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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28717977/-challenges-of-implementing-a-geriatric-trauma-network-a-regional-structure
#1
Carsten Schoeneberg, Bjoern Hussmann, Thomas Wesemann, Ludger Pientka, Marie-Christin Vollmar, Christine Bienek, Markus Steinmann, Benjamin Buecking, Sven Lendemans
BACKGROUND: At present, there is a high percentage and increasing tendency of patients presenting with orthogeriatric injuries. Moreover, significant comorbidities often exist, requiring increased interdisciplinary treatment. These developments have led the German Society of Trauma Surgery, in cooperation with the German Society of Geriatrics, to establish geriatric trauma centers. METHODS: As a conglomerate hospital at two locations, we are cooperating with two external geriatric clinics...
July 17, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28716100/quality-of-life-and-clinical-radiological-long-term-results-after-implant-associated-infections-in-patients-with-ankle-fracture-a-retrospective-matched-pair-study
#2
Patrick Ziegler, Donat Schlemer, Ingo Flesch, Sonja Bahrs, Ulrich Stoeckle, Sebastian Werner, Christian Bahrs
BACKGROUND: Ankle fractures are frequently occurring injuries. Despite the relatively simple operative technique, patients often suffer from postoperative complications. Little is known about postoperative treatment of implant-associated infections of the ankle. Therefore, this study shows and evaluates a treatment algorithm in long- and short-term outcomes compared to infection-free patients. METHODS: Data from patients of over 20 years of a level 1 trauma center and university hospital was retrospectively analyzed including age, gender, comorbidities, smoking status, fracture classification, number of revisions, length of in-patient stay due to fracture and infection, and results of microbiological specimen with the length of antibiotic treatment...
July 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#3
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28705753/invasive-fungal-infections-secondary-to-traumatic-injury
#4
REVIEW
Ryan Kronen, Stephen Y Liang, Grant Bochicchio, Kelly Bochicchio, William G Powderly, Andrej Spec
Invasive fungal infection (IFI) is a rare but serious complication of traumatic injury. The purpose of this article is to review the epidemiology, natural history, mycology, risk factors, diagnosis, treatment, and outcomes associated with post-traumatic IFI in military and civilian populations. The epidemiology of post-traumatic IFI is poorly characterized, but incidence appears to be rising. Patients often suffer from severe injuries and require extensive medical interventions. Fungi belonging to the order Mucorales are responsible for most post-traumatic IFI in both civilian and military populations...
July 10, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28695555/adherence-to-osteoporosis-pharmacotherapy-one-year-after-osteoporotic-fracture-a-swiss-trauma-center-secondary-prevention-project
#5
Sabrina Morell, Christoph Hemmeler, Felix Amsler, Thomas Gross
AIMS OF THE STUDY: According to current evidence, one out of ten fracture patients with osteoporosis does not sustain another fracture if he or she is on adequate medication. However, epidemiological surveys show that only about 15 to 30% of affected patients avail themselves of the treatments. This cohort study investigated how many fracture patients with a recommendation for antiosteoporotic therapy effectively received treatment and the possible reasons why the treatment was not implemented...
July 11, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28694618/single-parietal-burr-hole-craniostomy-with-irrigation-and-drainage-for-unilateral-chronic-subdural-hematoma-in-young-adults-40-years-a-rationale-behind-the-procedure
#6
Raj S Chandran, Milesh Nagar, M S Sharmad, Rajmohan B Prabhakar, Anil K Peethambaran, Shailesh Kumar, Saurabh Sharma, Sourabh K Jain
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. It is mostly a disease of elderly population with very little data about the young patients. There is also the debate regarding treatment strategies. We decided to determine the overall efficacy of the single burr-hole craniostomy (SBHC) for unilateral CSDH in young adults <40 years. SUBJECTS AND METHODS: We performed a retrospective study of young patients undergoing SBHC for unilateral CSDH between January 2013 and June 2016 at our institution...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28693815/comorbid-mild-traumatic-brain-injury-increases-pain-symptoms-in-patients-suffering-from-an-isolated-limb-fracture
#7
Marianne Jodoin, Dominique M Rouleau, Nadia Gosselin, Benoit Benoit, Stéphane Leduc, Yves Laflamme, Camille Larson-Dupuis, Louis De Beaumont
OBJECTIVES: This study seeks to evaluate the effects of a mild traumatic brain injury (mTBI) on pain in patients with an isolated limb fracture (ILF) when compared to a matched cohort group with no mTBI (control group). PATIENTS AND METHODS: All subjects included in this observational study suffered from an ILF. Groups were matched according to the type of injury, sex, age, and time since the accident. Main outcome measurements were: Standardized semi-structured interviews at follow-up of a Level I Trauma Center, and a questionnaire on fracture-related pain symptoms...
July 1, 2017: Injury
https://www.readbyqxmd.com/read/28692621/challenges-in-the-management-of-geriatric-trauma-a-case-report
#8
Ashley Gaebel, Megan Keiser
This article describes geriatric trauma and commonly associated difficulties emphasizing both the epidemiology and assessment of geriatric trauma. There is little data guiding decisions for trauma patients 65 years or older, as there are many unique characteristics to the geriatric population, including comorbidities, medications, and the aging physiology. The geriatric population in the United States has been steadily climbing for the last 20 years and is projected to continue on this trend. Although each patient presents differently, there remains a need for the consistent utilization of standard guidelines to help dictate care for geriatric patients, particularly for patients not receiving care at a trauma center...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692616/development-of-a-falls-registry-a-pilot-study
#9
Gina M Berg, Tara Carlson, Joanne Fairchild, Courtney Edwards, Ryan Sorell
Each year approximately 1 in 4 healthy older adults aged 65+ years and 1 in 2 aged 80+ years living in the community will fall. Fall-related injuries are the leading cause of death and disability and cost the United States approximately $31 billion annually. Currently, no repository of scene data exists that informs prevention programs regarding circumstances that contribute to older adult falls. This was a multicenter (4 sites: Kansas, Maryland, Oregon, and Texas) pilot study consisting of interviews of older (55+ years) patients who had been admitted to a trauma center with fall-related injuries...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28681713/childhood-adversities-in-patients-with-fibromyalgia-are-they-related-to-comorbid-lifetime-major-depression
#10
Alessandra Alciati, Fabiola Atzeni, Massimiliano Grassi, Daniela Caldirola, Alice Riva, Piercarlo Sarzi-Puttini, Giampaolo Perna
OBJECTIVES: Fibromyalgia (FM) is a syndrome of unknown aetiology that is frequently associated with depressive disorders, and childhood adversities (including maltreatment and parental loss) are frequently described in subjects with FM and depression. The aim of this study was to investigate the extent to which the high percentage of childhood adversities reported by patients with FM is related to FM itself or to a comorbid lifetime depressive disorder. METHODS: Ninety-four consecutive FM patients were assessed for lifetime major depression using the DSM-IVSCID-CV interview...
May 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28681628/the-management-of-fibromyalgia-from-a-psychosomatic-perspective-an-overview
#11
Federica Sancassiani, Sergio Machado, Valeria Ruggiero, Enrico Cacace, Claudia Carmassi, Camilla Gesi, Liliana Dell'Osso, Mauro Giovanni Carta
Fibromyalgia (FM) is a central sensitization syndrome characterized by chronic widespread pain. FM is often comorbid with psychiatric disorders, as well as psychological distress that worsens the quality-of-life of people affected. The aim was to collect current evidence about the management of FM from a psychosomatic perspective. The literature was synthesized and summarized in a narrative format. The literature search was carried out in PubMed; review articles, meta-analysis, overview, and guidelines published in the last 10 years written in English were included...
July 6, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28680540/a-randomized-controlled-trial-of-brief-somatic-experiencing-for-chronic-low-back-pain-and-comorbid-post-traumatic-stress-disorder-symptoms
#12
Tonny Elmose Andersen, Yael Lahav, Hanne Ellegaard, Claus Manniche
Background: It is well documented that comorbid post-traumatic stress disorder (PTSD) in chronic pain is associated with a more severe symptom profile with respect to pain, disability and psychological distress. However, very few intervention studies exist targeting both PTSD and pain. The current study is the first randomized controlled trial evaluating the effect of the body-oriented trauma approach of Somatic Experiencing (SE) for comorbid PTSD and low back pain. Although the method is well recognized by clinicians and widely used, SE still needs to be tested in a randomized clinical trial in comparison with an active control group...
2017: European Journal of Psychotraumatology
https://www.readbyqxmd.com/read/28678652/postoperative-c-reactive-protein-concentration-and-clinical-outcome-comparison-of-open-cystectomy-to-robot-assisted-laparoscopic-cystectomy-with-extracorporeal-or-intracorporeal-urinary-diversion-in-a-prospective-study
#13
Pernille Skjold Kingo, Rikke Nørregaard, Michael Borre, Jørgen Bjerggaard Jensen
OBJECTIVE: This study aimed to compare clinical outcome and postoperative systemic inflammatory response using C-reactive protein (CRP) levels, to quantify the degree of tissue injury in open mini-laparotomy cystectomy (OMC) versus robot-assisted laparoscopic cystectomy with extracorporeal (RALC-EUD) or intracorporeal urinary diversion (RALC-IUD). MATERIALS AND METHODS: From September 2012 to September 2015, 309 patients diagnosed with bladder cancer underwent radical cystectomy with urinary diversion...
July 5, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28676385/syncope-workup-greater-yield-in-select-trauma-population
#14
Melike Harfouche, Michael Cline, Michael Mazzei, Thomas Santora
BACKGROUND: There is great variation in practice regarding the assessment of trauma patients who present with syncope. The purpose of this study was to determine the yield of screening studies (electrocardiogram, echocardiogram, and carotid duplex) and define characteristics to identify groups that may benefit from these investigations. METHODS: We conducted a retrospective cohort study of all trauma patients from 2003 to 2015 who received a carotid duplex as part of a syncope evaluation at our urban Level 1 Trauma Center...
July 1, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28670669/primary-report-of-totally-tubeless-percutaneous-nephrolithotomy-despite-pelvi-calyceal-perforations
#15
Seyed Mohammad Kazem Aghamir, Alborz Salavati, Morteza Hamidi, Asghar FallahNejad
PURPOSE: Nephrostomy tube insertion and/or a ureteral stent placement is advised when pelvi-calyceal perforations are encountered during percutaneous nephrolithotomy (PNL) nevertheless totally tubeless PNL is a possible exit strategy in percutaneous renal surgery therefore case series on the short term clinical outcomes of noninvasive management of iatrogenic pelvicalyceal perforations encountered during PNL is presented. PATIENTS AND METHODS: During retrospective analysis of 1271 PNL procedures, 25 incidents of accidental ureteral catheter/ jj stent dislodgement during first 24 post-operative hours were identified in patient who had pelvi calyceal perforations and had no nephrostomy tube (tubeless)...
July 2, 2017: Urology Journal
https://www.readbyqxmd.com/read/28668659/morbidity-and-mortality-amongst-indian-hajj-pilgrims-a-3-year-experience-of-indian-hajj-medical-mission-in-mass-gathering-medicine
#16
Inam D Khan, Shahbaz A Khan, Bushra Asima, Syed B Hussaini, M Zakiuddin, F A Faisal
The Hajj, a mass-gathering of over 3.5-million pilgrims, faces challenges to global health-security, housing, food, water, transportation, communication, sanitation, crowd-control and security. The Indian Medical Mission extended health-security to approximately 140,000 pilgrims, through outreach medical teams, primary-care clinics, tent-clinics, secondary-care hospitals and evacuation capabilities. Data on medical attendance, bed-occupancy, investigations, referrals, medication usage and deaths was compared...
June 28, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28653376/has-the-income-of-the-residential-area-impact-on-the-use-of-intensive-care
#17
J H Liisanantti, R Käkelä, L V Raatiniemi, P Ohtonen, S Hietanen, T I Ala-Kokko
BACKGROUND: The socioeconomic factors have an impact on case mix and outcome in critical illness, but how these factors affect the use of intensive care is not studied. The aim of this study was to evaluate the incidence of intensive care unit (ICU) admissions in patients from residential areas with different annual incomes. METHODS: Single-center, retrospective study in Northern Finland. All the non-trauma-related emergency admissions from the hospital district area were included...
June 26, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28649383/impact-of-therapist-change-after-initial-contact-and-traumatic-burden-on-dropout-in-a-naturalistic-sample-of-inpatients-with-borderline-pathology-receiving-dialectical-behavior-therapy
#18
Carolin Steuwe, Michaela Berg, Martin Driessen, Thomas Beblo
BACKGROUND: This study focused on the predictors of therapy dropout in a naturalistic sample of patients with borderline pathology receiving dialectical behavior therapy (DBT) in an inpatient setting. We assumed that the change of the therapist between DBT-briefing and start of DBT-treatment as well as comorbid posttraumatic stress disorder (PTSD) and childhood trauma history were associated with elevated dropout. METHODS: Eighty-nine participants with borderline pathology (≥ 3 borderline personality disorder criteria) receiving an inpatient DBT program completed a quality assurance questionnaire set assessing demographic information and pretreatment psychopathology during the days of their inpatient stay...
2017: Borderline Personality Disorder and Emotion Dysregulation
https://www.readbyqxmd.com/read/28649270/low-values-of-central-venous-oxygen-saturation-scvo2-during-surgery-and-anastomotic-leak-of-abdominal-trauma-patients
#19
Andres Isaza-Restrepo, Jose F Moreno-Mejia, Juan S Martin-Saavedra, Milciades Ibañez-Pinilla
BACKGROUND: There is a well known relationship between hypoperfusion and postoperative complications like anastomotic leak. No studies have been done addressing this relationship in the context of abdominal trauma surgery. Central venous oxygen saturation is an important hypoperfusion marker of potential use in abdominal trauma surgery for identifying the risk of anastomotic leak development. The purpose of this study was to identify the relationship between low values of central venous oxygen saturation and anastomotic leak of gastrointestinal sutures in the postoperative period in abdominal trauma surgery...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28645598/efficacy-of-early-surgery-for-neurological-improvement-in-spinal-cord-injury-without-radiographic-evidence-of-trauma-in-the-elderly
#20
Tomoo Inoue, Shinsuke Suzuki, Toshiki Endo, Hiroshi Uenohara, Teiji Tominaga
OBJECT: The optimal timing for surgery for patients with spinal cord injury without radiographic evidence of trauma (SCIWORET) remains unclear. This is especially true in the elderly, because most studies are done with younger patients to avoid age-related comorbidities. We therefore aimed to compare the efficacy of early (less than 24 hours post-injury) versus late (more than 24 hours post-injury) surgery in patients with SCIWORET aged 65 years or older. METHODS: We identified patients aged 65 years or older who underwent surgery for SCIWORET between January 1995 and February 2016...
June 20, 2017: World Neurosurgery
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