreyer, Lena-Marie Dendl, Stephan Schleder
PURPOSE: To assess biomechanical factors in aortic arch geometry contributing to the development of non-penetrating aortic arch injury (NAAI) in multiply injured patients with an Injury Severity Score (ISS) ≥ 16. MATERIAL AND METHODS: 230 consecutive multiply injured trauma patients with an ISS ≥ 16 admitted to our Level-I trauma center during a consecutive 24-month period were prospectively included of whom 13 presented with NAAI (5.7%). Standardized whole-body CT in a 2x128-detector-row scanner included a head-and-neck CTA...
2017: PloS One
https://www.readbyqxmd.com/read/28616810/accuracy-of-non-contrast-pmct-for-determining-cause-of-death
#17
Garyfalia Ampanozi, Yannick A Thali, Wolf Schweitzer, Gary M Hatch, Lars C Ebert, Michael J Thali, Thomas D Ruder
The aim of this study was (1) to compare levels of accuracy regarding the categorization of causes of death between non-contrast post-mortem computed tomography (PMCT) and the final forensic report as well as between autopsy and the final forensic report, and (2) to assess levels of confidence regarding the categorization of causes of death after non-contrast PMCT and after autopsy. This prospective study was conducted over a 5 month period during which 221 cases were admitted to our institute for forensic investigations...
June 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28610777/a-meta-analysis-of-the-efficacy-of-whole-body-computed-tomography-imaging-in-the-management-of-trauma-and-injury
#18
Swathikan Chidambaram, En Lin Goh, Mansoor A Khan
BACKGROUND: Traumatic injury is the third leading cause of death overall. To optimize the outcomes in these patients, hospitals employ whole-body computed tomography (WBCT) imaging due to the high diagnostic yield and potential to identify missed injuries. However, this delays time-critical interventions. Currently, there is an absence of any high-level evidence to support or refute either view. We present a meta-analysis of the available literature to elucidate the efficacy of WBCT in improving the outcomes of trauma, specifically the mortality rate...
August 2017: Injury
https://www.readbyqxmd.com/read/28565961/non-penetrating-traumatic-injuries-of-the-aortic-arch
#19
Andreas Schicho, Lukas Lürken, Ramona Meier, Christian Stroszczynski, Andreas Schreyer, Lena-Marie Dendl, Stephan Schleder
Background In severely injured trauma patients, non-penetrating aortic arch injuries (NAAI) have a remarkable incidence and mortality. Both diagnostics and therapy of NAAI recently underwent significant changes. Purpose To assess mortality, morbidity, and the risk factors associated with NAAI in severely injured patients (Injury Severity Score [ISS] ≥16) under the light of recent technical and procedural advances in trauma care. Material and Methods A total of 230 consecutive trauma patients with ISS ≥16 admitted to our level-I trauma center during a 24-month period, were prospectively included and underwent standardized whole-body computed tomography (CT) in a 2 × 128-detector-row scanner...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28542848/change-of-transfusion-and-treatment-paradigm-in-major-trauma-patients
#20
P Stein, A Kaserer, K Sprengel, G A Wanner, B Seifert, O M Theusinger, D R Spahn
Trauma promotes trauma-induced coagulopathy, which requires urgent treatment with fixed-ratio transfusions of red blood cells, fresh frozen plasma and platelet concentrates, or goal-directed administration of coagulation factors based on viscoelastic testing. This retrospective observational study compared two time periods before (2005-2007) and after (2012-2014) the implementation of changes in trauma management protocols which included: use of goal-directed coagulation management; admission of patients to designated trauma centres; whole-body computed tomography scanning on admission; damage control surgery; permissive hypotension; restrictive fluid resuscitation; and administration of tranexamic acid...
November 2017: Anaesthesia
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