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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28435490/correlation-of-physical-exam-findings-with-fever-in-patients-with-skin-and-soft-tissue-infections
#1
Jillian Mongelluzzo, Brian Tu, Barbara Grimes, Sharvina Ziyeh, Jonathan Fortman, Jersey Neilson, Robert M Rodriguez
INTRODUCTION: The objectives of this study were to determine the prevalence of fever in adult ED patients with skin and soft tissue infections (SSTI) and to determine which, if any, physical exam, radiograph and laboratory test findings were associated with fever. METHODS: We conducted a prospective, observational study at an urban county trauma center of adults who presented to the ED for evaluation of suspected SSTI. ED providers measured area of erythema and induration using a tape measure, and completed data sheets indicating comorbid conditions and the presence or absence of physical exam findings...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431413/novel-oral-anticoagulants-and-trauma-the-results-of-a-prospective-american-association-for-the-surgery-of-trauma-multi-institutional-trial
#2
Leslie Kobayashi, Galinos Barmparas, Patrick Bosarge, Carlos V Brown, Marko Bukur, Matthew M Carrick, Richard D Catalano, Jan Holly-Nicolas, Kenji Inaba, Stephen Kaminski, Amanda L Klein, Tammy Kopelman, Eric J Ley, Ericca M Martinez, Forrest O Moore, Jason Murry, Raminder Nirula, Douglas Paul, Jacob Quick, Omar Rivera, Martin Schreiber, Raul Coimbra
BACKGROUND: The number of anticoagulated trauma patients is increasing. Trauma patients on warfarin have been found to have poor outcomes, particularly after intracranial hemorrhage (ICH). However, the effect of novel oral anticoagulants (NOAs) on trauma outcomes is unknown. We hypothesized that patients on NOAs would have higher rates of ICH, ICH progression, and death compared with patients on traditional anticoagulant and antiplatelet agents. METHODS: This was a prospective observational trial across 16 trauma centers...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426560/universal-screening-for-intimate-partner-and-sexual-violence-in-trauma-patients-an-east-multicenter-trial
#3
Tanya L Zakrison, Xiomara Ruiz, Rondi Gelbard, John Cline, David Turay, Xian Luo-Owen, Nicholas Namias, Marie Crandall, Jessica George, Brian H Williams
BACKGROUND: A single center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) amongst both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening, and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS: We designed an EAST- supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424138/comparative-analysis-of-the-paravertebral-analgesic-pump-catheter-with-the-epidural-catheter-in-elderly-trauma-patients-with-multiple-rib-fractures
#4
Brian S Shapiro, Tarik Wasfie, Mathew Chadwick, Kimberly R Barber, Raquel Yapchai
Presently, trauma guidelines recommend epidural analgesia as the optimal modality of pain relief from rib fractures. They are not ideally suited for elderly trauma patients and have disadvantages including bleeding risk. The paravertebral analgesic pump (PVP) eliminates such disadvantages and includes ease of placement in the trauma setting. This study compares pain control in patients treated by EPI versus PVP. This is a retrospective, historical cohort study comparing two methods of pain management in the trauma setting...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28421547/effect-of-health-literacy-on-adherence-to-osteoporosis-treatment-among-patients-with-distal-radius-fracture
#5
Young Hak Roh, Young Do Koh, Jung Ho Noh, Hyun Sik Gong, Goo Hyun Baek
Patients with inadequate health literacy, those with medical comorbidities, or those with a previous history of adverse drug events have a higher likelihood of non-adherence to osteoporosis treatment after sustaining a distal radius fracture. INTRODUCTION: Patients with a distal radial fracture (DRF) have a higher risk of subsequent fractures, which provides an important opportunity to begin treatment for osteoporosis. This study assessed the effect that health literacy of patients suffering from a DRF has on the subsequent adherence to osteoporosis treatment...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28421283/shunting-of-the-over-80s-in-normal-pressure-hydrocephalus
#6
Simon D Thompson, J D Shand Smith, A A Khan, A M V Luoma, A K Toma, L D Watkins
BACKGROUND: Idiopathic normal pressure hydrocephalus is predominantly a disease of the elderly. By its nature, many of those who present to clinic are in advanced old age with multiple comorbidities. Majority of patients treated are younger than 80 years old. We present the clinical outcomes and complication rates of patients over the age of 80 years at the time of operation, during the past 11 years at a single institution. METHODS: Retrospective analysis of clinical records of all patients over the age of 80 years, who presented to our institution between 2006 and 2016...
April 18, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28419820/community-acquired-infections-among-the-refugees-leading-to-intensive-care-unit-admissions-in-turkey
#7
Mediha Turktan, Oznur Ak, Hakan Erdem, Dilek Ozcengiz, Sally Hargreaves, Safak Kaya, Emre Karakoc, Ozlem Ozkan-Kuscu, Gunay Tuncer-Ertem, Recep Tekin, Handan Birbicer, Gul Durmus, Canan Yilmaz, Funda Kocak, Edmond Puca, Jordi Rello
OBJECTIVES: Data on the impact of refugees on Intensive Care Units (ICUs) are lacking in the literature, in particular for community-acquired (CA) infectious diseases, for which they are known to be at higher risk. We did a descriptive, multicenter study to analyze CA infections among refugee patients requiring ICU admission. METHODS: Inclusion criteria were adult refugee patients admitted to an ICU due to CA infections. Anonymized data were collected between January 1, 2010 and December 30, 2015 across 10 referral centers...
April 11, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28406852/survivorship-after-high-energy-geriatric-trauma
#8
Ida Leah Gitajn, Renan Castillo, Stephen Breazeale, Carrie Schoonover, Peter Berger, Yanjie Huang, Nathan O'Hara, Robert V O'Toole, Marcus F Sciadini
OBJECTIVES: To evaluate in-hospital, 1-year, and 5-year survivorship of geriatric patients after high-energy trauma, to compare survivorship of geriatric patients who sustained high-energy trauma with that of those who sustained low-energy trauma, and to identify predictors for mortality. DESIGN: Retrospective. SETTING: Urban Level I trauma center. PATIENTS: Study group of 1849 patients with high-energy trauma and comparison group of 761 patients with low-energy trauma...
April 18, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28398916/attentional-avoidance-is-associated-with-increased-pain-sensitivity-in-patients-with-chronic-posttraumatic-pain-and-comorbid-posttraumatic-stress
#9
Mathea Harvold, Colin MacLeod, Henrik Bjarke Vaegter
OBJECTIVES: Posttraumatic stress disorder (PTSD) is common in chronic posttraumatic pain. Theoretical models suggest that attentional biases (AB) contribute to the development and maintenance of chronic pain and PTSD, however, the influence of AB on clinical and heat pain sensitivity in chronic posttraumatic pain patients is unknown. This study investigated AB for linguistic pain- and trauma-related stimuli, and clinical and thermal sensitivity in patients with chronic posttraumatic pain with and without PTSD...
April 7, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#10
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28388283/does-trauma-exposure-predict-prescription-drug-problems-beyond-the-contribution-of-ptsd-depression-an-analysis-of-the-mind-your-heart-cohort-study
#11
Raj K Kalapatapu, Tatiana P Dannenbaum, John D Harbison, Beth E Cohen
BACKGROUND: It is not clear from prior studies whether trauma exposure predicts substance use problems independent of psychiatric comorbidities. Most prior studies were cross-sectional in nature, and none focused on prescription drug problems. AIMS: To address this gap in the literature, this paper is a secondary analysis of veterans from the Mind Your Heart prospective cohort study. The primary research question is whether trauma exposure predicts prescription drug problems even after controlling for major psychiatric symptoms, such as posttraumatic stress disorder and depression...
April 7, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28381727/long-term-outcomes-of-pancreatic-function-following-pancreatic-trauma
#12
Toshio Morita, Osamu Takasu, Teruo Sakamoto, Shinjirou Mori, Atsuo Nakamura, Masakazu Nabeta, Nobuhisa Hirayu, Mariko Moroki, Norio Yamashita
The objective of this study is to retrospectively assess long-term outcomes and late complications of pancreatic trauma. We studied 14 patients with pancreatic trauma who were treated at the Advanced Emergency Medical Service Center, Kurume University Hospital, between 1981 and 2012 and discharged alive. Relevant data were extracted from patient records and a retrospective patient questionnaire and blood test were completed to evaluate pancreatic function. The median patient age at the time of the survey was 49 years; the median post-injury period was 23 years and 5 months...
April 3, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28376919/eye-movement-desensitization-and-reprocessing-therapy-versus-supportive-therapy-in-affective-relapse-prevention-in-bipolar-patients-with-a-history-of-trauma-study-protocol-for-a-randomized-controlled-trial
#13
Ana Moreno-Alcázar, Joaquim Radua, Ramon Landín-Romero, Laura Blanco, Mercè Madre, Maria Reinares, Mercè Comes, Esther Jiménez, Jose Manuel Crespo, Eduard Vieta, Victor Pérez, Patricia Novo, Marta Doñate, Romina Cortizo, Alicia Valiente-Gómez, Walter Lupo, Peter J McKenna, Edith Pomarol-Clotet, Benedikt L Amann
BACKGROUND: Up to 60% of patients with bipolar disorder (BD) have a history of traumatic events, which is associated with greater episode severity, higher risk of comorbidity and higher relapse rates. Trauma-focused treatment strategies for BD are thus necessary but studies are currently scarce. The aim of this study is to examine whether Eye Movement Desensitization and Reprocessing (EMDR) therapy focusing on adherence, insight, de-idealisation of manic symptoms, prodromal symptoms and mood stabilization can reduce episode severity and relapse rates and increase cognitive performance and functioning in patients with BD...
April 4, 2017: Trials
https://www.readbyqxmd.com/read/28368919/a-national-perspective-on-ecmo-utilization-in-patients-with-burn-injury
#14
Lauren B Nosanov, Melissa M McLawhorn, Mariana Vigiola Cruz, Jason H Chen, Jeffrey W Shupp
Extracorporeal membranous oxygenation (ECMO) has become an increasingly utilized strategy to support patients in cardiac and cardiopulmonary failure. The Extracorporeal Life Support Organization reports adult survival rates between 40 and 50%. Utilization and outcomes for burned patients undergoing ECMO are poorly understood. The National Burn Repository (version 8.0) was queried for patients with ICD9 procedure codes for ECMO. Demographics, comorbidities, mechanism, injury details, and clinical outcomes were recorded...
March 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28363497/the-effects-of-social-exclusion-on-response-inhibition-in-borderline-personality-disorder-and-major-depression
#15
Mareike Ernst, Harald M Mohr, Margerete Schött, Constanze Rickmeyer, Tamara Fischmann, Marianne Leuzinger-Bohleber, Heinz Weiß, Ralph Grabhorn
It is a prevalent notion that borderline personality disorder (BPD) is characterized by deficits in executive functions (EF) like inhibition. Yet experimental studies yield inconsistent results. However, despite emotional dysregulation being a core feature of BPD, most paradigms did not control for emotional state or comorbid mental disorders. In the present study, subjects with BPD and comorbid MDD (BPD+MDD), with major depression (MDD) and healthy controls (HC) partook in a social exclusion paradigm combined with an inhibition task...
March 27, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28363228/super-thin-and-suprafascial-anterolateral-thigh-perforator-flaps-for-extremity-reconstruction
#16
Akhil K Seth, Matthew L Iorio
Background The anterolateral thigh (ALT) flap remains a workhorse for soft tissue reconstruction. However, the traditional ALT flap is often too bulky for resurfacing shallow, distal extremity defects, prohibiting adequate function, or well-fitted orthotics. This study evaluates extremity reconstruction using ALT flaps elevated in the suprafascial or super-thin plane. Methods Retrospective review of ALT free flap reconstruction from October 2014 to July 2016 was performed. Suprafascial and super-thin flaps were those elevated just above the crural fascia and within the superficial scarpal plane, respectively...
March 31, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/28360248/transfusion-of-red-blood-cells-in-patients-with-traumatic-brain-injuries-admitted-to-canadian-trauma-health-centres-a-multicentre-cohort-study
#17
Amélie Boutin, Lynne Moore, François Lauzier, Michaël Chassé, Shane English, Ryan Zarychanski, Lauralyn McIntyre, Donald Griesdale, Dean A Fergusson, Alexis F Turgeon
BACKGROUND: Optimisation of healthcare practices in patients sustaining a traumatic brain injury is of major concern given the high incidence of death and long-term disabilities. Considering the brain's susceptibility to ischaemia, strategies to optimise oxygenation to brain are needed. While red blood cell (RBC) transfusion is one such strategy, specific RBC strategies are debated. We aimed to evaluate RBC transfusion frequency, determinants of transfusions and associated clinical outcomes...
March 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28359364/age-dependent-risk-factors-for-malnutrition-in-traumatology-and%C3%A2-orthopedic-patients
#18
Christine Lambert, Andreas Nüssler, Hans Konrad Biesalski, Thomas Freude, Christian Bahrs, Gunnar Ochs, Ingo Flesch, Ulrich Stöckle, Christoph Ihle
OBJECTIVE: The aim of this study was to investigate the prevalence of risk of malnutrition (RoM) in an orthopedic and traumatology patient cohort with a broad range of ages. In addition to the classical indicators for risk assessment (low body mass index, weight loss, and comorbidity), this study aimed to analyze the effects of lifestyle factors (eating pattern, smoking, physical activity) on RoM. METHODS: The prospective cohort study included 1053 patients in a level 1 trauma center in Germany...
May 2017: Nutrition
https://www.readbyqxmd.com/read/28358976/analysis-of-bony-and-internal-organ-injuries-associated-with-26-357-adult-femoral-shaft-fractures-and-their-impact-on-mortality
#19
Nidharshan S Anandasivam, Glenn S Russo, Jennifer M Fischer, Andre M Samuel, Nathaniel T Ondeck, Matthew S Swallow, Sophie H Chung, Daniel D Bohl, Jonathan N Grauer
The spectrum of injuries associated with femoral shaft fractures and those injuries' association with mortality have not been well delineated previously. Patients in the National Trauma Data Bank who presented with femoral shaft fractures from 2011 to 2012 were analyzed in 3 age groups (18-39, 40-64, and 65+ years). For each group, modified Charlson Comorbidity Index (CCI), mechanism of injury (MOI), injury severity score (ISS), and associated injuries were reported. Multivariate logistic regression was used to identify predictors of mortality...
March 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28348532/ethical-implications-of-the-mild-encephalitis-hypothesis-of-schizophrenia
#20
Rita Riedmüller, Sabine Müller
Schizophrenia is a serious mental disease with a high mortality rate and severe social consequences. Due to insufficient knowledge about its etiopathogenesis, curative treatments are not available. One of the most promising new research concepts is the mild encephalitis hypothesis of schizophrenia, developed mainly by Karl Bechter and Norbert Müller. According to this hypothesis, a significant subgroup of schizophrenia patients suffer from a mild, but chronic, form of encephalitis with markedly different etiologies ranging from viral infections, traumas to autoimmune diseases...
2017: Frontiers in Psychiatry
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