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Comorbidities in trauma patients

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https://www.readbyqxmd.com/read/28335637/reversing-the-anticoagulation-effects-of-dabigatran
#1
William E Dager, Linda Banares
The standard of care for oral anticoagulation therapy has primarily been warfarin, which is limited by its indirect mechanism-of-action, variable kinetics, tolerability, and routine monitoring concerns. The direct-acting oral anticoagulants (DOACs) have predictable pharmacokinetics and pharmacodynamics, and improved safety and efficacy compared to warfarin for the prevention of stroke in patients with nonvalvular atrial fibrillation and prevention or management of venous thromboembolism. Consequential bleeding is a concern with all anticoagulants...
March 24, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28331951/failure-to-rescue-the-elderly-a-superior-quality-metric-for-trauma-centers
#2
G Barmparas, E J Ley, M J Martin, A Ko, M Harada, D Weigmann, K R Catchpole, B L Gewertz
BACKGROUND: Trauma centers require reliable metrics to better compare the quality of care delivered. We compared mortality after a reported complication, termed failure to rescue (FTR), and FTR in the elderly (age >65 years) (FTRE) to determine which is a superior metric to assess quality of care delivered by trauma centers. METHODS: This was a retrospective review of the National Trauma Databank (NTDB) research data sets 2010 and 2011. Patients ≥16 years admitted to centers reporting ≥80% of AIS and/or ≥ 20% of comorbidities with > 200 subjects in the NTDB were selected...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28327565/impaired-nutritional-status-in-geriatric-trauma-patients
#3
F S Müller, O W Meyer, P Chocano-Bedoya, S Schietzel, M L Gagesch, G Freystaetter, V Neuhaus, H-P Simmen, W Langhans, H A Bischoff-Ferrari
BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23...
March 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28323807/the-trauma-collaborative-care-study-tccs
#4
Stephen T Wegener, Andrew N Pollak, Katherine P Frey, Robert A Hymes, Kristin R Archer, Clifford B Jones, Rachel B Seymour, Robert V OʼToole, Renan C Castillo, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Previous research suggests that the care provided to trauma patients could be improved by including early screening and management of emotional distress and psychological comorbidity. The Trauma Collaborative Care (TCC) program, which is based on the principles of well-established models of collaborative care, was designed to address this gap in trauma center care. This article describes the TCC program and the design of a multicenter study to evaluate its effectiveness for improving patient outcomes after major, high-energy orthopaedic trauma at level 1 trauma centers...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#5
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#6
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28319493/advantages-of-robotic-right-colectomy-with-intracorporeal-anastomosis
#7
Henry J Lujan, Gustavo Plasencia, Brian X Rivera, Andres Molano, Alex Fagenson, Louis A Jane, Diego Holguin
Through retrospective review of consecutive charts, we compare the short-term and long-term clinical outcomes after robotic-assisted right colectomy with intracorporeal anastomosis (RIA) (n=89) and laparoscopic right colectomy with extracorporeal anastomosis (LEA) (n=135). Cohorts were similar in demographic characteristics, comorbidities, pathology, and perioperative outcomes (conversion, days to flatus and bowel movement, and length of hospitalization). The RIA cohort experienced statistically significant: less blood loss, shorter incision lengths, and longer specimen lengths than the LEA cohort...
March 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28317613/retrospective-study-2009-2014-perineal-hernias-and-related-comorbidities-in-bitches
#8
Ayne Murata Hayashi, Sandra Aparecida Rosner, Thais Cristine Alves de Assumpção, Angelo João Stopiglia, Julia Maria Matera
Retrospective study based on data extracted from medical records of dogs diagnosed with perineal hernia between 2009 and 2014; medical records of bitches were selected for further analysis to determine the prevalence of perineal hernias in bitches and to investigate potential comorbidities. Perineal hernia was diagnosed in 182 dogs (174 males and 8 females; 96% and 4%, respectively). Surgical correction was performed in 6 bitches. Surgical procedures corresponded to internal obturator muscle transposition with or without polypropylene mesh reinforcement (n = 5) and semitendinosus muscle transposition flap (n = 1)...
December 2016: Topics in Companion Animal Medicine
https://www.readbyqxmd.com/read/28302084/effectiveness-of-emdr-in-patients-with-substance-use-disorder-and-comorbid-ptsd-study-protocol-for-a-randomized-controlled-trial
#9
Ingo Schäfer, Laycen Chuey-Ferrer, Arne Hofmann, Peter Lieberman, Günter Mainusch, Annett Lotzin
BACKGROUND: Eye Movement Desensitization and Reprocessing (EMDR) is an evidence-based treatment for PTSD. However, it is unclear whether EMDR shows the same effectiveness in patients with substance use disorders (SUD) and comorbid PTSD. In this trial, we examine the effectiveness of EMDR in reducing PTSD symptoms in patients with SUD and PTSD. METHODS/DESIGN: We conduct a single-blinded RCT among 158 patients with SUD and comorbid PTSD admitted to a German addiction rehabilitation center specialized for the treatment of patients with SUD and comorbid PTSD...
March 16, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28294478/the-predictive-value-of-dorsal-cingulate-activity-and-fractional-anisotropy-on-long-term-ptsd-symptom-severity
#10
Mitzy Kennis PhD, Sanne J H van Rooij PhD, Alieke Reijnen MSc, Elbert Geuze PhD
BACKGROUND: Posttraumatic stress disorder (PTSD) can be treated with trauma-focused therapy, although only about 50% of the patients recover on the short-term. In order to improve response rates it is important to identify who will and will not recover from trauma-focused therapy. Although previous studies reported dorsal anterior cingulate cortex (ACC) activity, as well as dorsal cingulum bundle white matter microstructure integrity as markers for the persistence of PTSD symptoms on the short-term, it remains unclear whether these markers also predict long-term PTSD symptom severity...
March 15, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28294462/disruption-of-white-matter-structural-integrity-and-connectivity-in-posttraumatic-stress-disorder-a-tbss-and-tractography-study
#11
Elizabeth A Olson, Jiaolong Cui, Rena Fukunaga, Lisa D Nickerson, Scott L Rauch, Isabelle M Rosso
BACKGROUND: Most studies of brain white matter (WM) in posttraumatic stress disorder (PTSD) have focused on combat trauma, and often were confounded by neurological and substance dependence comorbidity. This study used tract-based spatial statistics (TBSS) and probabilistic tractography to characterize WM microstructure in a mixed-sex community sample of PTSD patients exposed to diverse and multiple traumas, and in trauma-exposed normal comparison (TENC) subjects. METHODS: TBSS compared diffusion measures between 20 adults with DSM-IV PTSD and 17 TENC, using a whole-brain voxel-wise approach...
March 15, 2017: Depression and Anxiety
https://www.readbyqxmd.com/read/28286275/spontaneous-pyogenic-spondylodiscitis-in-the-thoracic-or-lumbar-spine-a-retrospective-cohort-study-comparing-the-safety-and-efficacy-of-minimally-invasive-and-open-surgery-over-a-nine-year-period
#12
Lennart Viezens, Christian Schaefer, Rachel Helmers, Eik Vettorazzi, Malte Schroeder, Nils Hansen-Algenstaedt
PURPOSE: Pyogenic spondylodiscitis is a rare disease, but its incidence is increasing. Over the last decade, spinal surgery has been modified to become minimally invasive. In degenerative spinal disorders, such minimally invasive surgery (MIS) reduces blood loss, muscular trauma and the hospital stay. However, it is not known whether MIS also confers these benefits to patients with pyogenic spondylodiscitis. This retrospective cohort study compared the safety and efficacy of minimally invasive surgery (MIS) and the conventional open surgical procedure in patients with pyogenic spondylodiscitis...
March 9, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28281430/provision-of-an-emergency-theatre-in-tertiary-hospitals-is-cost-effective-audit-and-cost-of-cancelled-planned-elective-general-surgical-operations-at-pietersburg-hospital-limpopo-province-south-africa
#13
M M Z U Bhuiyan, R Mavhungu, A Machowski
BACKGROUND: Cancellations of planned elective surgical operations increase financial cost to the patient and the hospital. OBJECTIVES: To determine the rate and reasons for cancellations, estimate the cost incurred by such cancellations and recommend possible solutions. METHODS: We did a prospective descriptive study of cancellations of elective general surgical operations over the 1-year period January - December 2014 in the main theatre at Pietersburg (PTB) Hospital, Limpopo Province, South Africa...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28281427/trends-in-admissions-morbidity-and-outcomes-at-red-cross-war-memorial-children-s-hospital-cape-town-2004-2013
#14
Y Isaacs-Long, L Myer, H J Zar
BACKGROUND: Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA) hospitals. OBJECTIVES: To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children's Hospital (RCWMCH), a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013...
February 27, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28280315/collagenase-clostridium-histolyticum-in-the-treatment-of-peyronie-s-disease-patient-selection-and-perspectives
#15
REVIEW
Paige K Kuhlmann, Kenneth J DeLay, James Anaissie, Wayne Jg Hellstrom, Faysal A Yafi
The safety and efficacy of the use of collagenase Clostridium histolyticum (CCH) for the treatment of Peyronie's disease has been confirmed over the past several years. However, identification of the ideal patient population for use of this treatment is not well established. Multiple studies have attempted to delineate various patient-specific factors that may predict response to treatment with CCH, with the intent of enhancing patient selection. To date, these include baseline curvature severity, duration of disease, disease phase at presentation, plaque calcification, baseline erectile function, plaque size, age, comorbid diabetes, previous penile trauma, responsiveness to first treatment cycle, baseline penile shortening or pain, prior treatment with intralesional injection, compliance with plaque modeling, and atypical curvature...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#16
Sarah E Deery, Katie E Shean, Grace J Wang, James H Black, Gilbert R Upchurch, Kristina A Giles, Virendra I Patel, Marc L Schermerhorn
OBJECTIVE: Whereas sex differences in the pathogenesis, presentation, and outcomes of repair for abdominal aortic aneurysms are well studied, less is known about sex differences after thoracic endovascular aortic repair (TEVAR). The goal of this study was to evaluate the association between sex and morbidity and mortality after TEVAR. METHODS: A retrospective review of all TEVARs in the Society for Vascular Surgery Vascular Quality Initiative (VQI) registry from 2011 to 2015 was conducted, excluding those with dissection, trauma, and rupture...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28252512/echoes-of-the-past-recognizing-co-occurring-alcohol-use-disorder-and-posttraumatic-stress-disorder-in-the-american-veteran-population
#17
Susanne A Fogger, Joshua J Hart
PURPOSE: The aim of this editorial is to explore and highlight the importance of identifying both the alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) in the veteran population. REVIEW: Determining if the patient has military experience can assist in both an accurate and complete assessment. Being aware of the patient's military service time can help better understand some of the presenting physical and mental complaints that may incorrectly be attributed to substances...
January 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28241151/outcomes-associated-with-resuming-warfarin-treatment-after-hemorrhagic-stroke-or-traumatic-intracranial-hemorrhage-in-patients-with-atrial-fibrillation
#18
Peter Brønnum Nielsen, Torben Bjerregaard Larsen, Flemming Skjøth, Gregory Y H Lip
Importance: The increase in the risk for bleeding associated with antithrombotic therapy causes a dilemma in patients with atrial fibrillation (AF) who sustain an intracranial hemorrhage (ICH). A thrombotic risk is present; however, a risk for serious harm associated with resumption of anticoagulation therapy also exists. Objective: To investigate the prognosis associated with resuming warfarin treatment stratified by the type of ICH (hemorrhagic stroke or traumatic ICH)...
February 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28230626/resiliency-and-quality-of-life-trajectories-after-injury
#19
Ben L Zarzaur, Teresa M Bell, Stephen A Zanskas
BACKGROUND: Injury can greatly impact patients' long-term quality of life. Resilience refers to an individual's ability to positively adapt after facing stress or trauma. The objective of this study was to examine the relationship between pre-injury resiliency scores and quality of life after injury. METHODS: 225 adults admitted with an injury severity score > 10 but without neurological injury were included. The SF-36 was administered at the time of admission and repeated at 1, 2, 4 and 12 months after injury...
February 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28228789/long-term-outcome-of-grade-iii-and-iv-chondral-injuries-of-the-knee-treated-with-steadman-microfracture-technique
#20
Marco Pellegrino, Ermanno Trinchese, Michele Bisaccia, Giuseppe Rinonapoli, Luigi Meccariello, Gabriele Falzarano, Antonio Medici, Luigi Piscitelli, Pellegrino Ferrara, Auro Caraffa
INTRODUCTION: The aim of our study is to demonstrate the effectiveness of Steadman microfracture technique in the management of high-grade chondral defects at the level of the knee by clinical follow-ups at eleven years. MATERIALS AND METHODS: This is a study conducted on fifteen patients suffering from Outerbridge grade III and IV chondral lesions of the knee, who underwent Steadman microfracture surgery between 2003 and 2004. Selective exclusion criteria to prevent that other treatments or comorbidities could invalidate the results were used...
September 2016: Clinical Cases in Mineral and Bone Metabolism
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