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Long-term outcomes in trauma patients

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https://www.readbyqxmd.com/read/28643996/age-related-outcome-of-patients-after-traumatic-brain-injury-a-single-centre-observation
#1
Rolf Erlebach, Alberto Pagnamenta, Stephanie Klinzing, Federica Stretti, Silvia Cottini, Reto Schüpbach, Peter Steiger, Giovanna Brandi
BACKGROUND: Study-purpose is to analyze clinical features of patients with traumatic brain injury (TBI), their age-related outcomes and determinants of long- term outcome. METHODS: This retrospective cohort study was conducted in a level I University Swiss trauma center. Consecutive patients with moderate to severe TBI admitted for more than 48 hours to the Intensive Care Unit were included. Patients' and trauma characteristics, management during ICU-stay, prognostic scores and long- term outcomes were analyzed...
June 22, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28622616/treatment-of-substance-use-disorders-effects-on-patients-with-higher-or-lower-levels-of-ptsd-symptoms
#2
Carol E M Wieferink, Hein A de Haan, Boukje A G Dijkstra, Martine Fledderus, Tim Kok
While guidelines advise integrated treatment of patients with substance use disorder (SUD) and posttraumatic stress disorder (PTSD), recent studies and reviews find no convincing evidence of different outcomes following treatment between non-trauma focused integrated programs and SUD treatment alone. In this study, we analyzed whether SUD patients with higher levels of PTSD symptoms receiving standard, non-integrated SUD treatment (N=145) differed in outcomes compared to patients with lower levels of PTSD symptoms (N=152)...
June 8, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28608735/hearing-preservation-does-electrode-choice-matter
#3
Leila J Mady, Daniel C Sukato, Jenifer Fruit, Catherine Palmer, Yael Raz, Barry E Hirsch, Andrew A McCall
Objective Evaluate if electrode design affects hearing preservation (HP) following cochlear implantation (CI) with full-length electrodes. Study Design Case series with chart review. Setting Tertiary referral academic center. Subjects and Methods Forty-five adults with low-frequency hearing (≤85 dB at 250 and 500 Hz) who underwent unilateral CI with full-length electrode arrays made by 1 manufacturer were included. HP was calculated with (1) mean low-frequency pure-tone average (LFPTA) at 250 and 500 Hz (MEAN method), (2) a percentile method across the audiometric frequency spectrum generating an S-value (HEARRING method), and (3) functional if hearing remained ≤85 dB at 250 and 500 Hz...
June 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28606639/isolated-serratus-palsy-etiology-influences-its-long-term-outcome
#4
Martti Vastamäki, Leena Ristolainen, Heidi Vastamäki, Veera Pikkarainen
HYPOTHESIS AND BACKGROUND: The cause of isolated serratus palsy is multifactorial, but evaluation of the mechanism of the injury indicates that the lesion to the long thoracic nerve is mechanical in origin in most cases. What is unknown, however, is how etiology influences its long-term outcome. We believed that overuse injuries may recover sooner and better than acute traumatic, infectious, or inflammatory injuries. METHODS: We determined the presumed etiology of isolated serratus palsy in 92 patients treated by brace or observation only and compared it with its long-term outcome after a mean follow-up of 18...
June 9, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28604577/pain-after-cochlear-implantation-an-unusual-complication
#5
Charlotte Celerier, Isabelle Rouillon, Marion Blanchard, Marine Parodi, Françoise Denoyelle, Natalie Loundon
OBJECTIVE: To analyze clinical signs and better define the underestimated long-term pain after implantation, to discuss etiological hypothesis, and to propose our department treatment algorithm and results. STUDY DESIGN AND SETTING: Retrospective review of children implanted with complaints of atypical pain in the area of device implantation, not in the immediate postoperative period, more than or equal to 4 on the Visual Analog Pain Scale (VAPS: 0-10) in the ENT pediatric department of Trousseau and Necker Enfants Malades Hospitals between 1998 and 2015...
June 9, 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28594486/challenges-and-controversies-of-foot-and-ankle-trauma
#6
Cyrus E Taghavi, Michael Isiah Sandlin, David B Thordarson
Traumatic injury to the foot and ankle can result in long-term disability, which may have substantial negative implications on a patient's functional outcomes and quality of life. The diagnosis and appropriate management of these challenging injuries are not always agreed on or straightforward. In particular, the appropriate diagnosis and management of distal tibiofibular syndesmotic injuries as well as the surgical approach and role of primary subtalar arthrodesis for intra-articular calcaneal fractures are controversial...
February 15, 2017: Instructional Course Lectures
https://www.readbyqxmd.com/read/28574329/spinal-epidural-hematomas-personal-experience-and-literature-review-of-more-than-1000-cases
#7
Maurizio Domenicucci, Cristina Mancarella, Giorgio Santoro, Demo Eugenio Dugoni, Alessandro Ramieri, Maria Felice Arezzo, Paolo Missori
OBJECTIVE The goal of this study was to identify factors that contribute to the formation of acute spinal epidural hematoma (SEH) by correlating etiology, age, site, clinical status, and treatment with immediate results and long-term outcomes. METHODS The authors reviewed their series of 15 patients who had been treated for SEH between 1996 and 2012. In addition, the authors reviewed the relevant international literature from 1869 (when SEH was first described) to 2012, collecting a total of 1010 cases. Statistical analysis was performed in 959 (95%) cases that were considered valid for assessing the incidence of age, sex, site, and clinical status at admission, correlating each of these parameters with the treatment results...
June 2, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28567339/hallux-rigidus-how-do-i-approach-it
#8
REVIEW
Aaron Lam, Jimmy J Chan, Michele F Surace, Ettore Vulcano
Hallux rigidus is a degenerative disease of the first metatarsalphalangeal (MTP) joint and affects 2.5% of people over age 50. Dorsal osteophytes and narrowed joint space leads to debilitating pain and limited range of motion. Altered gait mechanics often ensued as 119% of the body force transmit through the 1(st) MTP joint during gait cycle. Precise etiology remains under debate with trauma being often cited in the literature. Hallux valgus interphalangeus, female gender, inflammatory and metabolic conditions have all been identified as associative factors...
May 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28566474/mitral-valve-repair-for-degenerative-mitral-valve-disease-surgical-approach-patient-selection-and-long-term-outcomes
#9
REVIEW
Gonçalo F Coutinho, Manuel J Antunes
Mitral valve repair (MVRepair) has become the procedure of choice to correct severe degenerative mitral regurgitation (MR), due to its documented superiority to valve replacement regarding long-term survival, freedom from valve-related adverse events and preservation of left ventricular (LV) function. The refinement of MVRepair techniques has rendered almost all valves (more than 95%) amenable to repair with a 15-year freedom from reoperation of 90%. The concept of 'centres of excellence for MVRepair' has emerged, encouraging referring doctors to select the most experienced institutions or individual surgeons to deal with the most complex cases, based on repair volume, appropriate peri-procedural imaging and data regarding expected outcomes (repair, mortality and durability of repair)...
May 31, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28557726/modifiable-resilience-factors-to-childhood-adversity-for-clinical-pediatric-practice
#10
REVIEW
Flora Traub, Renée Boynton-Jarrett
Childhood adversity is highly prevalent and associated with risk for poor health outcomes in childhood and throughout the life course. Empirical literature on resilience over the past 40 years has identified protective factors for traumatized children that improve health outcomes. Despite these empirical investigations of resilience, there is limited integration of these findings into proactive strategies to mitigate the impact of adverse childhood experiences. We review the state of resilience research, with a focus on recent work, as it pertains to protecting children from the health impacts of early adversity...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28546048/long-and-short-intramedullary-nails-for-fixation-ofintertrochanteric-femur-fractures-ota-31-a1-a2-and-a3-a-systematic-review-and-meta-analysis
#11
REVIEW
Zhang Yibao, Zhang Shaobo, Wang Shenghong, Zhang Hua, Zhang Wei, Liu Peng, Ma Jinglin, Nabeel Pervaiz, Wang Jing
INTRODUCTION: Previous studieshave reported conflicting findings concerningthe efficacy and safety ofthe treatment ofintertrochanteric fractures(OTA 31-A1,A2 and A3) usingshort intramedullary nails (SIN) and long intramedullary nails (LIN). The present meta-analysis and literature review investigated the outcomes of SIN and LIN, thereby providing guidance for the treatment of intertrochanteric femur fractures. HYPOTHESIS: When used totreat intertrochanteric femur fractures, LIN did not decrease the secondary femoral shaft refractureorreoperation rates...
May 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28544811/differential-protein-expression-in-exosomal-samples-taken-from-trauma-patients
#12
Ron B Moyron, Amber Gonda, Matthew J Selleck, Xian Luo-Owen, Richard D Catalano, Thomas O'Callahan, Carlos Garberoglio, David Turay, Nathan R Wall
Traumatic Brain Injuries (TBI) are among the most misdiagnosed and underreported types of head trauma. The potential long-term impact of undiagnosed or incorrectly identified concussions and other head injuries are potentially devastating, as evidenced by the increasing societal burden exhibited by soldiers returning from combat and athletes in contact sports. Concussions and TBI are notoriously difficult to correctly diagnose and prognosis for these injuries is poorly understood. In order to increase the likelihood of successful diagnosis, treatment, and prediction of outcomes, a definitive differential diagnosis will need to be established...
May 25, 2017: Proteomics. Clinical Applications
https://www.readbyqxmd.com/read/28538643/immature-patients-in-a-mature-system-regional-analysis-of-florida-s-pediatric-trauma-system
#13
Christopher W Snyder, Nicole M Chandler, Cristen N Litz, Etienne E Pracht, Paul D Danielson, David J Ciesla
BACKGROUND: The state of Florida's trauma system is organized into seven regions, two of which lack designated pediatric trauma centers. Injured children residing in these regions often require transfer out of their home region for definitive care. The purpose of this study was to evaluate the effectiveness and efficiency of the current regionalization approach, focusing on variations between regions. METHODS: Using the Florida Agency for Health Care Administration database, we identified all trauma patients 15 years old or younger admitted between 2009 and 2014...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#14
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538630/the-evolution-of-care-improves-outcome-in-blunt-thoracic-aortic-injury-a-western-trauma-association-multicenter-study
#15
Steven R Shackford, Casey E Dunne, Riyad Karmy-Jones, William Long, Desarom Teso, Martin A Schreiber, Justin Watson, Cheri Watson, Robert C McIntyre, Lisa Ferrigno, Mark L Shapiro, Kevin Southerland, Julie A Dunn, Paul Reckard, Thomas M Scalea, Megan Brenner, William A Teeter
BACKGROUND: The management of blunt thoracic aortic injury (BTAI) has evolved radically in the last decade with changes in the processes of care and the introduction of thoracic endovascular repair (TEVAR). These changes have wrought improved outcome, but the direct effect of TEVAR on outcome remains in question as previous studies have lacked vigorous risk adjustment and long-term follow-up. To address these knowledge gaps, we compared the outcomes of TEVAR, open surgical repair, and nonoperative management for BTAI...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538451/similar-anatomical-reduction-and-lower-complication-rates-with-the-sinus-tarsi-approach-compared-with-the-extended-lateral-approach-in-displaced-intra-articular-calcaneal-fractures
#16
Tim Schepers, Manouk Backes, Siem A Dingemans, Vincent M de Jong, Jan S K Luitse
OBJECTIVES: To investigate whether the sinus tarsi approach (STA) allows for a similar anatomical reduction of the posterior talocalcaneal facet as the extended lateral approach (ELA) and compare the rate of postoperative wound complications. DESIGN: Retrospective. SETTING: Level 1 trauma center. PATIENTS: All consecutive patients from 2012 to 2015 with a closed displaced intra-articular calcaneal fracture Sanders type II and III surgically treated with the ELA (N = 60) and the STA (N = 65)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538288/the-trajectory-of-short-and-long-term-recovery-of-tibial-shaft-fractures-following-intramedullary-nail-fixation
#17
Sebastian J Ko, Peter J O'Brien, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Kelly A Lefaivre
OBJECTIVE: To determine the trajectory of recovery following tibial shaft fracture treated with intramedullary nail over the first five years, and to evaluate the magnitude of the changes in functional outcome at various time intervals. DESIGN: Prospective cohort study. SETTING: A level 1 trauma center. PATIENTS/PARTICIPANTS: 132 patients with tibial shaft fracture (OTA 42-A,B,C) were enrolled into the Center's prospectively enrolled orthopaedic trauma database between January 2005 and February 2010...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538287/cost-utility-analysis-of-reconstruction-compared-with-primary-amputation-for-patients-with-severe-lower-limb-trauma-in-colombia
#18
Mateo Ceballos, Carlos Oliver Valderrama, Luis Esteban Orozco, Laura Sánchez, Juan Pablo Valderrama, Luz Helena Lugo
BACKGROUND: To establish, from the health system perspective, the cost-utility relationship of limb reconstruction compared with primary amputation for patients over 32 years with grade IIIB and IIIC severe lower limb trauma in Colombia, S.A. METHODS: A Markov model was built including different short-term and long-term states that represent the main events that a patient could experience after a lower limb amputation or a reconstruction. A 42-year time horizon was considered for the base case...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537494/survival-from-traumatic-injury-does-not-end-at-hospital-discharge-hospital-acquired-infections-increase-post-discharge-mortality
#19
Nitasha Dhiman, Ram C Rimal, Mark Hamill, Katie M Love, Daniel Lollar, Bryan Collier
BACKGROUND: Hospital-acquired infections (HAI) in trauma patients increase inpatient morbidity and mortality. However, their impact on long-term mortality is not well understood. PATIENTS AND METHODS: A retrospective trauma registry analysis of all patients admitted to an academic level I trauma center between July 1, 2008 and December 31, 2012 was performed. Patients included survived to discharge and were 18 years of age or older. Age, gender, Injury Severity Score (ISS), ventilator use, history of chronic obstructive pulmonary disease (COPD), and HAI were reviewed...
May 24, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28533056/white-matter-damage-after-traumatic-brain-injury-a-role-for-damage-associated-molecular-patterns
#20
REVIEW
Molly Braun, Kumar Vaibhav, Nancy M Saad, Sumbul Fatima, John R Vender, Babak Baban, Md Nasrul Hoda, Krishnan M Dhandapani
Traumatic brain injury (TBI) is a leading cause of mortality and long-term morbidity worldwide. Despite decades of pre-clinical investigation, therapeutic strategies focused on acute neuroprotection failed to improve TBI outcomes. This lack of translational success has necessitated a reassessment of the optimal targets for intervention, including a heightened focus on secondary injury mechanisms. Chronic immune activation correlates with progressive neurodegeneration for decades after TBI; however, significant challenges remain in functionally and mechanistically defining immune activation after TBI...
May 19, 2017: Biochimica et Biophysica Acta
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