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Long-term outcomes in trauma patients

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
https://www.readbyqxmd.com/read/28525675/acellular-dermal-matrix-and-heel-reconstruction-a-new-prospective
#11
Alessandro Scalise, Matteo Torresetti, Federica Verdini, Marianna Capecci, Elisa Andrenelli, Alessandro Mengarelli, Maria Gabriella Ceravolo, Sandro Fioretti, Giovanni Di Benedetto
BACKGROUND: Heel reconstruction represents a challenge for all plastic surgeons due to the anatomical and functional features of this weight-bearing area. In the last decade a combined use of acellular dermal matrices and skin grafts has been proposed as a reliable and less invasive alternative for complex wound management; nevertheless only a few cases have been reported in the literature. METHODS: We describe the long-term outcome of 2 cases of severe degloving trauma of the plantar region with massive soft tissue defects of the foot, that underwent surgical reconstruction with artificial dermis and skin grafts...
May 19, 2017: Journal of Applied Biomaterials & Functional Materials
https://www.readbyqxmd.com/read/28520680/acute-pediatric-monteggia-fractures-a-conservative-approach-to-stabilization
#12
Ian Foran, Vidyadhar V Upasani, Charles D Wallace, Elise Britt, Tracey P Bastrom, James D Bomar, Andrew T Pennock
BACKGROUND: In 2015, a multicenter study group proposed a treatment algorithm for pediatric Monteggia fractures based upon the ulnar fracture pattern. This strategy recommends surgical stabilization for all complete ulna fractures. The purpose of this study was to evaluate whether an initial nonoperative approach to pediatric Monteggia fractures resulted in poorer outcomes and a higher rate of complications. METHODS: This institutional review board approved retrospective study evaluated all Monteggia fractures presenting to a level 1 pediatric trauma center between 2008 and 2014...
May 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28516217/prenatal-surgery-for-myelomeningocele-review-of-the-literature-and-future-directions
#13
Gregory G Heuer, Julie S Moldenhauer, N Scott Adzick
Open spina bifida or myelomeningocele (MMC) is one of the most common serious congenital malformations. Historically, this condition has been treated with closure of the MMC defect shortly after birth. The goal of postnatal closure is to cover the exposed spinal cord and prevent infection. However, postnatal surgery does not reverse or prevent the neurologic injury seen in MMC, reverse hindbrain herniation, or prevent hydrocephalus. The neurologic defects result from primary incomplete neurulation and secondary chronic prenatal damage to the exposed neural elements through mechanical and chemical trauma...
May 17, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#14
Markus F Luger, Thomas J Luger
Elderly patients increasingly need to undergo surgery under anesthesia, especially following trauma. A timely interdisciplinary approach to the perioperative management of these patients is decisive for the long-term outcome. Orthogeriatric co-management, which includes geriatricians and anesthesiologists from an early stage, is of great benefit for geriatric patients. Patient age, comorbidities and self-sufficiency in activities of daily life are decisive for an anesthesiological assessment of the state of health and preoperative risk stratification...
May 12, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28500436/the-efficacy-of-a-multimodal-analgesia-protocol-in-preventing-heterotopic-ossification-after-acetabular-fractures-surgery
#15
Liang Cheng, Hai-Tao Long, Bu-Hua Sun, Shu-Shan Zhao, Yong Zhu
Background Heterotopic ossification (HO) after joint surgery is always a disturbing problem for patients and surgeons. Prophylaxis is the most effective therapy. Objective To assess the efficacy and safety of a multimodal analgesia protocol that included parecoxib and celecoxib in preventing HO after acetabular fracture surgery. Setting Selecting patients from trauma registry of our hospital. Method We identified 259 patients who had acetabular fracture surgery between January 2008 and December 2014. Hundredsixty-three patients received parecoxib and celecoxib (Group A) and 96 patients received no prophylaxis (Group B)...
May 12, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28489714/feasibility-of-and-rationale-for-the-collection-of-orthopaedic-trauma-surgery-quality-of-care-metrics
#16
Anna N Miller, Rosemary Kozar, Philip Wolinsky
INTRODUCTION: Reproducible metrics are needed to evaluate the delivery of orthopaedic trauma care, national care, norms, and outliers. The American College of Surgeons (ACS) is uniquely positioned to collect and evaluate the data needed to evaluate orthopaedic trauma care via the Committee on Trauma and the Trauma Quality Improvement Project. METHODS: We evaluated the first quality metrics the ACS has collected for orthopaedic trauma surgery to determine whether these metrics can be appropriately collected with accuracy and completeness...
June 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28489206/lower-extremity-reconstruction-epidemiology-management-and-outcomes-of-patients-of-the-federal-district-north-wing-regional-hospital
#17
Jefferson Lessa Soares Macedo, Simone Corrêa Rosa, Daniel Lobo Botelho, Clendes Pereira Dos Santos, Murilo Neves DE Queiroz, Tabatha Gonçalves Andrade Castelo Branco Gomes
Objective: to evaluate the management of lower limbs complex traumatic injuries by analyzing their characteristics, types, conduct and evolution, with emphasis on surgical treatment. Methods: we conducted a prospective study of patients treated by Plastic Surgery at a regional hospital of the Federal District during a one-year period. We collected data through serial evaluations and telephone contact records. Results: we studied 40 patients, with a mean age of 25...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28486966/the-clinical-course-of-trauma-related-disorders-and-personality-disorders-study-protocol-of-two-year-follow-up-based-on-structured-interviews
#18
Sanne Swart, Marleen Wildschut, Nel Draijer, Willemien Langeland, Jan H Smit
BACKGROUND: Trauma-related disorders and personality disorders are prevalent in survivors of chronic childhood trauma and neglect. Both conditions have serious consequences for patients, their families, society and public health and a high risk of development of chronicity. However, information on the long term course trajectories is lacking and predictors of course outcome in survivors of chronic childhood traumatization are unknown. The first aim of the current study is to identify two-year course trajectories of pathology in patients with trauma-related disorders and personality disorders...
May 10, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28486696/coronary-artery-bypass-surgery-within-48%C3%A2-hours-after-cardiac-arrest-due-to-acute-myocardial-infarction
#19
Christina Grothusen, Christine Friedrich, Tim Attmann, Jette Meinert, Eva Ohnewald, Ulysses Ulbricht, Katharina Huenges, Assad Haneya, Derk Frank, Jan-Thorsten Graesner, Jan Schoettler, Jochen Cremer
OBJECTIVES: Cardiac arrest (CA) in patients with acute myocardial infarction is associated with a poor prognosis. Due to the additional trauma, risk of stroke and lack of data, coronary artery bypass grafting (CABG) is a controversial revascularization strategy for patients who cannot be treated percutaneously. Against this background, we investigated the outcome of patients from our department with acute myocardial infarction undergoing CABG after CA. METHODS: Between January 2001 and January 2015, 129 patients with preoperative CA due to acute myocardial infarction underwent CABG at our institution within 48 h after the CA had occurred...
May 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28471152/endovascular-treatment-of-traumatic-thoracic-aortic-lesions-a-systematic-review-and-meta-analysis
#20
Cornelis P van der Zee, Tryfon Vainas, Freek A van Brussel, Ignace F Tielliu, Clark J Zeebregts, Maarten J van der Laan
BACKGROUND: To provide an overview of the experience of endovascular treatment for traumatic thoracic aortic lesions (TTAL). Thoracic aortic injury secondary to high-energy chest trauma constitutes an emergency situation with potentially devastating outcome. In the present time, the majority of patients are treated with thoracic endovascular aortic repair. The aim of this study was to provide a systematic overview of endovascular aortic repair in patients with TTAL with special attention to perioperative mortality, paraplegia, stroke, influence of left subclavian artery (LSA) coverage herein, and long term stent related complications...
May 3, 2017: Journal of Cardiovascular Surgery
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