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Long-term outcomes in trauma patients

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https://www.readbyqxmd.com/read/28340652/management-of-pediatric%C3%A2-nasal-surgery-rhinoplasty
#1
REVIEW
Matthew D Johnson
Nasal surgery in children, most often performed after trauma, can be performed safely in selected patients with articulate, deliberate, and conscientious operative plan. All nasal surgery in children seeks to avoid disruption of the growth centers, preserving and optimizing nasal growth while improving the form and function of the nose. A solid appreciation of long-term outcomes and effects on growth remain elusive.
May 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28338552/is-the-future-of-coronary-arterial-revascularization-a-hybrid-approach-the-canadian-experience-across-three-centers
#2
Vincenzo Giambruno, Ahmad Hafiz, Stephanie A Fox, Hugues Jeanmart, Richard C Cook, Feras H Khaliel, Patrick Teefy, Kumar Sridhar, Shahar Lavi, Rodrigo Bagur, Varinder K Randhawa, Ivan Iglesias, Philip M Jones, Christopher C Harle, Daniel Bainbridge, Michael W A Chu, Bob B Kiaii
OBJECTIVE: Hybrid coronary revascularization offers and combines the advantages of both surgical and percutaneous revascularization and eliminates at the same time the disadvantages of both procedures. The objective of this study was to assess graft and stent patency at 6 months, rate of bleeding, intensive care unit and hospital stay, rate of reintervention, and long-term clinical follow-up. METHODS: From March 2004 to November 2015, a total of 203 patients underwent robotic-assisted minimally invasive direct coronary artery bypass graft of the left internal thoracic artery to the left anterior descending artery and PCI of a non-left anterior descending vessel in a single or two stage, at three different centers...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28330928/surgery-for-cancer-a-trigger-for-metastases
#3
REVIEW
Samer Tohme, Richard L Simmons, Allan Tsung
Surgery is a crucial intervention and provides a chance of cure for patients with cancer. The perioperative period is characterized by an increased risk for accelerated growth of micrometastatic disease and increased formation of new metastatic foci. The true impact for cancer patients remains unclear. This review summarizes the often fragmentary clinical and experimental evidence supporting the role of surgery and inflammation as potential triggers for disease recurrence. Surgery induces increased shedding of cancer cells into the circulation, suppresses antitumor immunity allowing circulating cells to survive, upregulates adhesion molecules in target organs, recruits immune cells capable of entrapping tumor cells, and induces changes in the target tissue and in the cancer cells themselves to enhance migration and invasion to establish at the target site...
March 22, 2017: Cancer Research
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#4
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28323806/improving-pain-management-and-long-term-outcomes-following-high-energy-orthopaedic-trauma-pain-study
#5
Renan C Castillo, Srinivasa N Raja, Katherine P Frey, Heather A Vallier, Paul Tornetta, Todd Jaeblon, Brandon J Goff, Allan Gottschalk, Daniel O Scharfstein, Robert V OʼToole
Poor pain control after orthopaedic trauma is a predictor of physical disability and numerous negative long-term outcomes. Despite increased awareness of the negative consequences of poorly controlled pain, analgesic therapy among hospitalized patients after orthopaedic trauma remains inconsistent and often inadequate. The Pain study is a 3 armed, prospective, double-blind, multicenter randomized trial designed to evaluate the effect of standard pain management versus standard pain management plus perioperative nonsteroidal anti-inflammatory drugs or pregabalin in patients of ages 18-85 with extremity fractures...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323802/outcomes-after-severe-distal-tibia-ankle-and-or-foot-trauma-comparison-of-limb-salvage-versus-transtibial-amputation-outlet
#6
Michael J Bosse, David Teague, Lisa Reider, Joshua L Gary, Saam Morshed, Rachel B Seymour, James Toledano, Lisa K Cannada, Barbara Steverson, Daniel O Scharfstein, Jason Luly, Ellen J MacKenzie
Severe foot and ankle injuries are complex and challenging to treat, often requiring multiple operations to salvage the limb contributing to a prolonged healing period. There is some evidence to suggest that early amputation for some patients may result in better long-term outcomes than limb salvage. The challenge is to identify the regional injury burden for an individual that would suggest a better outcome with an amputation. The OUTLET study is a prospective, multicenter observational study comparing 18-month outcomes after limb salvage versus early amputation among patients aged 18-60 years with severe distal tibia, ankle, and foot injuries...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323248/accuracy-and-reproducibility-of-preoperative-three-dimensional-planning-for-total-hip-arthroplasty-using-biplanar-low-dose-radiographs-a-pilot-study
#7
Didier Mainard, Olivier Barbier, Yohann Knafo, Rémi Belleville, Laurence Mainard-Simard, Jean-Baptiste Gross
BACKGROUND: In total hip arthroplasty (THA), the acetabular cup and femoral stem must be correctly sized and positioned to avoid intraoperative and postoperative complications, achieve good functional outcomes and ensure long-term survival. Current two-dimensional (2D) techniques do not provide sufficient accuracy, while low-dose biplanar X-rays (EOS) had not been assessed in this indication. Therefore we performed a case-control study to: 1) evaluate the prediction of stem and cup size for a new 3D planning technique (stereoradiographic imaging plus 3D modeling) in comparison to 2D templating on film radiographs and 2) evaluate the accuracy and reproducibility of this 3D technique for preoperative THA planning...
March 16, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28319493/advantages-of-robotic-right-colectomy-with-intracorporeal-anastomosis
#8
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/28317586/strategies-to-improve-local-control-of-resected-pancreas-adenocarcinoma
#9
Paul H Sugarbaker
BACKGROUND: Only approximately one in ten pancreas cancer patients is a candidate for potentially curative resection of this disease. Even this small fraction of patients has a poor prognosis following pancreatico-duodenectomy. The disease has an anatomic location that makes it difficult for the surgeon to maintain adequate margins of resection and prevent tumor spillage at the time of resection. Also, the disease is biologically aggressive and even with a complete visible resection of the disease, micrometastases are likely to remain behind...
March 2017: Surgical Oncology
https://www.readbyqxmd.com/read/28303214/evidence-based-management-and-controversies-in-blunt-splenic-trauma
#10
REVIEW
D C Olthof, C H van der Vlies, J C Goslings
PURPOSE OF REVIEW: The study aims to describe the evidence-based management and controversies in blunt splenic trauma. RECENT FINDINGS: A shift from operative management to non-operative management (NOM) has occurred over the past decades where NOM has now become the standard of care in haemodynamically stable patients with blunt splenic injury. Splenic artery embolisation (SAE) is generally believed to increase the success rate of NOM. Not all the available evidence is that optimistic about SAE however...
2017: Current Trauma Reports
https://www.readbyqxmd.com/read/28302283/pediatric-thoracic-trauma-current-trends
#11
Erik G Pearson, Caitlin A Fitzgerald, Matthew T Santore
Pediatric thoracic trauma is relatively uncommon but results in disproportionately high levels of morbidity and mortality when compared with other traumatic injuries. These injuries are often more devastating due to differences in children׳s anatomy and physiology relative to adult patients. A high index of suspicion is of utmost importance at the time of presentation because many significant thoracic injuries will have no external signs of injury. With proper recognition and management of these injuries, there is an associated improved long-term outcome...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28294478/the-predictive-value-of-dorsal-cingulate-activity-and-fractional-anisotropy-on-long-term-ptsd-symptom-severity
#12
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/28283308/percutaneous-collagen-induction-as-an-additive-treatment-for-scar-formation-following-thermal-injuries-preliminary-experience-in-47-children
#13
Rainer Kubiak, Bettina Lange
BACKGROUND: Thermal injuries are one of the most physically and psychologically devastating causes of pediatric trauma. Post-traumatic sequelae such as hypertrophic scars and contractures often result in long lasting morbidity and disfigurement. Conservative therapy, including pressure garments and silicone, is the gold standard for scar management in the pediatric population. Most recently percutaneous collagen induction (PCI) was introduced as an alternative treatment in adults. The aim of this report was to share our experience with PCI in children and adolescents in scar management following thermal injuries...
March 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28280907/high-prevalence-of-knee-osteoarthritis-at-a-minimum-10-year-follow-up-after-knee-dislocation-surgery
#14
Gilbert Moatshe, Grant J Dornan, Tom Ludvigsen, Sverre Løken, Robert F LaPrade, Lars Engebretsen
PURPOSE: Long-term outcomes and the prevalence of osteoarthritis after surgical treatment of knee dislocations are lacking in the literature. The purpose of this study was to investigate the prevalence of knee osteoarthritis and knee function at a minimum of 10 years after knee dislocation surgery. METHODS: Sixty-five patients surgically treated for knee dislocations at a single level I trauma center between May 1996 and December 2004 were evaluated at a minimum of 10 years...
March 9, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28275834/%C3%AE-blocker-after-severe-traumatic-brain-injury-is-associated-with-better-long-term-functional-outcome-a-matched-case-control-study
#15
R Ahl, E P Thelin, G Sjölin, B-M Bellander, L Riddez, P Talving, S Mohseni
PURPOSE: Severe traumatic brain injury (TBI) is the predominant cause of death and disability following trauma. Several studies have observed improved survival in TBI patients exposed to β-blockers, however, the effect on functional outcome is poorly documented. METHODS: Adult patients with severe TBI (head AIS ≥ 3) were identified from a prospectively collected TBI database over a 5-year period. Patients with neurosurgical ICU length of stay <48 h and those dying within 48 h of admission were excluded...
March 8, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28267125/clinical-evaluation-of-a-skin-protectant-for-the-management-of-incontinence-associated-dermatitis-an-open-label-nonrandomized-prospective-study
#16
Mary R Brennan, Catherine T Milne, Marie Agrell-Kann, Bruce P Ekholm
PURPOSE: The purpose of this study was to evaluate the efficacy of an investigational skin protectant product at managing severe skin breakdown associated with incontinence. DESIGN: Open-label, nonrandomized, prospective study. SUBJECTS AND SETTING: The sample comprised 16 patients; inclusion criteria were: patients older than 18 years, cared for in the intensive care unit of a level I trauma center hospital or in long-term care facilities in the northeast region of the United States, and had incontinence-associated dermatitis (IAD)...
March 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28262280/shared-decision-making-in-the-management-of-midshaft-clavicular-fractures-nonoperative-treatment-or-plate-fixation
#17
Sarah Woltz, Pieta Krijnen, Sven A G Meylaerts, Arwen H Pieterse, Inger B Schipper
INTRODUCTION: Most patients with a displaced midshaft clavicular fracture can be treated either operatively or nonoperatively, with similar long-term outcomes. The treatment choice depends on individual preferences, and is therefore suited for a shared decision making (SDM) approach. However, little is known about SDM in fracture treatment. The purpose of this study was to evaluate the current daily practice of shared decisional behaviour in clavicular fracture treatment, in order to assess the need for improvement and set a baseline level for future research...
February 27, 2017: Injury
https://www.readbyqxmd.com/read/28259576/female-sex-independently-predicts-mortality-after-thoracic-endovascular-aortic-repair-for-intact-descending-thoracic-aortic-aneurysms
#18
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/28249349/revision-of-total-knee-arthroplasties-performed-in-young-active-patients-with-posttraumatic-and-osteoarthritis
#19
Andrew Brian Old, William John Long, W Norman Scott
Rates of total knee arthroplasty (TKA) in younger patients are rising significantly. A recent study performed at our institute illustrated the excellent survivorship of TKAs in patients younger than 55 years at a mean follow-up period of 25 years. This study reports on the 25 knees in this series that required revision surgery. Twenty-five revisions were performed in 24 patients. Indication for revision, clinical outcomes, and radiographs were reviewed at their most recent follow-up. Revisions were performed in 5 cases of infection, 2 cases of fracture/trauma, 17 cases of wear/loosening, and 1 case of instability...
March 1, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28237532/ureteral-reconstruction-with-ileum-long-term-follow-up-of-renal-function
#20
Joshua D Roth, M Francesca Monn, Konrad M Szymanski, Richard J Bihrle, Matthew J Mellon
OBJECTIVE: To assess long-term renal preservation and surgical outcomes in patients undergoing ureteric substitution with ileum. This has been a mainstay of reconstruction options for lengthy ureteral defects. METHODS: Consecutive patients aged 18 or older undergoing ileal ureters at our institution were retrospectively reviewed (1989-June 2013). Patients with <6 months of follow-up were excluded. Demographic, surgical and renal functional outcomes were reviewed...
February 22, 2017: Urology
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