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https://www.readbyqxmd.com/read/28931255/initial-single-center-technical-experience-with-the-brainpath-system-for-acute-intracerebral-hemorrhage-evacuation
#1
Andrew M Bauer, Peter A Rasmussen, Mark D Bain
BACKGROUND: Surgical intervention has been proposed as a means of reducing the high morbidity and mortality associated with acute intracerebral hemorrhage (ICH), but many previously reported studies have failed to show a clinically significant benefit. Newer, minimally invasive approaches have shown some promise. OBJECTIVE: We report our early single-center technical experience with minimally invasive clot evacuation using the BrainPath system. METHODS: Prospective data were collected on patients who underwent ICH evacuation with BrainPath at the Cleveland Clinic from August 2013 to May 2015...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28931251/managing-arterial-injury-in-endoscopic-skull-base-surgery-case-series-and-review-of-the-literature
#2
Alicia Del Carmen Becerra Romero, Jagath Lal Gangadharan, Evan D Bander, Yves Pierre Gobin, Vijay K Anand, Theodore H Schwartz
BACKGROUND: The most feared complications following endoscopic endonasal skull base surgery are arterial vascular injuries. Previously published literature is restricted to internal carotid artery injuries. The ideal method for controlling arterial bleeding during this kind of procedure is debated, and a variety of techniques have been advocated. OBJECTIVE: To evaluate the management and outcome following intraoperative arterial injury during endoscopic endonasal skull base surgery...
February 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28931222/the-role-of-human-immunodeficiency-virus-associated-vasculopathy-in-the-etiology-of-stroke
#3
Laura A Benjamin, Theresa J Allain, Henry Mzinganjira, Myles D Connor, Colin Smith, Sebastian Lucas, Elizabeth Joekes, Sam Kampondeni, Karen Chetcuti, Ian Turnbull, Mark Hopkins, Steve Kamiza, Elizabeth L Corbett, Robert S Heyderman, Tom Solomon
Background: Human immunodeficiency virus (HIV) infection is a recognized risk factor for stroke among young populations, but the exact mechanisms are poorly understood. We studied the clinical, radiologic, and histologic features of HIV-related ischemic stroke to gain insight into the disease mechanisms. Methods: We conducted a prospective, in-depth analysis of adult ischemic stroke patients presenting to Queen Elizabeth Central Hospital, Blantyre, Malawi, in 2011...
September 1, 2017: Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28931197/study-of-factors-responsible-for-recidivism-in-allergic-fungal-rhinosinusitis
#4
Bipin Kishore Prasad
Patients with allergic fungal rhinosinusitis (AFRS) are typically atopic and immunocompetent. Despite combined modality treatment based on surgery and immunomodulation, the potential for recidivism is well recognized. A study was conducted in a military hospital in India to identify the factors responsible for recidivism in AFRS and to suggest measures to overcome it. Sixty patients with AFRS (42 new cases and 18 cases that required revision surgery) were managed between January 2009 and July 2013. Patients underwent endoscopic, radiologic, and laboratory evaluation for AFRS followed by functional endoscopic sinus surgery...
September 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28931096/-nutrition-therapy-of-cancer-patients
#5
József Lövey
The majority of cancer patients becomes malnourished during the course of their disease. Malnutrition deteriorates the efficiency of all kinds of oncologic interventions. As a consequence of it, treatment-related toxicity increases, hospital stay is lengthened, chances of cure and survival as well as the quality of life of the patients worsen. Nutritional status therefore influences all aspects of outcome of oncology care. In spite of this the use of nutritional therapy varies across health care providers but its application is far from being sufficient during active oncology interventions as well as rehabilitation and supportive care...
September 20, 2017: Magyar Onkologia
https://www.readbyqxmd.com/read/28931025/the-clinical-and-microbiological-characteristics-of-enteric-fever-in-cambodia-2008-2015
#6
Laura M F Kuijpers, Thong Phe, Chhun H Veng, Kruy Lim, Sovann Ieng, Chun Kham, Nizar Fawal, Laetitia Fabre, Simon Le Hello, Erika Vlieghe, François-Xavier Weill, Jan Jacobs, Willy E Peetermans
BACKGROUND: Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi. METHODOLOGY: A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015...
September 20, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28930960/prehospital-administration-of-freeze-dried-plasma-is-it-the-solution-for-trauma-casualties
#7
Amir Shlaifer, Maya Siman-Tov, Irina Radomislensky, Kobi Peleg, Avi Shina, Erez Nachum Baruch, Elon Glassberg, Avraham Yitzhak
BACKGROUND: Hemorrhage is the leading cause of possible preventable death in the battlefield. There is an increasing evidence for the effectiveness of blood component therapy in general, and plasma infusion in particular but their use is less applicable in the prehospital setting due to logistic difficulties. Israeli Defense Force has implemented the use of freeze-dried plasma (FDP) at the point of injury (POI), this adoption of FDP use entailed doubts regarding the feasibility and effectiveness of this practice...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#8
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#9
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930953/proposed-clinical-pathway-for-nonoperative-management-of-high-grade-pediatric-pancreatic-injuries-based-on-a-multicenter-analysis-a-pediatric-trauma-society-collaborative
#10
Bindi J Naik-Mathuria, Eric H Rosenfeld, Ankush Gosain, Randall Burd, Richard A Falcone, Rajan Thakkar, Barbara Gaines, David Mooney, Mauricio Escobar, Mubeen Jafri, Anthony Stallion, Denise B Klinkner, Robert Russell, Brendan Campbell, Rita V Burke, Jeffrey Upperman, David Juang, Shawn St Peter, Stephon J Fenton, Marianne Beaudin, Hale Wills, Adam Vogel, Stephanie Polites, Adam Pattyn, Christine Leeper, Laura V Veras, Ilan Maizlin, Shefali Thaker, Alexis Smith, Megan Waddell, Joseph Drews, James Gilmore, Lindsey Armstrong, Alexis Sandler, Suzanne Moody, Brandon Behrens, Laurence Carmant
BACKGROUND: Guidelines for nonoperative management (NOM) of high-grade pancreatic injuries in children have not been established, and wide practice variability exists. The purpose of this study was to evaluate common clinical strategies across multiple pediatric trauma centers to develop a consensus-based standard clinical pathway. METHODS: A multicenter, retrospective review was conducted of children with high-grade (American Association of Surgeons for Trauma grade III-V) pancreatic injuries treated with NOM between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930951/routine-computed-tomography-after-recent-operative-exploration-for-penetrating-trauma-what-injuries-do-we-miss
#11
April E Mendoza, Christopher A Wybourn, Anthony G Charles, Andre R Campbell, Bruce A Cairns, Margaret M Knudson
BACKGROUND: Patients with penetrating trauma who cannot be stabilized undergo operative intervention without preoperative imaging. In such cases, postoperative imaging may reveal additional injuries not identified during the initial operative exploration. The purpose of this study is to explore the utility of postoperative CT imaging in the setting of penetrating trauma. METHODS: This was a retrospective analysis of patients with penetrating trauma treated at an urban Level 1 trauma center between 2010 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930950/increased-mortality-in-trauma-patients-who-develop-postintubation-hypotension
#12
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Postintubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada, between 2000 and 2015...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930947/the-mortality-ascent-hourly-risk-of-death-for-hemodynamically-unstable-trauma-patients-at-level-ii-versus-level-i-trauma-centers
#13
Juan P Herrera-Escobar, Arturo J Rios-Diaz, Cheryl Zogg, Lindsey L Wolf, Alyssa Harlow, Eric B Schneider, Zara Cooper, Carlos A Ordonez, Ali Salim, Adil H Haider
BACKGROUND: Severely injured trauma patients have higher in-hospital mortality at Level II versus Level I Trauma Centers (TCs). In order to better understand these differences, we sought to determine if there were any time-periods during which hemodynamically unstable trauma patients are at higher risk of death at Level II versus Level I TCs within the first 24 hours post-admission. STUDY DESIGN: Trauma patients aged 18-64 years, with Injury Severity Score ≥15, SBP <90 mmHg at admission, and treated at Level II or Level I TCs, were identified using the 2007-2012 National Trauma Data Bank...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930944/negative-ct-can-safely-rule-out-clinically-significant-intra-abdominal-injury-in-the-asymptomatic-patient-after-blunt-trauma-prospective-evaluation-of-1193-patients
#14
Elizabeth Benjamin, Jayun Cho, Gustavo Recinos, Evren Dilektasli, Lydia Lam, John Brunner, Kenji Inaba, Demetrios Demetriades
BACKGROUND: Computed tomography of the abdomen and pelvis (CTAP) is highly specific for injury identification and commonly used in the evaluation of blunt trauma patients. Despite this, there is no consensus on the required clinical observation period after negative imaging, often impacting patient flow and hospital cost. The purpose of this study was to evaluate the use of CTAP after blunt trauma and the need for observation following negative imaging. METHODS: A prospective analysis at a large level I trauma center was conducted from 11/2014-5/2015...
September 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930926/fractures-of-the-nasal-bones-is-external-splinting-really-warranted
#15
Ourania Schoinohoriti, Dimosthenis Igoumenakis, George Rallis
BACKGROUND: It has been advocated that reduction of nasal bone fractures should be followed by internal packing and/or external splinting. Despite the ample literature concerning the advantages and limitations of various splint types, the necessity and effectiveness of external splinting has not been well documented. OBJECTIVE: To present the authors' experience and review the literature on treatment of nasal bone fractures, focusing on the indications and effectiveness of external splinting following closed reduction...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930925/conical-modification-of-forearm-free-flaps-for-single-stage-reconstruction-after-total-orbital-exenteration
#16
Chad A Purnell, Elbert E Vaca, Marco F Ellis
BACKGROUND: Orbital exenteration is a significant reconstructive challenge for plastic surgeons. Options described for these defects range from healing by secondary intention to free tissue transfer. The authors present our preferred reconstruction of orbital defects with free forearm-based flaps, which provides quality soft tissue and orbital contouring in 1 stage to consistently allow placement of bone-anchored implants for eventual orbital prosthesis. METHODS: This conical shape of the orbit is deconstructed into a "Pac-Man" type shaped flap that leaves adequate depth for a prosthesis...
September 19, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28930900/retrospective-evaluation-of-the-impact-of-a-geriatric-trauma-institute-on-fragility-hip-fracture-patient-outcomes
#17
Elizabeth D Katrancha, Jami Zipf, Nancy Abrahams, Richard Schroeder
BACKGROUND: Fragility hip fractures occur in the older than 65-year population at an alarming rate. It is estimated that 260,000 hip fractures occur annually. Patient outcomes following hip fractures are devastating. One of every 5 patients dies within 1 year of injury, and 1 of 3 remains in a nursing home for years after the injury. Published literature recommends an interdisciplinary approach to caring for hip-fractured patients and expediting surgery to improve outcomes. PURPOSE: The purpose of this study was to retrospectively evaluate the impact of the Geriatric Trauma Institute (GTI) on fragility hip fracture patient outcomes...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28930888/what-matters-most-to-whom-racial-ethnic-and-language-differences-in-the-health-care-experiences-most-important-to-patients
#18
Rebecca L Collins, Ann Haas, Amelia M Haviland, Marc N Elliott
BACKGROUND: Some aspects of patient experience are more strongly related to overall ratings of care than others, reflecting their importance to patients. However, little is known about whether the importance of different aspects of this experience differs across subgroups. OBJECTIVES: To determine whether the aspects of health care most important to patients differ according to patient race, ethnicity, and language preference. RESEARCH DESIGN: In response to the 2013 Medicare Consumer Assessment of Health Plans Study (CAHPS) survey, patients rated their overall health care and completed items measuring five patient experience domains...
September 19, 2017: Medical Care
https://www.readbyqxmd.com/read/28930858/a-retrospective-study-comparing-percutaneous-and-open-pedicle-screw-fixation-for-thoracolumbar-fractures-with-spinal-injuries
#19
Bowen Wang, Yong Fan, Jingjing Dong, Hu Wang, Faqi Wang, Zhichen Liu, Haoyuan Liu, Yafei Feng, Fengrong Chen, Zheyuan Huang, Ruisong Chen, Wei Lei, Zixiang Wu
BACKGROUND: The purpose of this study was to evaluate the effectiveness between percutaneous and open pedicle screw fixation for treating thoracolumbar fractures with spinal injuries. METHODS: A total of 105 patients with thoracolumbar fractures and spinal injuries were divided into a percutaneous pedicle screw fixation (PPSF) group with 56 patients, who underwent percutaneous pedicle screw fixation, and an open pedicle screw fixation (OPSF) group with 49 patients, who underwent open pedicle screw fixation in accordance with the treatment project...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28930856/the-role-of-ultrasonography-in-examination-of-the-stability-of-tile-b2-pelvic-fractures-7-case-reports-and-a-literature-review
#20
Bin-Fei Zhang, Hong Zhang, Peng-Fei Wang, Hu Wang, Jin-Lai Lei, Ya-Hui Fu, Yu-Xuan Cong, Hai Huang, Xiao-Ming Huo, Yan Zhuang, Kun Zhang
BACKGROUND: Determining whether a Tile-B2 pelvic fracture is stable is very challenging. We sought to identify the role of ultrasonography in determining the stability of Tile-B2 pelvic fractures. METHODS: We collected the clinical data of patients with Tile-B2 pelvic fractures who presented at Xi'an Hong-Hui Hospital between June 1, 2016, and August 5, 2016. The treatment strategy of each patient was determined by a team of senior surgeons in the department. A single sinologist observed the movement of the fracture sites in patients during rest, under compression, and during separation to determine fracture stability...
September 2017: Medicine (Baltimore)
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