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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28099776/understanding-the-connection-between-posttraumatic-stress-symptoms-and-respiratory-problems-contributions-of-anxiety-sensitivity
#1
Brittain L Mahaffey, Adam Gonzalez, Samantha G Farris, Michael J Zvolensky, Evelyn J Bromet, Benjamin J Luft, Roman Kotov
Respiratory problems and posttraumatic stress disorder (PTSD) are the signature health consequences associated with the September 11, 2001 (9/11), World Trade Center disaster and frequently co-occur. The reasons for this comorbidity, however, remain unknown. Anxiety sensitivity is a transdiagnostic trait that is associated with both PTSD and respiratory symptoms. The present study explored whether anxiety sensitivity could explain the experience of respiratory symptoms in trauma-exposed smokers with PTSD symptoms...
January 18, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28091428/refractive-aim-and-visual-outcome-after-phacoemulsification-a-2-year-review-from-a-tertiary-private-eye-hospital-in-sub-saharan-africa
#2
O Oderinlo, A O Hassan, F O Oluyadi, A O Ogunro, O N Okonkwo, M O Ulaikere, O Ashano
AIM: To review the short-term visual outcome of phacoemulsification in adults with uncomplicated cataracts in Eye Foundation Hospital, Lagos, Nigeria. MATERIALS AND METHODS: A retrospective review of records of patients that had phacoemulsification between January 2012 and December 2013 in Eye Foundation Hospital, Lagos, Nigeria, was done. Preoperative visual acuity, refractive aim, intraoperative complications, postoperative unaided, and best-corrected visual acuity at 1 and 3 months were analyzed...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28087547/risk-of-pneumonia-in-patients-with-isolated-minor-rib-fractures-a-nationwide-cohort-study
#3
Sai-Wai Ho, Ying-Hock Teng, Shun-Fa Yang, Han-Wei Yeh, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh
OBJECTIVES: Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. DESIGN: Nationwide population-based cohort study. SETTING: Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28068498/adapting-dialectical-behavior-therapy-for-the-treatment-of-dissociative-identity-disorder
#4
Brad Foote, Kim Van Orden
Dialectical Behavior Therapy (DBT), created by Marsha Linehan, has been shown to be an effective therapy for the treatment of borderline personality disorder (BPD) and for suicidal and self-harming behavior. Dissociative identity disorder (DID) is a complex post-traumatic disorder which is highly comorbid with BPD, shares a number of clinical features with BPD, and which like BPD features a high degree of suicidality. The DID treatment literature emphasizes the importance of a staged approach, beginning with the creation of a safe therapeutic frame prior to addressing traumatic material; DBT is also a staged treatment, in which behavioral and safety issues are addressed in Stage 1, and trauma work reserved for Stage 2...
December 31, 2016: American Journal of Psychotherapy
https://www.readbyqxmd.com/read/28045742/management-of-anticoagulation-with-rivaroxaban-in-trauma-and-acute-care-surgery-complications-and-reversal-strategies-as-compared-to-warfarin-therapy
#5
Sara P Myers, Esmaeel R Dadashzadeh, Jessica Cheung, Louis Alarcon, Matthew Kutcher, Joshua B Brown, Matthew D Neal
BACKGROUND: Rivaroxaban has gained popularity as an anticoagulant (AC) for stroke prevention in nonvalvular atrial fibrillation (afib) and venous thromboembolism (VTE). Although adverse bleeding events are associated with all AC, lack of point of care testing to measure the effect of rivaroxaban in emergent situations has contributed to perceived increased risk amongst physicians. METHODS: To describe a single center experience with trauma and emergency general surgery (EGS) patients taking rivaroxaban and evaluate outcomes compared with patients taking warfarin using a propensity score analysis...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28041754/not-all-patients-meet-the-1day-per-percent-burn-rule-a-simple-method-for-predicting-hospital-length-of-stay-in-patients-with-burn
#6
Sandra L Taylor, Soman Sen, David G Greenhalgh, MaryBeth Lawless, Terese Curri, Tina L Palmieri
INTRODUCTION: Hospital length of stay (LOS) is utilized to estimate resource utilization and quality of care. In burns the LOS estimation is 1day per percent total body surface area burn (1day/%TBSA). Our purpose was to evaluate the 1day/%TBSA burn rule and develop simple accurate formulas to predict LOS. METHODS: The American Burn Association National Burn Repository (NBR) from 2000 to 2013 was utilized to collate data on patients >18 years. We divided 106,543 records in half, utilizing one set to develop a model (training set) and the other to test the model (test set)...
December 29, 2016: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28039008/risk-factors-for-severe-complications-of-operative-mandibular-fractures
#7
Brian J Christensen, Donald E Mercante, John P Neary, Brett J King
PURPOSE: The purpose of the present study was to identify the risk factors for major complications developing during the operative treatment of mandibular fractures. PATIENTS AND METHODS: We conducted a retrospective medical record review of patients who had undergone open reduction, internal fixation of mandibular fractures from August 1, 2012 to December 31, 2014 at a large, urban teaching hospital and level 1 trauma center. The outcome variable of interest was major complications, defined as the occurrence of any one of the following events: hospital readmission, return to the operating room, and a prolonged, unexpected postoperative stay...
December 11, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28038786/epidemiologic-data-of-trauma-related-lower-limb-amputees-a-single-center-10-year-experience
#8
Evren Yaşar, Fatih Tok, Serdar Kesikburun, A Mustafa Ada, Bayram Kelle, A Salim Göktepe, Kamil Yazıcıoğlu, A Kenan Tan
OBJECTIVE: The aim of this study is three fold: 1) to introduce epidemiologic data of patients with trauma-related amputations as a 10-year experience of a rehabitation center; 2) to determine comorbidities and secondary conditions of lower limb loss; 3) to determine the rehospitalization reasons for lower limb amputee patients. MATERIALS AND METHODS: This retrospective study was conducted in a tertiary rehabilitation center in Turkey. Clinical and demographic data of amputees including sex, age, employment status, time since amputation, time after amputation to first hospitalization, length of hospitalization, how many times the patient was hospitalized, reason for hospitalization, stump complications, comorbid conditions, amputation level and K classifacation were documented...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28030757/altered-resting-state-functional-connectivity-of-fear-and-reward-circuitry-in-comorbid-ptsd-and-major-depression
#9
Xi Zhu, Liat Helpman, Santiago Papini, Franklin Schneier, John C Markowitz, Page E Van Meter, Martin A Lindquist, Tor D Wager, Yuval Neria
BACKGROUND: Individuals with comorbid posttraumatic stress disorder and major depressive disorder (PTSD-MDD) often exhibit greater functional impairment and poorer treatment response than individuals with PTSD alone. Research has not determined whether PTSD-MDD is associated with different network connectivity abnormalities than PTSD alone. METHODS: We used functional magnetic resonance imaging (fMRI) to measure resting state functional connectivity (rs-FC) patterns of brain regions involved in fear and reward processing in three groups: patients with PTSD-alone (n = 27), PTSD-MDD (n = 21), and trauma-exposed healthy controls (TEHCs, n = 34)...
December 28, 2016: Depression and Anxiety
https://www.readbyqxmd.com/read/28030504/hospitals-with-higher-volumes-of-emergency-general-surgery-patients-achieve-lower-mortality-rates-a-case-for-establishing-designated-centers-for-emergency-general-surgery
#10
Gerald O Ogola, Adil Haider, Shahid Shafi
BACKGROUND: Higher volume has been associated with lower mortality for several surgical diseases. It is not known if this relationship exists in the management of Emergency General Surgery (EGS). Our hypothesis was that EGS patients treated at hospitals with higher EGS volume experienced lower mortality rates than those treated at low-volume hospitals. METHODS: This was a retrospective analysis of 2010 National Inpatient Sample data, maintained by the Agency for Healthcare Quality and Research as a representative national sample of inpatients...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28027844/effect-of-hospital-volume-on-success-of-thumb-replantation
#11
Elham Mahmoudi, Kevin C Chung
PURPOSE: Hospital volume-outcome association has been examined for many high-risk surgical procedures. Little is known about this association for thumb replantation, a complex but essential surgical procedure to restore hand function. We aimed to determine patient and hospital characteristics that are associated with increased probability of replanted thumb survival and to examine volume-outcome association among hospitals that performed thumb replantation. METHODS: We used data from 2008 to 2012 from the National Trauma Data Bank...
December 24, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28027182/treatment-options-for-exposed-calvarium-due-to-trauma-and-burns
#12
Samuel Golpanian, Wrood Kassira, Mutaz B Habal, Seth R Thaller
Wounds involving the calvarium secondary to trauma or burns are rare. However, they can present with challenging potential clinical sequelae. A wide variety of reconstructive options have evolved over the last century. Technical aspects have progressively improved as well over time. For proper surgical restoration of function and cosmesis reconstructive surgeons must have a detailed understanding of both the scalp and skull anatomy. Several factors such as etiology of the injury, including whether or not calvarial bone defects exists or simply soft tissue loss, as well as size, local tissue environment and patient comorbidities play major roles in appropriate choice for reconstruction...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28026728/-influence-of-the-weather-on-the-incidence-of-fractures-in-the-elderly
#13
F Burget, O Foltán, J Kraus, K Kudrna, M Novák, J Ulrych
PURPOSE OF THE STUDY The incidence of geriatric fractures (proximal femur, distal radius, proximal humerus and thoracolumbar spine injuries) in the population increases with ageing. However, the role of weather conditions, such as icy and slippery winter, should not be overlooked. A deeper insight into this relationship may bring about a better understanding of the fracture aetiology and thus allow for improvement in the prevention of fractures in elderly people. MATERIAL AND METHODS This prospective study included 676 patients (469 women and 207 men) aged 65 and over...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28009614/factors-associated-with-patient-initiated-telephone-calls-after-orthopaedic-trauma-surgery
#14
Michael M Hadeed, Abdurrahman Kandil, Vandan Patel, Avery Morrison, Wendy M Novicoff, Seth Yarboro
OBJECTIVES: The primary aim of this study is to investigate the incidence of early patient-initiated postoperative telephone calls and reasons for those calls. Secondary goals are to determine perioperative predictive factors for calls including the procedures most frequently associated with them. DESIGN: Retrospective chart review SETTING:: Academic Level 1 Trauma Center PATIENTS/PARTICIPANTS:: 684 patients who underwent surgical treatment by our orthopaedic trauma division between January 1, 2014 and December 31, 2014...
November 7, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28000125/prevalence-and-risk-factors-for-early-seizure-in-patients-with-traumatic-brain-injury-analysis-from-national-trauma-data-bank
#15
Shahram Majidi, Yamane Makke, Amr Ewida, Bahareh Sianati, Adnan I Qureshi, Mohamad Z Koubeissi
BACKGROUND: Traumatic brain injury (TBI) is a well-known risk factor for seizures. We aimed to identify the frequency and risk factors for seizure occurrence during hospitalization for TBI. METHODS: We used ICD-9-CM codes to identify patients 18 years of age or older from the National Trauma Data Bank who were admitted with TBI. We also used ICD-9-CM codes to identify the subset who had seizures during hospitalization. Patient demographics, comorbidities, Glasgow Coma Scale (GCS) score, Injury Severity Score Abbreviated Injury Scale (ISSAIS), in-hospital complications, and discharge disposition were compared in the seizure group (SG) and no-seizure group (NSG)...
December 20, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/27993211/trauma-patients-who-present-in-a-delayed-fashion-a-unique-and-challenging-population
#16
Mary J Kao, Hector Nunez, Sean F Monaghan, Daithi S Heffernan, Charles A Adams, Stephanie N Lueckel, Andrew H Stephen
BACKGROUND: A proportion of trauma patients present for evaluation in a delayed fashion after injury, likely due to a variety of medical and nonmedical reasons. There has been little investigation into the characteristics and outcomes of trauma patients who present delayed. We hypothesize that trauma patients who present in a delayed fashion are a unique population at risk of increased trauma-related complications. MATERIALS AND METHODS: This was a retrospective review from 2010-2015 at a Level I trauma center...
February 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27979485/discharge-destination-and-readmission-rates-in-older-trauma-patients
#17
David S Strosberg, Blain Chaise Housley, Daniel Vazquez, Amy Rushing, Steven Steinberg, Christian Jones
BACKGROUND: In older trauma patients, the impact of discharge destination on readmission rates is not known. The objective of this study was to evaluate the association between the discharge destination and the 30-day readmission rate in older trauma patients. MATERIALS AND METHODS: A previously validated database of all patients aged 45 years or older undergoing trauma evaluation at our level 1 trauma center between January 1, 2008 and December 31, 2008 was analyzed to retrospectively compare the incidences of 30-day readmission between patients discharged to home, to inpatient rehabilitation facilities, and to other extended care facilities (ECFs)...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27942737/prothrombin-complex-concentrates-an-alternative-to-fresh-frozen-plasma
#18
David R Burk, Jordan L Smith, Jason R Wild
Insufficiency fractures are a common cause of morbidity among geriatric patients worldwide. Improved outcomes are known to result from decreased delay to definitive operative fixation and mobilization. Use of warfarin is an important potential cause of delay. The ideal mode of warfarin reversal is currently unknown. Prothrombin complex concentrates (PCCs) offer rapid correction with small infusion volume, both of which are important for elderly patients with multiple comorbidities. The authors present 2 cases of insufficiency fractures occurring in geriatric patients receiving warfarin therapy reversed with a 3-factor PCC...
December 8, 2016: Orthopedics
https://www.readbyqxmd.com/read/27932031/number-of-rib-fractures-thresholds-independently-predict-worse-outcomes-in-older-patients-with-blunt-trauma
#19
Nikita O Shulzhenko, Tiffany J Zens, Megan V Beems, Hee Soo Jung, Ann P O'Rourke, Amy E Liepert, John E Scarborough, Suresh K Agarwal
BACKGROUND: There have been conflicting reports regarding whether the number of rib fractures sustained in blunt trauma is associated independently with worse patient outcomes. We sought to investigate this risk-adjusted relationship among the lesser-studied population of older adults. METHODS: A retrospective review of the National Trauma Data Bank was performed for patients with blunt trauma who were ≥65 years old and had rib fractures between 2009 and 2012 (N = 67,695)...
December 5, 2016: Surgery
https://www.readbyqxmd.com/read/27910090/spinal-fractures-in-older-adult-patients-admitted-after-low-level-falls-10-year-incidence-and-outcomes
#20
Randeep S Jawa, Adam J Singer, Daniel N Rutigliano, Jane E McCormack, Emily C Huang, Marc J Shapiro, Suzanne D Fields, Brian N Morelli, James A Vosswinkel
OBJECTIVES: To evaluate the incidence of spinal fractures and their outcomes in the elderly who fall from low-levels in a suburban county. DESIGN: Retrospective county-wide trauma registry review from 2004 to 2013. SETTING: Suburban county with regionalized trauma care consisting of 11 hospitals. PARTICIPANTS: Adult trauma patients aged ≥65 years who were admitted after falling from <3 feet. MEASUREMENTS: Demographic characteristics, comorbidities, and outcomes...
December 2, 2016: Journal of the American Geriatrics Society
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