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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28789695/clinical-profile-and-comorbidity-of-traumatic-brain-injury-among-younger-and-older-men-and-women-a-brief-research-notes
#1
Vincy Chan, Tatyana Mollayeva, Kenneth J Ottenbacher, Angela Colantonio
OBJECTIVE: Comorbid disorders influence the course and outcomes of rehabilitation following traumatic brain injury (TBI), yet sex- and age-related disparities in the frequency distribution of these disorders remain poorly understood. We aimed to describe comorbid disorders by the International Classification of Diseases in patients with TBI undergoing inpatient rehabilitation in Ontario, Canada over a 3-year period, by sex and age, and discuss their potential impact on rehabilitation outcomes...
August 8, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28780503/late-mortality-after-acute-hypoxic-respiratory-failure
#2
Hallie C Prescott, Michael W Sjoding, Kenneth M Langa, Theodore J Iwashyna, Daniel F McAuley
BACKGROUND: Acute hypoxic respiratory failure (AHRF) is associated with significant acute mortality. It is unclear whether later mortality is predominantly driven by pre-existing comorbid disease, the acute inciting event or is the result of AHRF itself. METHODS: Observational cohort study of elderly US Health and Retirement Study (HRS) participants in fee-for-service Medicare (1998-2012). Patients hospitalised with AHRF were matched 1:1 to otherwise similar adults who were not currently hospitalised and separately to patients hospitalised with acute inciting events (pneumonia, non-pulmonary infection, aspiration, trauma, pancreatitis) that may result in AHRF, here termed at-risk hospitalisations...
August 5, 2017: Thorax
https://www.readbyqxmd.com/read/28780196/can-we-reduce-morphine-use-in-elderly-proximal-femoral-fracture-patients-using-a-fascia-iliac-block
#3
Al-Amin M Kassam, Anthony T Gough, Joanna Davies, Rathan Yarlagadda
Proximal femoral fractures are becoming increasingly common with an ageing population. Many patients have multiple comorbidities increasing their risk of opiate complications. 40 consecutive patients presenting with a proximal femoral fracture to a trauma centre in the UK were given either a Fascia Iliaca Block (FIB) with oral analgesia or just oral analgesia to control their pre-operative pain. Numeric pain scores and morphine consumption were used as outcome measures. Patients receiving a FIB had significant reduction in their pain scores compared to patients only receiving oral pain relief...
August 2, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28766080/trajectories-in-quality-of-life-of-patients-with-a-fracture-of-the-distal-radius-or-ankle-using-latent-class-analysis
#4
M A C Van Son, J De Vries, W Zijlstra, J A Roukema, T Gosens, M H J Verhofstad, B L Den Oudsten
PURPOSE: This prospective study aimed to identify the different trajectories of quality of life (QOL) in patients with distal radius fractures (DRF) and ankle fractures (AF). Secondly, it was examined if subgroups could be characterized by sociodemographic, clinical, and psychological variables. METHODS: Patients (n = 543) completed the World Health Organization Quality of Life assessment instrument-Bref (WHOQOL-Bref), the pain, coping, and cognitions questionnaire, NEO-five factor inventory (neuroticism and extraversion), and the state-trait anxiety inventory (short version) a few days after fracture (i...
August 1, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28765023/a-multicenter-retrospective-cohort-study-of-talk-and-die-after-traumatic-brain-injury
#5
Keita Shibahashi, Kazuhiro Sugiyama, Yoshihiro Okura, Hidenori Hoda, Yuichi Hamabe
BACKGROUND: Patients who "talk and die" after traumatic brain injury (TBI) are potentially salvageable. The reported incidences and risk factors for the "talk and die" phenomenon are conflicting, and do not take into account recent improvements in trauma care. The aim of this study was to determine the incidences of "talk and die" after TBI in a modern trauma care system, as well as associated risk factors. METHODS: We identified patients who experienced TBI (abbreviated injury scale 3-5) between 2004 and 2015 who talked on admission (i...
July 29, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28759479/bipolar-disorder-and-early-emotional-trauma-a-critical-literature-review-on-indicators-of-prevalence-rates-and-clinical-outcomes
#6
Aline Limiéri Dualibe, Flávia L Osório
OBJECTIVES: We performed a systematic literature review to (1) evaluate the prevalence rates of early emotional trauma (EET) in patients with bipolar disorder (BD) and the impact of these traumas on the development of the disorder, and (2) integrate the findings of our review with those previously reported by Fisher and Hosang, Daruy-Filho and colleagues, and Maniglio. METHODS: The literature search was performed on PubMed, SciELO, and PsycINFO databases using the keywords bipolar disorder, early trauma, physical abuse, emotional abuse, sexual abuse, maltreatment, adversity, and neglect...
July 29, 2017: Harvard Review of Psychiatry
https://www.readbyqxmd.com/read/28758144/immune-signaling-mechanisms-of-ptsd-risk-and-symptom-development-insights-from-animal-models
#7
Jessica Deslauriers, Susan Powell, Victoria B Risbrough
Post-traumatic stress disorder (PTSD) is characterized by persistent re-experiencing of a traumatic event, avoidance, and increased arousal. The approved pharmacological treatments for PTSD have limited efficacy (~60% treatment response), supporting the need for identification of biomarkers and novel pharmacological therapies. Mounting evidence suggests increased inflammatory markers and altered immune gene expression correlate with the severity of symptoms in PTSD patients. However a causal role of immune signaling in development and maintenance of PTSD symptoms is not clear, as inflammation may also be an epiphenomenon related to metabolic and behavioral effects of stress...
April 2017: Current Opinion in Behavioral Sciences
https://www.readbyqxmd.com/read/28755207/use-of-prazosin-for-pediatric-ptsd-associated-nightmares-and-sleep-disturbances-a-retrospective-chart-review
#8
Brooks R Keeshin, Qian Ding, Angela P Presson, Steven J Berkowitz, Jeffrey R Strawn
INTRODUCTION: Youth exposed to trauma have an increased risk for developing posttraumatic stress disorder (PTSD) and associated sleep disturbances and nightmares. The alpha-1 antagonist prazosin reduces sleep disturbances and nightmares in adults with PTSD; however, its use in youth with PTSD has not been systematically evaluated. We retrospectively examined the tolerability and clinical outcomes associated with prazosin treatment in youth with PTSD-related nightmares and dysomnias. METHOD: A retrospective chart review identified youth with PTSD (N = 40) treated with prazosin between 2014 and 2016 in a trauma clinic...
July 28, 2017: Neurology and Therapy
https://www.readbyqxmd.com/read/28746559/factors-associated-with-the-risk-of-falls-in-hospitalized-adult-patients
#9
Vivian Lemes Lobo Bittencourt, Sandra Leontina Graube, Eniva Miladi Fernandes Stumm, Iara Denise Endruweit Battisti, Marli Maria Loro, Eliane Roseli Winkelmann
OBJECTIVE: Analyzing factors related to the risk of falls in hospitalized adult patients. METHOD: A cross-sectional, analytical and quantitative study, developed in Clinical and Surgical Hospitalization Units from June to August 2015. Data collection instruments were sociodemographic and clinical forms, and the Morse Scale. Data were obtained with the patients and from medical records. Absolute and relative frequencies were used in the univariate statistical analysis, and chi-square test in the bivariate analysis...
July 20, 2017: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#10
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28717977/-challenges-of-implementing-a-geriatric-trauma-network-a-regional-structure
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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