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Long-term outcomes in trauma patients

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https://www.readbyqxmd.com/read/28426563/routine-inclusion-of-long-term-functional-and-patient-reported-outcomes-pros-into-trauma-registries-the-forte-project
#1
Arturo J Rios-Diaz, Juan P Herrera-Escobar, Elizabeth J Lilley, Jessica R Appelson, Belinda Gabbe, Karen Brasel, Terri deRoon-Cassini, Eric B Schneider, George Kasotakis, Haytham Kaafarani, George Velmahos, Ali Salim, Adil H Haider
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine (formerly the Institute of Medicine) recently recommended inclusion of post-discharge health-related quality of life (HRQoL) and patient-reported outcomes (PROs) metrics to benchmark the quality of trauma care. Currently, these measures are not routinely collected at most trauma centers. We sought to determine the feasibility and value of adding such long-term outcome measures to trauma registries. METHODS: As part of the Functional Outcomes and Recovery after Trauma Emergencies (FORTE) project we included patients with an ISS ≥9, admitted to the Brigham and Women's Hospital in Boston, MA who were identified retrospectively using the institutional trauma registry and contacted 6 or 12-months post-injury to participate in a telephone survey evaluating: HRQoL (Short Form-12 [SF-12]), PROs (Trauma Quality of Life [T-QoL]), post-traumatic stress disorder (PTSD), return to work, residential status, and healthcare utilization...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28419996/polydimethyl-siloxane-as-an-internal-tamponade-for-vitreoretinal-surgery
#2
Rumana N Hussain, Jayavani Myneni, Theodor Stappler, David Wong
PURPOSE: To report the efficacy and safety of polydimethyl siloxane (Siluron Xtra®) as an internal tamponade. DESIGN: Audit and adverse event screening of procedures (March 2014-2015). METHODS: Patients who had undergone vitreoretinal procedures with Siluron Xtra® tamponade were retrospectively analysed with respect to anatomical outcome, visual outcomes, and perioperative complications, in particular intraocular pressure. INCLUSION CRITERIA: all patients who had undergone Siluron Xtra® tamponade...
April 19, 2017: Ophthalmologica. Journal International D'ophtalmologie
https://www.readbyqxmd.com/read/28408294/resilience-and-cross-network-connectivity-a-neural-model-for-post-trauma-survival
#3
Marcella Brunetti, Laura Marzetti, Gianna Sepede, Filippo Zappasodi, Vittorio Pizzella, Fabiola Sarchione, Federica Vellante, Giovanni Martinotti, Massimo Di Giannantonio
Literature on the neurobiological bases of Post-Traumatic Stress Disorder (PTSD) considers medial Prefrontal cortex (mPFC), a core region of the Default Mode Network (DMN), as a region involved in response regulation to stressors. Disrupted functioning of the DMN has been recognized at the basis of the pathophysiology of a number of mental disorders. Furthermore, in the evaluation of the protective factors to trauma consequence, an important role has been assigned to resilience. Our aim was to investigate the specific relation of resilience and PTSD symptoms severity with resting state brain connectivity in a traumatized population using magnetoencephalography (MEG), a non-invasive imaging technique with high temporal resolution and documented advantages in clinical applications...
April 10, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28400216/high-mortality-rates-after-both-open-surgical-and-endovascular-thoracic-aortic-interventions-in-patients-with-end-stage-renal-disease
#4
Nathan L Liang, Theodore H Yuo, Georges E Al-Khoury, Eric S Hager, Michel S Makaroun, Michael J Singh
BACKGROUND: Morbidity and mortality have improved with the evolution of endovascular techniques (thoracic endovascular aortic repair [TEVAR]) for thoracic aortic disease, but results after aortic intervention in patients with end-stage renal disease (ESRD) remain unclear. The objective of this study was to evaluate outcomes of open and endovascular descending thoracic aortic repair in dialysis-dependent patients. METHODS: We identified 352 patients with ESRD on dialysis undergoing open repair (n = 136) or TEVAR (n = 216) of the thoracic aorta from 2005 to 2008 using the United States Renal Data System database...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28394751/practice-patterns-for-the-use-of-antibiotic-agents-in-damage-control-laparotomy-and-its-impact-on-outcomes
#5
Stephanie R Goldberg, Jennifer Henning, Luke G Wolfe, Therese M Duane
BACKGROUND: The purpose of this study was to identify practice patterns associated with the use of antimicrobial agents with damage control laparotomy (DCL) and the relationship with post-operative intra-abdominal infection (IAI) rates. PATIENTS AND METHODS: The study was a retrospective review of trauma patients undergoing laparotomy at a Level 1 trauma center in 2010. Patients undergoing DCL versus those primarily closed (PCL) were compared for antimicrobial use (ABX) and its correlation with IAI rates (p < 0...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28384898/primary-management-and-outcome-open-laryngotracheal-trauma
#6
Santosh Uttarkar Pandurangarao, Prashanth Basavaraj, Supriya Baswaraj Yempalle, Lavanya Karnam
Acute external injury to the larynx is both life threatening and a potential long term management challenge. As Otorhinolaryngologist we must be prepared and well versed to manage these patients. In our study seven patients of open laryngeal traumas were managed by primary closure. In five patients nature of injury was known in other two patients exact nature of injury was not known. After primary closure five patients with known injury survived and two patients with unknown injury died. As per our experience, we recommend primary closure, if the exact nature of injury is known as the outcome is definitely favourable...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28383625/the-saxophonist-s-hernia-a-rare-case-report-of-anterior-primary-perineal-hernia-in-a-young-male-patient
#7
V D Palumbo, B Di Trapani, B Molinelli, S Tomasini, A Bruno, G Tomasello
Perineal hernia is the protrusion of an intra-abdominal structure into the perineal area, that could be primitive or secondary to trauma or abdominoperineal resection. Main treatment could be transabdominal, transperineal or combined. Here is a rare case of anterior perineal hernia in a young saxophone male patient, treated with a mininvasive perineal approach. A 25-year-old Caucasian male patient referred 1-year history of perineal pain. The pain was more severe when he played his saxophone. Local exam was negative but a dynamic perineal ultrasonography revealed a small anterior perineal hernia...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28381727/long-term-outcomes-of-pancreatic-function-following-pancreatic-trauma
#8
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/28381344/stability-of-coping-and-the-role-of-self-efficacy-in-the-first-year-following-mild-traumatic-brain-injury
#9
Myrthe E Scheenen, Harm J van der Horn, Myrthe E de Koning, Joukje van der Naalt, Jacoba M Spikman
BACKGROUND AND AIMS: Coping, the psychological adaptation to stressors and serious life events, has been found to have a great influence on the development and persistence of posttraumatic complaints. Coping has received much attention for having been found to be modifiable in treatment following mild traumatic brain injury (mTBI) and for its potential to identify the Patients who are at risk of suffering from long-term complaints. Currently, coping styles are assumed to be stable over time...
March 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28377126/vascular-impairment-as-a-pathological-mechanism-underlying-long-lasting-cognitive-dysfunction-after-pediatric-traumatic-brain-injury
#10
Ichkova Aleksandra, Beatriz Rodriguez-Grande, Claire Bar, Frederic Villega, Jan Pieter Konsman, Jerome Badaut
Traumatic brain injury (TBI) is the leading cause of death and disability in children. Indeed, the acute mechanical injury often evolves to a chronic brain disorder with long-term cognitive, emotional and social dysfunction even in the case of mild TBI. Contrary to the commonly held idea that children show better recovery from injuries than adults, pediatric TBI patients actually have worse outcome than adults for the same degree of injury severity. Acute trauma to the young brain likely interferes with the fine-tuned developmental processes and may give rise to long-lasting consequences on brain's function...
April 1, 2017: Neurochemistry International
https://www.readbyqxmd.com/read/28374894/endoscopic-drainage-of-pancreatic-fluid-collections-long-term-outcomes-in-children
#11
Zaheer Nabi, Sundeep Lakhtakia, Jahangeer Basha, Radhika Chavan, Rajesh Gupta, Mohan Ramchandani, Rakesh Kalapala, Partha Pal, Santosh Darisetty, Guduru Venkat Rao, D Nageshwar Reddy
BACKGROUND AND OBJECTIVE: Endoscopic drainage of pancreatic fluid collections (PFC) is the standard of care in adult patients. The literature is limited in children. In the present study, we aim to evaluate the safety and long term efficacy of endoscopic ultrasound (EUS) guided drainage of PFC in children. METHODS: The data of all children (<18 years) with PFC who underwent EUS-drainage with plastic stents was analysed retrospectively. Technical feasibility, clinical efficacy and adverse events (AE) were analysed...
April 4, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28374472/a-prospective-outcome-study-observing-patients-with-severe-traumatic-brain-injury-over-10-15%C3%A2-years
#12
E Andersson, D Rackauskaite, E Svanborg, L Csajbók, M Öst, B Nellgård
BACKGROUND: Severe traumatic brain injury (sTBI) can be divided into primary and secondary injuries. Intensive care protocols focus on preventing secondary injuries. This prospective cohort study was initiated to investigate outcome, including mortality, in patients treated according to the Lund Concept after a sTBI covering 10-15 years post-trauma. METHODS: Patients were included during 2000-2004 when admitted to the neurointensive care unit, Sahlgrenska University Hospital...
May 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28366792/serum-macrophage-migration-inhibitory-factor-concentrations-correlate-with-prognosis-of-traumatic-brain-injury
#13
Ding-Bo Yang, Wen-Hua Yu, Xiao-Qiao Dong, Zu-Yong Zhang, Quan Du, Qiang Zhu, Zhi-Hao Che, Hao Wang, Yong-Feng Shen, Li Jiang
BACKGROUND: Macrophage migration inhibitory factor (MIF) is a well-known pro-inflammatory cytokine. Serum MIF concentrations are associated with the severity and prognosis of ischemic stroke. METHODS: In this prospective, observational study, white blood cell (WBC) count and serum concentrations of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and MIF among 108 severe traumatic brain injury (TBI) patients and 108 controls were measured...
March 30, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28365647/consequences-of-transfusing-blood-components-in-patients-with-trauma-a-conceptual-model
#14
Allison R Jones, Susan K Frazier
Transfusion of blood components is often required in resuscitation of patients with major trauma. Packed red blood cells and platelets break down and undergo chemical changes during storage (known as the storage lesion) that lead to an inflammatory response once the blood components are transfused to patients. Although some evidence supports a detrimental association between transfusion and a patient's outcome, the mechanisms connecting transfusion of stored components to outcomes remain unclear. The purpose of this review is to provide critical care nurses with a conceptual model to facilitate understanding of the relationship between the storage lesion and patients' outcomes after trauma; outcomes related to trauma, hemorrhage, and blood component transfusion are grouped according to those occurring in the short-term (≤30 days) and the long-term (>30 days)...
April 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#15
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
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
#16
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/28356682/dental-implants-in-children-a-multidisciplinary-perspective-for-long-term-success
#17
REVIEW
Nidhi Agarwal, Dipanshu Kumar, Ashish Anand, Surendrakumar Kaluram Bahetwar
Congenital hypodontia or trauma is a frequent cause of loss of teeth in children. The absence of teeth leads to loss of function and lack of normal alveolar growth, along with unpleasant esthetics that hamper the psychosocial development of the young child. Traditionally, the management of tooth loss in the young child is done by conservative means. None of those methods of treatment are completely satisfactory and have their own drawbacks. Dental implants in a young child would be an ideal mode of treatment for the absence of teeth...
July 2016: National Journal of Maxillofacial Surgery
https://www.readbyqxmd.com/read/28353417/do-patients-with-pre-existing-psychiatric-illness-have-an-increased-risk-of-infection-after-injury
#18
Catherine M Dickinson, Daniel R Karlin, Hector R Nunez, Shiliang A Cao, Daithi S Heffernan, Sean F Monaghan, Tareq Kheirbek, Charles A Adams, Andrew H Stephen
BACKGROUND: Trauma remains a leading cause of death and long term-morbidity. We have shown that patients who sustain traumatic injuries are at increased risk for the development of infectious complications. Psychiatric illnesses (PIs) are also noted to occur frequently among the general population. The presence of a PI has been shown to be a risk factor for the development of infections. Despite the prevalence of both traumatic injuries and psychiatric diseases, there are little data relating the impact of PI on the outcome of patients with trauma...
March 29, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28347554/long-term-mortality-of-emergency-medical-services-patients
#19
Morten T Bøtker, Christian J Terkelsen, Jan N Sørensen, Søren B Jepsen, Søren P Johnsen, Erika F Christensen, Mikkel S Andersen
STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital, and vital status data from 3 of 5 geographic regions in Denmark. We included events from July 1, 2011, to December 31, 2012. We classified EMS events according to primary dispatch category (unconsciousness/cardiac arrest, accidents/trauma, chest pain, dyspnea, neurologic symptoms, and other EMS patients)...
March 25, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28340652/management-of-pediatric%C3%A2-nasal-surgery-rhinoplasty
#20
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
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