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Trauma And Anesthesia

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https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#1
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28500499/-anesthesiological-care-of-trauma-patients-in-orthogeriatric-co-management
#2
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/28499298/-cochlear-implant-state-of-the-art
#3
Thomas Lenarz
Cochlear implants are the treatment of choice for the auditory rehabilitation of patients with sensory deafness. They restore the missing function of inner hair cells by transforming the acoustic signal into electrical stimuli for activation of auditory nerve fibers. Due to the very fast technology development cochlear implants provide open-set speech understanding in the majority of patients including the use of the telephone. Children can achieve a near to normal speech and language development provided their deafness is detected early after onset and implantation is performed quickly thereafter...
April 2017: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/28494884/less-postoperative-sore-throat-after-nasotracheal-intubation-using-a-fiberoptic-bronchoscope-than-using-a-macintosh-laryngoscope-a-double-blind-randomized-controlled-study
#4
Nobuko Tachibana, Yukitoshi Niiyama, Michiaki Yamakage
STUDY OBJECTIVE: To evaluate whether nasotracheal intubation using a fiberoptic bronchoscope reduces postoperative sore throat. DESIGN: Prospective, double-blinded, randomized, and controlled study. SETTING: Postoperative areas and surgical ward of a university hospital. PATIENTS: Seventy-four patients with American Society of Anesthesiologists physical status I-II who were scheduled for elective general anesthesia requiring nasotracheal intubation...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28486318/asking-a-better-question-development-and-evaluation-of-the-need-for-trauma-intervention-nfti-metric-as-a-novel-indicator-of-major-trauma
#5
Jacob W Roden-Foreman, Nakia R Rapier, Luanna Yelverton, Michael L Foreman
Many existing metrics, such as Injury Severity Score (ISS), cannot fully describe many trauma patients because of comorbidities. This study developed and evaluated the Need For Trauma Intervention (NFTI) metric as a novel indicator of major trauma. The NFTI metric was developed from an analysis of 2,396 trauma patients at a Level I trauma center. Six commonly recorded registry variables were found to be indicative of major trauma and comprised the NFTI criteria: receiving packed red blood cells within 4 hr; discharge from the emergency department (ED) to the operating room within 90 min; discharge from the ED to interventional radiology; discharge from the ED to the intensive care unit (ICU) with an ICU length of stay (LOS) of 3 or more days; mechanical ventilation outside of procedural anesthesia within 3 days; or death within 60 hr...
May 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28452901/effect-of-pain-and-analgesia-on-compensatory-reserve
#6
Carmen Hinojosa-Laborde, Jessie Renee D Fernandez, Gary W Muniz, Corinne D Nawn, Rebecca K Burns, Thuan H Le, Kathy B Porter, John T Hardy, Victor A Convertino
BACKGROUND: The measurement of the body's capacity to compensate for reduced blood volume can be assessed with a Compensatory Reserve Measurement (CRM). The CRM, which is calculated from changes in features of the arterial waveform, represents the integration of compensatory mechanisms during states of low tissue perfusion and oxygenation such as hemorrhage. This study was designed to test the hypothesis that pain which activates compensatory mechanisms and analgesia that result in reduced blood pressure are associated with lower compensatory reserve...
April 27, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28447275/risk-factors-for-shoulder-dystocia-the-impact-of-mother-s-race-and-ethnicity
#7
Jennifer Gaudet Hefele, Palmira Santos, Grant Ritter, Neha Varma, Ann Hendrich
Shoulder dystocia is a rare but severe birth trauma where the neonate's shoulders fail to deliver after delivery of the head. Failure to deliver the shoulders quickly can lead to severe, long-term injury to the infant, including nerve injury, skeletal fractures, and potentially death. This observational study examined shoulder dystocia risk factors by race and ethnicity using a sample of 19,236 pregnant women who presented for labor and delivery from July 1, 2010 until June 30, 2013 at five locations. Multivariate analyses were used to identify risk factors associated with shoulder dystocia occurrence in racial/ethnic groups with high incidence rates...
April 26, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28416832/-minimally-invasive-plate-osteosynthesis-for-treatment-of-proximal-humeral-fractures-through-anterolateral-acromial-approach
#8
Q Zhang, N Sun, Q Huang, S W Zhu
OBJECTIVE: To investigate the feasibility, surgical technique and effect of osteosynthesis for proximal humerus fractures through the minimal incision anterolateral acromion. METHODS: In this study, 32 patients of proximal humeral fractures were selected and treated through the minimal incision antero-lateral acromion between January 2012 and October 2014. Of these patients, there were 19 males and 13 females, with mean age 46 years old (range: 22-78 years). The mechanism of injury was a trauma of simple fall for 21 patients and motor vehicle accident for 11 patients...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28414275/a-new-hypothesis-on-the-frequency-discrimination-of-the-cochlea
#9
Erdoğan Bulut, Cem Uzun, Levent Öztürk, Pınar Turan, Mehmet Kanter, Serap Arbak
OBJECTIVE: Medial olivocochlear efferent (MOCE) neurons innervate outer hair cells (OHCs) of the cochlea, which in turn leads to basilar membrane motion. We hypothesized that MOCE-induced alterations in basilar membrane motion, independent of traveling waves, is responsible for the cochlear frequency discrimination of sound. MATERIALS AND METHODS: Eleven guinea pigs underwent bilateral otoscopic and audiologic evaluations under general anesthesia. The study comprised two parts...
April 17, 2017: Journal of International Advanced Otology
https://www.readbyqxmd.com/read/28413552/trigeminocardiac-reflex-preceding-development-of-postoperative-superior-orbital-fissure-syndrome
#10
Rudrashish Haldar, Prakhar Gyanesh, Arun Srivastava, Guru Prasad Bettaswamy
The superior orbital fissure syndrome (SOFS) is a rare condition presenting as painful unilateral opthalmoplegia, ptosis, pupillary dilatation and anesthesia of the upper eyelid and forehead. It has been described after facial trauma. Other etiologies include infections, tumors or spontaneous hemorrhages in the retro-orbital space. Occurrence of SOFS after surgery in the skull base has not been described before. We recently encountered a case where a young female developed SOFS following surgery for cerebrospinal fluid (CSF) rhinorrhea...
January 2017: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/28400682/unplanned-intensive-care-unit-admission-following-elective-surgical-adverse-events-incidence-patient-characteristics-preventability-and-outcome
#11
Mohammed Meziane, Sidi Driss El Jaouhari, Abdelghafour ElKoundi, Mustapha Bensghir, Hicham Baba, Redouane Ahtil, Khalil Aboulaala, Hicham Balkhi, Charki Haimeur
CONTEXT: Adverse events (AEs) are a persistent and an important reason for Intensive Care Unit (ICU) admission. They lead to death, disability at the time of discharge, unplanned ICU admission (UIA), and prolonged hospital stay. They impose large financial costs on health-care systems. AIMS: This study aimed to determine the incidence, patient characteristics, type, preventability, and outcome of UIA following elective surgical AE. SETTINGS AND DESIGN: This is a single-center prospective study...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28400499/the-coherence-of-macrocirculation-microcirculation-and-tissue-metabolic-response-during-nontraumatic-hemorrhagic-shock-in-swine
#12
Halvor Langeland, Oddveig Lyng, Petter Aadahl, Nils-Kristian Skjærvold
Hemorrhagic shock is clinically observed as changes in macrocirculatory indices, while its main pathological constituent is cellular asphyxia due to microcirculatory alterations. The coherence between macro- and microcirculatory changes in different shock states has been questioned. This also applies to the hemorrhagic shock. Most studies, as well as clinical situations, of hemorrhagic shock include a "second hit" by tissue trauma. It is therefore unclear to what extent the hemorrhage itself contributes to this lack of circulatory coherence...
April 2017: Physiological Reports
https://www.readbyqxmd.com/read/28387890/effects-of-propofol-and-dexmedetomidine-anesthesia-on-th1-th2-of-rat-spinal-cord-injury
#13
F-Y He, W-Z Feng, J Zhong, W Xu, H-Y Shao, Y-R Zhang
OBJECTIVE: Spinal cord injury (SCI) patients had major trauma during surgery, which thus necessitates optimal choice of anesthesia drugs. The specific selection of anesthesia agents may affect body immune system. Therefore, this study aims to investigate the anesthesia effect of propofol and dexmedetomidine on the rat SCI and their effects of Th1/Th2. MATERIALS AND METHODS: Improved ALLEN's pouching method was used to generate rat SCI model. The SCI rat models were further divided into propofol and dexmedetomidine group for analyzing anesthesia time, duration, post-op analgesia time, SCI sensory function Reuter score...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28383154/the-forensic-implications-of-amphetamine-intoxication-in-cases-of-inflicted-blunt-craniocerebral-trauma
#14
Roger W Byard, James Donkin, Robert Vink
The effects of D-amphetamine on outcome after blunt craniocerebral trauma are characterized and the potential legal implications discussed. Traumatic brain injury (TBI) was induced under general anesthesia in adult, male Sprague Dawley rats using the impact acceleration model. At 10 min prior to injury, D-amphetamine (5 mg/kg) or saline vehicle was administered subcutaneously; animals were subsequently assessed over a 7-day period post-trauma for motor outcome using a rotarod device. D-amphetamine treated animals performed significantly better (p < 0...
April 6, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28362683/thrombin-generation-profiles-as-predictors-of-symptomatic-venous-thromboembolism-after-trauma-a-prospective-cohort-study
#15
Myung S Park, Grant M Spears, Kent R Bailey, Ailing Xue, Michael J Ferrara, Amy Headlee, Sabtir K Dhillon, Donald H Jenkins, Scott P Zietlow, William S Harmsen, Aneel A Ashrani, John A Heit
BACKGROUND: Reliable biomarkers predictive of venous thromboembolism (VTE) after acute trauma are uncertain. The objective of the study was to identify risk factors for symptomatic VTE after trauma, including individual plasma coagulome characteristics as reflected by thrombin generation. METHODS: In a prospective, case-cohort study, trauma patients were enrolled over the 4.5 year period, 2011-2015. Blood was collected by venipuncture into 3.2% trisodium citrate at 0, 6, 12, 24 and 72 hours after injury, and at hospital discharge...
March 30, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28359172/efficacy-of-a-new-device-to-optimize-positive-pressure-ventilation-via-face-mask-in-edentulous-patients-a-randomized-trial
#16
Maria C Niño, Andres Pauwels, Fernando Raffan, Enrique Arango, David J Romero, Daniel Benitez
BACKGROUND: Mask ventilation is routinely performed during anesthesia. Under some circumstances, it might be difficult to perform, such as in edentulous patients, due to inadequate mask seal. We developed a new device called NIPARA and studied its use For ventilation optimization in edentulous patients. METHODS: This randomized controlled trial included edentulous adults who had no other predictors of difficult airway, scheduled to undergo general anesthesia. Patients were assigned either to the NIPARA device group or to the control group (oral airway only)...
April 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28341070/severe-hand-injuries-from-fireworks-%C3%A2-injury-patterns-%C3%A2-outcomes-and-fireworks-types
#17
Brinkley K Sandvall, Kari A Keys, Jeffrey B Friedrich
PURPOSE: The purpose of this study was to characterize injury patterns and outcomes of fireworks-related hand injuries and determine if there was an association with certain fireworks types. METHODS: A retrospective cohort study was conducted on patients treated at a trauma center between 2005 and 2015. A total of 105 patients sustaining operative hand injuries due to fireworks were identified. Medical records were reviewed to identify injury patterns, treatment outcomes, and fireworks types...
May 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28330928/surgery-for-cancer-a-trigger-for-metastases
#18
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...
April 1, 2017: Cancer Research
https://www.readbyqxmd.com/read/28328609/evaluation-of-dentoalveolar-trauma-in-children-and-adolescents-a-modified-classification-system-and-surgical-treatment-strategies-for-its-management
#19
Nadia Theologie-Lygidakis, Ourania K Schoinohoriti, Minas Leventis, Ioannis Iatrou
OBJECTIVE: To retrospectively analyze dentoalveolar trauma in pediatric patients, propose a modified classification, and delineate an approach for its urgent care from the surgeon's perspective. PATIENTS AND METHODS: Clinical records of patients, attended at the 'A. and P. Kyriakou' Children's Hospital Department of Oral and Maxillofacial Surgery from 2000 to 2015, were retrieved and data were analyzed. RESULTS: A total of 365 cases of dentoalveolar trauma, affecting 363 children and adolescents (221 males and 142 females), with an age range from 1 to 15 years, were treated in the authors' department...
March 21, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28306679/the-american-college-of-surgeons-children-s-surgery-verification-and-quality-improvement-program-implications-for-anesthesiologists
#20
Constance S Houck, Jayant K Deshpande, Randall P Flick
PURPOSE OF REVIEW: The Task Force for Children's Surgical Care, an ad-hoc multidisciplinary group of invited leaders in pediatric perioperative medicine, was assembled in May 2012 to consider approaches to optimize delivery of children's surgical care in today's competitive national healthcare environment. Over the subsequent 3 years, with support from the American College of Surgeons (ACS) and Children's Hospital Association (CHA), the group established principles regarding perioperative resource standards, quality improvement and safety processes, data collection, and verification that were used to develop an ACS-sponsored Children's Surgery Verification and Quality Improvement Program (ACS CSV)...
June 2017: Current Opinion in Anaesthesiology
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