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Trauma system

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https://www.readbyqxmd.com/read/28926849/-a-nationwide-survey-of-undergraduate-training-in-orthopaedics-and-trauma-surgery
#1
Miriam Ruesseler, Susanne Froehlich, Sigrid Ruesseler, Julian Zabel, Jasmina Sterz, Udo Obertacke
Background Musculoskeletal conditions are the most frequent cause of long-term pain and disability. Scientifically funded, structured training would be highly desirable for all medical students and of great economic relevance for the health care system. The present article portrays the status quo of undergraduate training in orthopaedics and trauma surgery, with a comparison to the status quo of 2008. Material and Methods A 51-item questionnaire was sent to all heads of the departments of orthopaedics or trauma surgery at the 37 medical faculties in Germany...
September 19, 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/28926192/testing-of-a-bioactive-moldable-bone-graft-substitute-in-an-infected-critically-sized-segmental-defect-model
#2
Matt E Brown, Yuan Zou, Rebecca Peyyala, Sarandeep S Huja, Larry L Cunningham, Todd A Milbrandt, Thomas D Dziubla, David A Puleo
Large infected bone defects, often resulting from high energy traumas, are difficult to treat due to their variability in complexity and location. Standard treatment for infected bone defects begins with a protocol that includes a series of debridements in conjunction with an extended course of systemic antibiotics. Only after the infection has been eliminated will repair of the defect commence, typically with implantation of autologous bone. To address some of the shortcomings of the standard treatment methods, such as serial procedures, limited grafting material, and the need for a second surgical site for autologous bone, a sequential, dual drug-releasing, moldable, calcium sulfate-based bone graft substitute was developed previously...
September 19, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28925637/hair-loss-common-causes-and-treatment
#3
T Grant Phillips, W Paul Slomiany, Robert Allison
Hair loss is often distressing and can have a significant effect on the patient's quality of life. Patients may present to their family physician first with diffuse or patchy hair loss. Scarring alopecia is best evaluated by a dermatologist. Nonscarring alopecias can be readily diagnosed and treated in the family physician's office. Androgenetic alopecia can be diagnosed clinically and treated with minoxidil. Alopecia areata is diagnosed by typical patches of hair loss and is self-limited. Tinea capitis causes patches of alopecia that may be erythematous and scaly and must be treated systemically...
September 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28924833/rho-inhibiting-c2in-c3-fusion-toxin-inhibits-chemotactic-recruitment-of-human-monocytes-ex-vivo-and-in-mice-in-vivo
#4
Tobias Martin, Amelie Möglich, Ina Felix, Christina Förtsch, Anne Rittlinger, Annette Palmer, Stephanie Denk, Julian Schneider, Lena Notbohm, Mona Vogel, Hartmut Geiger, Stephan Paschke, Markus Huber-Lang, Holger Barth
Bacterial protein toxins became valuable molecular tools for the targeted modulation of cell functions in experimental pharmacology and attractive therapeutics because of their potent and specific mode of action in human cells. C2IN-C3lim, a recombinant fusion toxin (~50 kDa) of the Rho-inhibiting C3lim from Clostridium (C.) limosum and a non-toxic portion of the C. botulinum C2 toxin (C2IN), is selectively internalized into the cytosol of monocytic cells where C3lim specifically ADP-ribosylates Rho A and -B, thereby inhibiting Rho-mediated signaling...
September 18, 2017: Archives of Toxicology
https://www.readbyqxmd.com/read/28923584/seeing-the-difference-painless-progressive-vision-loss-in-a-vasculopath
#5
Jenny L Lauschke, Katherine Masselos, Jennifer Sandbach, Clare L Fraser
A 78-year-old Caucasian man with significant vascular disease reported sudden onset of worsened vision during a routine wound-care appointment for non-healing necrotic leg ulcers. He described painless blurring of vision with grey scotomas in his RE, his only well-seeing eye, following trauma to the LE as a child. He presented with retinal ischemia, a cotton-wool spot and optic nerve swelling. Temporal artery biopsy showed myxoid degeneration and extensive calcium deposition which also was shown on imaging throughout his carotid and vertebral arterial system, the clinical picture of calciphylaxis...
September 15, 2017: Survey of Ophthalmology
https://www.readbyqxmd.com/read/28922235/perioperative-inflammation-and-its-modulation-by-anesthetics
#6
Jan Rossaint, Alexander Zarbock
Surgery and other invasive procedures, which are routinely performed during general anesthesia, may induce an inflammatory response in the patient. This inflammatory response is an inherent answer of the body to the intervention and can be both beneficial and potentially harmful. The immune system represents a unique evolutionary achievement equipping higher organisms with an effective defense mechanism against exogenous pathogens. However, not only bacteria might evoke an immune response but also other noninfectious stimuli like the surgical trauma or mechanical ventilation may induce an inflammatory response of varying degree...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28922053/distribution-and-function-of-voltage-gated-sodium-channels-in-the-nervous-system
#7
Jun Wang, Shao-Wu Ou, Yun-Jie Wang
Voltage-gated sodium channels (VGSCs) are the basic ion channels for neuronal excitability, which are crucial for the resting potential and the generation and propagation of action potentials in neurons. To date, at least nine distinct sodium channel isoforms have been detected in the nervous system. Recent studies have identified that voltage-gated sodium channels not only play an essential role in the normal electrophysiological activities of neurons but also have a close relationship with neurological diseases...
September 18, 2017: Channels
https://www.readbyqxmd.com/read/28921700/low-dose-fractionated-irradiation-promotes-axonal-regeneration-beyond-reactive-gliosis-and-facilitates-locomotor-function-recovery-after-spinal-cord-injury-in-beagle-dogs
#8
Qiang Zhang, Ying Xiong, Bo Zhu, Bifeng Zhu, Daishi Tian, Wei Wang
Injury to the adult central nervous system (CNS) results in the formation of glial scar tissues. Glial scar-induced failure of regenerative axon pathfinding may limit axon regrowth beyond the lesion site and cause incorrect reinnervation and dystrophic appearance of stalled growth after CNS trauma. Glial scars also upregulate chondroitin sulfate proteoglycans (CSPGs) and expression of proinflammatory factor(s) that form a barrier to axonal regeneration. Therefore, interventions for glial scarring are an attractive strategy for augmenting axonal sprouting and regeneration and overcoming the physical and molecular barriers impeding functional repair...
September 18, 2017: European Journal of Neuroscience
https://www.readbyqxmd.com/read/28921003/mortality-and-cardiorespiratory-complications-in-trochanteric-femoral-fractures-a-ten-year-retrospective-analysis
#9
Juliane Carow, John Bennet Carow, Mark Coburn, Bong-Sung Kim, Benjamin Bücking, Christopher Bliemel, Leo Cornelius Bollheimer, Cornelius Johannes Werner, Jan Philipp Bach, Matthias Knobe
PURPOSE: Despite intense research and innovations in peri-operative management, a high mortality rate and frequent systemic complications in trochanteric femoral fractures persist. The aim of the present study was to identify predictive factors for mortality and cardio-respiratory complications after different treatment methods in a ten year period at a level I trauma centre. METHODS: Retrospectively, all patients above 60 years of age with trochanteric femoral fracture between January 2000 and May 2011 were analyzed at a level I trauma centre...
September 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28920644/the-future-of-trauma-care-on-capitol-hill-implementing-military-civilian-trauma-care-and-establishing-a-national-trauma-system
#10
Carrie Zlatos, Justin Rosen
No abstract text is available yet for this article.
April 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28920524/remotely-supported-prehospital-ultrasound-a-feasibility-study-of-real-time-image-transmission-and-expert-guidance-to-aid-diagnosis-in-remote-and-rural-communities
#11
Leila Eadie, John Mulhern, Luke Regan, Alasdair Mort, Helen Shannon, Ashish Macaden, Philip Wilson
Introduction Our aim is to expedite prehospital assessment of remote and rural patients using remotely-supported ultrasound and satellite/cellular communications. In this paradigm, paramedics are remotely-supported ultrasound operators, guided by hospital-based specialists, to record images before receiving diagnostic advice. Technology can support users in areas with little access to medical imaging and suboptimal communications coverage by connecting to multiple cellular networks and/or satellites to stream live ultrasound and audio-video...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28920065/the-influence-of-sex-steroid-hormones-on-the-response-to-trauma-and-burn-injury
#12
REVIEW
K Al-Tarrah, N Moiemen, J M Lord
Trauma and related sequelae result in disturbance of homeostatic mechanisms frequently leading to cellular dysfunction and ultimately organ and system failure. Regardless of the type and severity of injury, gender dimorphism in outcomes following trauma have been reported, with females having lower mortality than males, suggesting that sex steroid hormones (SSH) play an important role in the response of body systems to trauma. In addition, several clinical and experimental studies have demonstrated the effects of SSH on the clinical course and outcomes following injury...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28919152/erector-spinae-plane-esp-block-in-the-management-of-post-thoracotomy-pain-syndrome-a-case-series
#13
Mauricio Forero, Manikandan Rajarathinam, Sanjib Adhikary, Ki Jinn Chin
BACKGROUND AND AIMS: Post thoracotomy pain syndrome (PTPS) remains a common complication of thoracic surgery with significant impact on patients' quality of life. Management usually involves a multidisciplinary approach that includes oral and topical analgesics, performing appropriate interventional techniques, and coordinating additional care such as physiotherapy, psychotherapy and rehabilitation. A variety of interventional procedures have been described to treat PTPS that is inadequately managed with systemic or topical analgesics...
September 11, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28919116/global-regional-and-national-age-sex-specific-mortality-for-264-causes-of-death-1980-2016-a-systematic-analysis-for-the-global-burden-of-disease-study-2016
#14
(no author information available yet)
BACKGROUND: Monitoring levels and trends in premature mortality is crucial to understanding how societies can address prominent sources of early death. The Global Burden of Disease 2016 Study (GBD 2016) provides a comprehensive assessment of cause-specific mortality for 264 causes in 195 locations from 1980 to 2016. This assessment includes evaluation of the expected epidemiological transition with changes in development and where local patterns deviate from these trends. METHODS: We estimated cause-specific deaths and years of life lost (YLLs) by age, sex, geography, and year...
September 16, 2017: Lancet
https://www.readbyqxmd.com/read/28919014/regulation-and-function-of-endothelial-glycocalyx-layer-in-vascular-diseases
#15
REVIEW
Irina Sieve, Anja Münster-Kühnel, Denise Hilfiker-Kleiner
In the vascular system, the endothelial surface layer (ESL) as the inner surface of blood vessels affects mechanotransduction, vascular permeability, rheology, thrombogenesis, and leukocyte adhesion. It creates barriers between endothelial cells and blood and neighbouring cells. The glycocalyx, composed of glycoconjugates and proteoglycans, is an integral component of the ESL and a key element in inter- and intracellular communication and tissue homeostasis. In pathophysiological conditions (atherosclerosis, infection, ischemia/reperfusion injury, diabetes, trauma and acute lung injury) glycocalyx-degrading factors, i...
September 12, 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28918934/reconstructive-microsurgical-approach-for-the-treatment-of-pyoderma-gangrenosum
#16
Karl Schwaiger, Elisabeth Russe, Hassan Kholosy, Michaela Hladik, Klemens Heinrich, Laurenz Weitgasser, Thomas Schoeller, Gottfried Wechselberger
INTRODUCTION: Pyoderma gangrenosum (PG) is a rare type of autoimmune disease that results in progressive ulcers with or without previous trauma. However, PG is not well understood to date, and its treatment therefore remains a challenge. Because of the disease's systemic characteristic and the unpredictability of the clinical course, no gold standard treatment is available, especially concerning the surgical procedures to treat pyodermic lesions. Often, PG is not recognized during routine clinical practice, and standard ulcer treatment (conservative wound care, debridement, skin grafting, and local flap coverage) is initiated; this induces an autoinflammatory response, resulting in disastrous ulcers, thereby making free flap coverage necessary...
August 16, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28918344/accesses-for-alcohol-intoxication-to-the-emergency-department-and-the-risk-of-re-hospitalization-an-observational-retrospective-study
#17
Maurizio Baldassarre, Fabio Caputo, Raimondo Maria Pavarin, Matteo Massimo Bossi, Maria Elena Bonavita, Paolo Caraceni, Alice Grignaschi, Mimosa Balloni, Mario Cavazza, Mauro Bernardi, Marco Domenicali
BACKGROUND: Alcohol use disorders (AUD) are a frequent cause of admission to emergency departments (EDs) for acute alcohol intoxication (AAI). Patients with AUD present a higher risk of readmission to EDs for AAI than the general population, however, the distinction between sporadic AAI and AAI in the context of AUD in the ED setting is difficult. AIMS: To analyze the epidemiological characteristics of patients admitted to EDs because of AAI and to identify factors associated with repeated admissions in order to develop a risk stratification system for patients with AUD based on objective data that can be easily applied in an ED setting...
September 1, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28915217/estradiol-modulates-local-gut-injury-induced-by-intestinal-ischemia-reperfusion-in-male-rats
#18
Fernanda Yamamoto Ricardo-da-Silva, Evelyn Thaís Fantozzi, Sara Rodrigues-Garbin, Ricardo Martins Oliveira-Filho, Bernardo Boris Vargaftig, Ana Cristina Breithaupt-Faloppa, Wothan Tavares de Lima
Intestinal ischemia and reperfusion (I/R) triggers a systemic inflammatory response characterized by leukocyte mobilization from the bone marrow, release of cytokines to the circulation, and increased microvascular permeability, leading to high mortality. Females have shown attenuated inflammatory response to trauma when compared with males, indicating a role for female sex hormones in this process. Here, we have evaluated the effect of estradiol on the local gut injury induced by I/R in male rats. I/R was induced by the clamping of the superior mesenteric artery for 45 min, followed by 2 h of reperfusion...
October 2017: Shock
https://www.readbyqxmd.com/read/28915215/mechanisms-involved-in-secondary-cardiac-dysfunction-in-animal-models-of-trauma-and-hemorrhagic-shock
#19
Nick M Wilson, Johanna Wall, Veena Naganathar, Karim Brohi, Henry D De'Ath
Clinical evidence reveals the existence of a trauma-induced secondary cardiac injury (TISCI) that is associated with poor patient outcomes. The mechanisms leading to TISCI in injured patients are uncertain. Conversely, animal models of trauma hemorrhage have repeatedly demonstrated significant cardiac dysfunction following injury, and highlighted mechanisms through which this might occur. The aim of this review was to provide an overview of the animal studies describing TISCI and its pathophysiology.Basic science models of trauma show evidence of innate immune system activation via Toll-like receptors, the exact protagonists of which remain unclear...
October 2017: Shock
https://www.readbyqxmd.com/read/28914355/nasal-injury-and-comfort-with-jet-versus-bubble-continuous-positive-airway-pressure-delivery-systems-in-preterm-infants-with-respiratory-distress
#20
Jafar Khan, Venkataseshan Sundaram, Srinivas Murki, Anuj Bhatti, Shiv Sajan Saini, Praveen Kumar
Nasal injuries with use of nasal continuous positive airway pressure (CPAP) range from blanching of nasal tip to septal necrosis and septal drop. This analysis was done in preterm neonates of < 34-week gestation, who received nasal CPAP as primary support as part of a randomized trial comparing Jet device with Bubble device for delivery of CPAP, both through nasal prongs of different structure, make and fixation methods. Nasal injury was assessed using a validated nasal injury score. Out of 170 neonates enrolled, 103 (61%) had nasal injuries; moderate and severe injuries were observed in 18 (11%) and 8 (5%) infants, respectively...
September 15, 2017: European Journal of Pediatrics
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