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Survival after trauma

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https://www.readbyqxmd.com/read/28743043/neurotrophy-and-immunomodulation-of-induced-neural-stem-cell-grafts-in-a-mouse-model-of-closed-head-injury
#1
Mou Gao, Hui Yao, Qin Dong, Yan Zhang, Yang Yang, Yihua Zhang, Zhijun Yang, Minhui Xu, Ruxiang Xu
Closed head injury (CHI) usually results in severe and permanent neurological impairments, which are caused by several intertwined phenomena, such as cerebral edema, blood-brain barrier (BBB) disruption, neuronal loss, astroglial scarring and inflammation. We previously reported that induced neural stem cells (iNSCs), similar to neural stem cells (NSCs), can accelerate neurological recovery in vivo and produce neurotrophic factors in vitro. However, the effects of iNSC neurotrophy following CHI were not determined...
July 18, 2017: Stem Cell Research
https://www.readbyqxmd.com/read/28742797/a-comparison-of-selective-aortic-arch-perfusion-and-resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-the-management-of-hemorrhage-induced-traumatic-cardiac-arrest-a-translational-model-in-large-swine
#2
Ed B G Barnard, James E Manning, Jason E Smith, Jason M Rall, Jennifer M Cox, James D Ross
BACKGROUND: Survival rates remain low after hemorrhage-induced traumatic cardiac arrest (TCA). Noncompressible torso hemorrhage (NCTH) is a major cause of potentially survivable trauma death. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) at the thoracic aorta (Zone 1) can limit subdiaphragmatic blood loss and allow for IV fluid resuscitation when intrinsic cardiac activity is still present. Selective Aortic Arch Perfusion (SAAP) combines thoracic aortic balloon hemorrhage control with intra-aortic oxygenated perfusion to achieve return of spontaneous circulation (ROSC) when cardiac arrest has occurred...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28740457/perioperative-increase-in-neutrophil-cd64-expression-is-an-indicator-for-intra-abdominal-infection-after-colorectal-cancer-surgery
#3
Milena Kerin Povsic, Bojana Beovic, Alojz Ihan
BACKGROUND: Colorectal surgery is associated with a high incidence of postoperative infections. Early clinical signs are difficult to distinguish from the systemic inflammatory response related to surgical trauma. Timely diagnosis may significantly improve the outcome. The objective of this study was to compare a new biomarker index CD64 for neutrophils (iCD64n) with standard biomarkers, white blood cell (WBC) count, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP) and procalcitonin (PCT) for the early detection of postoperative infection...
June 2017: Radiology and Oncology
https://www.readbyqxmd.com/read/28738812/effectiveness-of-trauma-team-on-medical-resource-utilization-and-quality-of-care-for-patients-with-major-trauma
#4
Chih-Jung Wang, Shu-Ting Yen, Shih-Fang Huang, Su-Chen Hsu, Jeremy C Ying, Yan-Shen Shan
BACKGROUND: Trauma is one of the leading causes of death in Taiwan, and its medical expenditure escalated drastically. This study aimed to explore the effectiveness of trauma team, which was established in September 2010, on medical resource utilization and quality of care among major trauma patients. METHODS: This was a retrospective study, using trauma registry data bank and inpatient medical service charge databases. Study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013, and was divided into case group (from January, 2011 to August, 2013) and comparison group (from January, 2009 to August, 2010)...
July 24, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#5
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28732652/correlation-of-tenascin-c-concentrations-in-serum-with-outcome-of-traumatic-brain-injury-in-humans
#6
Yuan-Yuan Zhao, Lin Lou, Kai-Chuang Yang, Hai-Bo Wang, Yan Xu, Gang Lu, Hai-Yan He
BACKGROUND: Tenascin-C, a matricellular protein, is involved in brain injury. However, change of tenascin-C concentrations in peripheral blood remains unknown after traumatic brain injury (TBI). METHODS: Serum tenascin-C concentrations were measured in 100 healthy controls, 108 severe TBI patients, 79 moderate TBI patients and 32 mild TBI patients. RESULTS: Serum tenascin-C concentrations of patients were significantly higher than those of controls...
July 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28730332/-a%C3%A2-phase-model-of-trauma-rehabilitation-how-can-we-avoid-the-rehab-hole
#7
Stefan Simmel, Wolf-Dieter Müller, Christoph Reimertz, Christian Kühne, Jean-Jacques Glaesener
Advances in the rescue chain and first aid of polytrauma patients, which have consequently increased their chance of survival, have led to an increase in demands for rehabilitation. However, there is still a large hole in the continuity of rehabilitation between acute patient care and in-patient rehabilitation, the so-called "rehab-hole". The consequences are untapped rehabilitation potential, loss of strength, endurance and motivation as well as impairment of function of the patient.Based on the phase model of neurological/neurosurgical rehabilitation, we propose a step model for the rehabilitation of polytrauma patients that ensures an uninterrupted chain of rehabilitation...
July 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28729903/tranexamic-acid-and-trauma-induced-coagulopathy
#8
REVIEW
Takeshi Nishida, Takahiro Kinoshita, Kazuma Yamakawa
Tranexamic acid (TXA) is a synthetic derivative of the amino acid lysine that inhibits fibrinolysis by blocking the interaction of plasminogen with the lysine residues of fibrin. Historically, TXA is commonly used for reduction of blood loss in perioperative situations, while recently it has attracted attention for clinical use in the trauma field. In 2010, the Clinical Randomization of an Antifibrinolytic in Significant Hemorrhage 2 (CRASH-2) trial demonstrated that intravenous administration of TXA improved mortality significantly in trauma patients with significant bleeding...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28724441/computed-tomography-during-initial-management-and-mortality-among-hemodynamically-unstable-blunt-trauma-patients-a-nationwide-retrospective-cohort-study
#9
Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi, Shunichi Fukuhara
BACKGROUND: Although many hemodynamically unstable trauma patients undergo computed tomography (CT) to identify a source of bleeding, this practice is currently only recommended by a few guidelines. To clarify whether CT has harmful effects among these patients, we examined the association between CT during initial management and mortality among unstable blunt trauma patients. METHODS: This was a retrospective cohort study based on Japan Trauma Data Bank 2004-2014 registry data...
July 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28723841/military-civilian-partnership-in-device-innovation-development-commercialization-and-application-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa
#10
Todd E Rasmussen, Jonathan L Eliason
Noncompressible torso hemorrhage (NCTH) and shock is a leading cause of trauma-related mortality and evidence suggests that survival from this injury pattern has not improved in decades. As such, innovating new approaches and devices, including technologies which can be used by providers within a short of time after severe injury, is a priority for the military. Guided by wartime observations, and through partnerships with civilian academia and private investment, the military has led an effort to define resuscitative endovascular balloon occlusion of the aorta (REBOA) and assess its potential to address this problem...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28720167/recovery-from-dsm-iv-post-traumatic-stress-disorder-in-the-who-world-mental-health-surveys
#11
A J Rosellini, H Liu, M V Petukhova, N A Sampson, S Aguilar-Gaxiola, J Alonso, G Borges, R Bruffaerts, E J Bromet, G de Girolamo, P de Jonge, J Fayyad, S Florescu, O Gureje, J M Haro, H Hinkov, E G Karam, N Kawakami, K C Koenen, S Lee, J P Lépine, D Levinson, F Navarro-Mateu, B D Oladeji, S O'Neill, B-E Pennell, M Piazza, J Posada-Villa, K M Scott, D J Stein, Y Torres, M C Viana, A M Zaslavsky, R C Kessler
BACKGROUND: Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors. METHODS: The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD...
July 19, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#12
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28715950/efficacy-of-the-novel-medical-adhesive-mar-vivo-107-in-an-acute-porcine-liver-resection-model
#13
Hirokazu Tanaka, Kenji Fukushima, Pramod Kadaba Srinivasan, Kerstin Pawlowsky, Babette Koegel, Koichiro Hata, Yonson Ku, Shinji Uemoto, René H Tolba
BACKGROUND: Despite modern surgical techniques, insufficient hemostasis after liver trauma is still a major cause of morbidity and mortality after injury. Therefore, efficient hemostatic agents are indicated. In this study, we evaluated the hemostatic efficacy of a novel synthetic wound adhesive (MAR-VIVO-107) based on polyurethane/polyurea, compared with a widely used fibrin adhesive (Tisseel). MATERIALS AND METHODS: Twelve German Landrace pigs were randomly assigned to 2 groups...
July 1, 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28715416/signatures-of-inflammation-and-impending-multiple-organ-dysfunction-in-the-hyperacute-phase-of-trauma-a-prospective-cohort-study
#14
Claudia P Cabrera, Joanna Manson, Joanna M Shepherd, Hew D Torrance, David Watson, M Paula Longhi, Mimoza Hoti, Minal B Patel, Michael O'Dwyer, Sussan Nourshargh, Daniel J Pennington, Michael R Barnes, Karim Brohi
BACKGROUND: Severe trauma induces a widespread response of the immune system. This "genomic storm" can lead to poor outcomes, including Multiple Organ Dysfunction Syndrome (MODS). MODS carries a high mortality and morbidity rate and adversely affects long-term health outcomes. Contemporary management of MODS is entirely supportive, and no specific therapeutics have been shown to be effective in reducing incidence or severity. The pathogenesis of MODS remains unclear, and several models are proposed, such as excessive inflammation, a second-hit insult, or an imbalance between pro- and anti-inflammatory pathways...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28715125/acute-alcohol-binge-deteriorates-metabolic-and-respiratory-compensation-capability-after-blunt-chest-trauma-followed-by-hemorrhagic-shock-a-new-research-model
#15
Nils Wagner, Niklas Franz, Scott Dieteren, Mario Perl, Katharina Mörs, Ingo Marzi, Borna Relja
BACKGROUND AND PURPOSE: The clinical relevance of blunt (thoracic) chest trauma (TxT) and hemorrhagic shock is indisputable due to the high prevalence of this injury type, as well as its close association with mortality and/or preventable deaths. Furthermore, there is an ongoing discussion about the influence of alcohol in trauma patients. Thus, we established a model of TxT followed by hemorrhagic shock and resuscitation (H/R) in alcohol-intoxicated rats. EXPERIMENTAL APPROACH: Depending on group allocation, twelve (sub-acute) or two (acute) hours before experimentation, the animals received a single oral dose of alcohol (ethanol, EtOH) or saline (NaCl) followed by TxT, hemorrhagic shock (35 ± 3 mm Hg) and resuscitation (TxT+H/R)...
July 17, 2017: Alcoholism, Clinical and Experimental Research
https://www.readbyqxmd.com/read/28712882/perfusion-of-muscle-flaps-independent-of-the-anatomical-vascular-pedicle-pedicle-autonomy
#16
K Bradshaw, M Wagels
INTRODUCTION: Free muscle flaps are being used more commonly for complex lower limb reconstruction. Up to 33% of flaps used to reconstruct lower limb trauma will require an orthopaedic procedure after reconstruction. To date there have been only case reports detailing the variable survival of muscle flaps after actual or simulated pedicle injury and the process and timeframe of neovascularisation remains undefined. We aim to show that perfusion of a muscle flap is possible after injury to its anatomical vascular pedicle...
June 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28709714/usefulness-of-serial-measurement-of-the-red-blood-cell-distribution-width-to-predict-28-day-mortality-in-patients-with-trauma
#17
Taeyoung Kong, Jong Eun Park, Yoo Seok Park, Hye Sun Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
BACKGROUND: This is the first study to evaluate the association between the serially measured RDW values and clinical severity in patients surviving >24 h after sustaining trauma. We evaluated the serial measurement and cut-off values of RDW to determine its significance as a prognostic marker of early mortality in patients with suspected severe trauma. METHODS: This study retrospectively analyzed prospective data of eligible adult patients who were admitted to the ED with suspected severe trauma...
June 8, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28703885/use-of-a-72-cm-long-extended-bilateral-deep-inferior-epigastric-artery-perforator-free-flap-for-reconstruction-of-a-lower-leg-with-no-suitable-recipient-vessel-around-the-injury-zone-a-case-report
#18
Hidehiko Yoshimatsu, Takumi Yamamoto, Akitatsu Hayashi, Takuya Iida
In free-flap reconstruction of the lower extremity, due either to trauma or pre-existing vascular disease, healthy vessels may not be readily available in the proximity of the defect. A variety of options including a cross-leg free flap, vein grafts, arteriovenous loops, and "bridging" flaps have been used to address the issue. The purpose of this report is to present a case in which a 72-cm long extended bilateral deep inferior epigastric artery perforator (DIEP) free flap was used for coverage of a 20 × 25 cm soft tissue defect of the lower leg following a Gustilo grade IIIC fracture in a 29-year-old man...
July 13, 2017: Microsurgery
https://www.readbyqxmd.com/read/28698803/sports-activities-after-total-hip-arthroplasty
#19
Martin Krismer
Performing sports after total hip arthroplasty (THA) may be associated with a risk of Trauma (fracture and dislocation)Shorter implant survivalThere is no proof that trauma occurs more often than in healthy individuals, but sequelae may be more severe.Shorter implant survival due to repetitive high contact forces is a fact, due to increased wear. The 15 year survival in highly active patients seems to be around 80%.Surgeons can address the needs of active patients by using bearings with low wear rates, and femoral heads up to 36 mm in diameter...
May 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28697154/interfacility-transport-shock-index-is-associated-with-decreased-survival-in-children
#20
Ryan M Jennings, Bradley A Kuch, Kathryn A Felmet, Richard A Orr, Joseph A Carcillo, Ericka L Fink
BACKGROUND: Shock index, the ratio of heart rate to systolic blood pressure that changes with age, is associated with mortality in adults after trauma and in children with sepsis. We assessed the utility of shock index to predict sepsis diagnosis and survival in children requiring interfacility transport to a tertiary care center. METHODS: We studied children aged 1 month to 21 years who had at least 2 sets of vital signs recorded during interfacility transport to the Children's Hospital of Pittsburgh by our critical care transport team...
July 11, 2017: Pediatric Emergency Care
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