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Survival after trauma

Ruslan Masgutov, Galina Masgutova, Liliya Mukhametova, Ekaterina Garanina, Svetlana S Arkhipova, Elena Zakirova, Yana O Mukhamedshina, Zhuravleva Margarita, Zarema Gilazieva, Valeriia Syromiatnikova, Adelya Mullakhmetova, Gulnaz Kadyrova, Mariya Nigmetzyanova, Sergeev Mikhail, Pankov Igor, Ramil Yagudin, Albert Rizvanov
We examined the effect of transplantation of allogenic adipose-derived stem cells (ADSCs) with properties of mesenchymal stem cells (MSCs) on posttraumatic sciatic nerve regeneration in rats. We suggested an approach to rat sciatic nerve reconstruction using the nerve from the other leg as a graft. The comparison was that of a critical 10 mm nerve defect repaired by means of autologous nerve grafting versus an identical lesion on the contralateral side. In this experimental model, the same animal acts simultaneously as a test model, and control...
2018: Frontiers in Pharmacology
Oliver Kamp, Oliver Jansen, Rolf Lefering, Renate Meindl, Christian Waydhas, Thomas A Schildhauer, Ume Hamsen
BACKGROUND: Sepsis and multiple organ failure (MOF) remain one of the main causes of death after multiple trauma. Trauma- and infection-associated immune reactions play an important role in the pathomechanism of MOF, but the exact pathways remain unknown. Spinal cord injury (SCI) may lead to an altered immune response, and some studies suggest a prognostic advantage for such patients having sepsis or multiple trauma. Yet these findings need to be evaluated in larger cohorts of trauma patients...
January 1, 2018: Journal of Intensive Care Medicine
Xinghua Cheng, Difan Zheng, Yuan Li, Hang Li, Yihua Sun, Jiaqing Xiang, Haiquan Chen
OBJECTIVE: Methods to minimize surgical trauma from mediastinal lymphadenectomy in patients with early-stage lung cancer are still immature. This study aimed to identify predictors of negative pathologic N2, which may be used to select patients for limited mediastinal lymphadenectomy. METHODS: Clinicopathologic features of 1430 patients with resected clinical stage I non-small cell lung cancer and complete mediastinal lymphadenectomy were retrospectively analyzed for variables associated with negative N2 nodal metastasis (2008-2015)...
February 13, 2018: Journal of Thoracic and Cardiovascular Surgery
Lauren Brookman-Frazee, Chanel Zhan, Nicole Stadnick, David Sommerfeld, Scott Roesch, Gregory A Aarons, Debbie Innes-Gomberg, Lillian Bando, Anna S Lau
Evidence-based practice (EBP) implementation requires substantial resources in workforce training; yet, failure to achieve long-term sustainment can result in poor return on investment. There is limited research on EBP sustainment in mental health services long after implementation. This study examined therapists' continued vs. discontinued practice delivery based on administrative claims for reimbursement for six EBPs [Cognitive Behavioral Interventions for Trauma in Schools (CBITS), Child-Parent Psychotherapy, Managing and Adapting Practices (MAP), Seeking Safety (SS), Trauma-Focused Cognitive Behavior Therapy (TF-CBT), and Positive Parenting Program] adopted in a system-driven implementation effort in public mental health services for children...
2018: Frontiers in Public Health
Zachary D W Dezman, Angela C Comer, Gordon S Smith, Peter F Hu, Colin F Mackenzie, Thomas M Scalea, Jon Mark Hirshon
BACKGROUND: Lactate clearance has been developed into a marker of resuscitation in trauma, but no study has compared the predictive power of the various clearance calculations. Our objective was to determine which method of calculating lactate clearance best predicted 24-hour and in-hospital mortality after injury. STUDY DESIGN: Retrospective chart review of patients admitted to a Level-1 trauma center directly from the scene of injury from 2010 to 2013 who survived >15min, had an elevated lactate at admission (≥3mmol/L), followed by another measurement within 24h of admission...
March 7, 2018: American Journal of Emergency Medicine
Antonio Ernstberger, Michael Koller, Florian Zeman, Maximilian Kerschbaum, Franz Hilber, Eva Diepold, Julika Loss, Tanja Herbst, Michael Nerlich
BACKGROUND: Trauma is a global burden of disease and one of the main causes of death worldwide. Therefore, many countries around the world have implemented a wide range of different initiatives to minimize mortality rates after trauma. One of these initiatives is the bundling of treatment expertise in trauma centers and the establishment of trauma networks. Germany has a decentralized system of trauma care medical centers. Severely injured patients ought to receive adequate treatment in both level I and level II centers...
2018: PloS One
S Gooran, A Javid, G Pourmand
One of the most catastrophic complications of kidney transplantation is non-traumatic delayed bleeding caused by arterial dissection and pseudoaneurysm, endangering the survival of the graft and the patient. Herein, we discuss the management of this condition in 3 cases. The patients included 2 men, 30 and 47 years old, and a 33-year-old woman, who developed a massive hemorrhage in the second week after kidney transplant. All our patients were diabetic for more than 5 years. Massive hemorrhage occurred in the second week without any trauma or precipitating factor...
2018: International Journal of Organ Transplantation Medicine
Brant M Wagener, Parker J Hu, Joo-Yeun Oh, Cilina A Evans, Jillian R Richter, Jaideep Honavar, Angela P Brandon, Judy Creighton, Shannon W Stephens, Charity Morgan, Randal O Dull, Marisa B Marques, Jeffrey D Kerby, Jean-Francois Pittet, Rakesh P Patel
BACKGROUND: Trauma is the leading cause of death and disability in patients aged 1-46 y. Severely injured patients experience considerable blood loss and hemorrhagic shock requiring treatment with massive transfusion of red blood cells (RBCs). Preclinical and retrospective human studies in trauma patients have suggested that poorer therapeutic efficacy, increased severity of organ injury, and increased bacterial infection are associated with transfusion of large volumes of stored RBCs, although the mechanisms are not fully understood...
March 2018: PLoS Medicine
Raquel Salomone, Alfredo Luiz Jácomo, Silvia Bona do Nascimento, Karina Lezirovitz, Flávio Carneiro Hojaij, Heloisa Juliana Zabeu Rossi Costa, Ricardo Ferreira Bento
BACKGROUND: Recent studies in invertebrates have taught us that early cell membrane regeneration is determinant for axonal recovery and survival after trauma. Many authors obtained extraordinary results in neural regeneration using polyethylene glycol fusion protocols, which also involved microsutures and antioxidants. METHODS: Sixty rats were evaluated with functional and histological protocol after facial nerve neurotmesis. Groups A and B had their stumps coapted with microsuture after 24 hours of neurotmesis and groups C and D after 72 hours...
March 9, 2018: Head & Neck
John P Kuckelman, Joseph Kononchik, Joshua Smith, Kevin R Kniery, Jeffrey T Kay, Zachary S Hoffer, Scott R Steele, Vance Sohn
BACKGROUND: Complications from adhesions after intra-abdominal surgery accounts for ~6% of hospital admissions. Currently, hyaluronate/carboxymethylcellulose represents the main option to prevent postoperative adhesion formation. Human amniotic membrane contains inherent anti-inflammatory properties that mitigate adhesion formation. OBJECTIVE: This study aimed to evaluate adhesion generation after surgical trauma with amniotic membranes compared with standard intraperitoneal adhesion barriers...
April 2018: Diseases of the Colon and Rectum
James M Bardes, Kenji Inaba, Morgan Schellenberg, Daniel Grabo, Aaron Strumwasser, Kazuhide Matsushima, Damon Clark, Niquelle Brown, Demetrios Demetriades
BACKGROUND: The distribution of trauma deaths was classically described as trimodal. With advances in both technology and trauma systems, this was re-evaluated and found to be bimodal in the early 2000s. Over the last decade there have been continued improvements in trauma and ICU care, related to damage control techniques and evidence based ICU pathways. A better understanding of the distribution of trauma deaths may be used to improve trauma systems. This study aimed to evaluate the contemporary distribution of trauma deaths after the widespread implementation of modern trauma and critical care principles...
March 8, 2018: Journal of Trauma and Acute Care Surgery
Sharon Wacht, Kristin Salottolo, Amy Atnip, Michelle Hooks, Mary Bailie, Matthew Carrick
Head strikes can be fatal for patients taking blood thinners (anticoagulants or antiplatelets). Our trauma center instituted the "head strike protocol" to provide uniform and expedited care for adult trauma patients taking preinjury anticoagulants and antiplatelet medications with suspected head injury. The purpose of this article is to describe the development and implementation of the head strike protocol and compare time metrics and outcomes before and after implementing the protocol. Per the head strike protocol, patients with suspected traumatic intracranial hemorrhage (tICH) were screened for anticoagulants or antiplatelet medications by emergency medical service personnel/at first contact, activated as a Level II trauma and received a computed tomographic scan of the head within 30 min of arrival, and started reversal of blood products within 30 min of tICH confirmation...
March 2018: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Wanjie Tang, Jingdong Zhao, Yi Lu, Yuliang Zha, Hao Liu, Yang Sun, Jun Zhang, Yanchun Yang, Jiuping Xu
BACKGROUND: Surviving an earthquake can greatly increase the risk of suicidality among children and adolescents, especially if they experience physical and emotional neglect or abuse within the family after the earthquake. How various types of childhood adversity affect the vulnerability of adolescents to suicidality after exposure to a natural disaster is not well understood. This study examined the relationships among different types of earthquake exposure, childhood trauma, psychopathology and suicidality...
February 27, 2018: Journal of Affective Disorders
Krista L Haines, Tiffany Zens, Megan Beems, Ryan Rauh, Hee Soo Jung, Suresh Agarwal
BACKGROUND: Health-care disparities based on socioeconomic status have been well documented in the trauma literature; however, there is a paucity of data on how these factors affect outcomes in patients experiencing severe thoracic trauma. This study aims to identify the effect of insurance status and race on patient mortality and disposition after thoracic trauma. METHODS: The National Trauma Data Bank was queried from 2007 to 2012 for patients with sternal fractures, rib fractures, and flailed chest...
April 2018: Journal of Surgical Research
Vincent I Lau, Joyce N H Lam, John Basmaji, Fran A Priestap, Ian M Ball
OBJECTIVES: Evaluate outcomes (mortality, morbidity, unplanned return visits) of patients who are discharged directly to home from the ICU. DESIGN: Prospective cohort study. SETTING: Two tertiary care medical-surgical-trauma ICUs at Canadian hospitals over 1 year (February 2016-2017). SUBJECTS: All adult patients who were either discharged directly to home (Recruited and Nonrecruited cohorts) from ICU or discharged home within 24 hours after ward transfer (Ward Transfer cohort)...
February 28, 2018: Critical Care Medicine
Semen V Meshcheryakov, Zhanna B Semenova, Valery I Lukianov, Elena G Sorokina, Olga V Karaseva
OBJECTIVES: We aimed to determine prognostic factors that can influence the outcome of severe traumatic brain injury (TBI) in children. MATERIALS AND METHODS: One hundred and sixty-nine patients with severe TBI were included. Consciousness was evaluated using the Glasgow Coma Scale (GCS). Severity of concomitant injuries was evaluated using the Injury Severity Score (ISS). Computer tomography (CT) scanning was used on admission and later. Intracranial injuries were classified using the Marshall CT scale...
2018: Acta Neurochirurgica. Supplement
Stephanie A Mason, Avery B Nathens, James P Byrne, Christina Diong, Robert A Fowler, Paul J Karanicolas, Rahim Moineddin, Marc G Jeschke
OBJECTIVE: To estimate long-term mortality following major burn injury compared with matched controls. SUMMARY BACKGROUND DATA: The effect of sustaining a major burn injury on long-term life expectancy is poorly understood. METHODS: Using health administrative data, all adults who survived to discharge after major burn injury between 2003 and 2013 were matched to between 1 and 5 uninjured controls on age, sex, and the extent of both physical and psychological comorbidity...
February 27, 2018: Annals of Surgery
Soo Hoon Lee, Daesung Lim, Dong Hoon Kim, Seong Chun Kim, Tae Yun Kim, Changwoo Kang, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Rock Bum Kim
BACKGROUND: Mortality prediction in patients with brain trauma during initial management in the emergency department (ED) is essential for creating the foundation for a better prognosis. OBJECTIVE: This study aimed to create a simple and useful survival predictive model for patients with isolated blunt traumatic brain injury that is easily available in the ED. METHODS: This is a retrospective study based on the trauma registry data of an academic teaching hospital...
February 22, 2018: Journal of Emergency Medicine
Sergio Henrique Bastos Damous, George Felipe Bezerra Darce, Renato Silveira Leal, Adilson Rodrigues Costa, Pedro Henrique Alves Ferreira, Celso de Oliveira Bernini, Edivaldo Massazo Utiyama
INTRODUCTION: Severe injuries of the pancreatic head and duodenum in haemodynamically unstable patients are complex management. The purpose of this study is to report a case of complex pancreatic trauma induced by gunshot and managed with surgical approaches at three different times. PRESENTATION OF CASE: Exploratory laparotomy was indicated after initial emergency room care, with findings of cloudy blood-tinged fluid and blood clots on the mesentery near the hepatic angle, on the region of the 2nd portion of the duodenum and at the pancreatic head...
February 15, 2018: International Journal of Surgery Case Reports
Wilhelmina H A M Mulders, Ian L Chin, Donald Robertson
Noise exposures that result in fully reversible changes in cochlear neural threshold can cause a reduced neural output at supra-threshold sound intensity. This so-called "hidden hearing loss" has been shown to be associated with selective degeneration of high threshold afferent nerve fiber-inner hair cell (IHC) synapses. However, the electrophysiological function of the IHCs themselves in hidden hearing loss has not been directly investigated. We have made round window (RW) measurements of cochlear action potentials (CAP) and summating potentials (SP) after two levels of a 10 kHz acoustic trauma...
February 14, 2018: Hearing Research
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