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Trauma Medicine

William Peacock
Dear Editor I read with great interest the manuscript titled "A New Panel of Blood Biomarkers for the Diagnosis of Mild Traumatic Brain Injury/Concussion in Adults" by Shan R, et al, published in the January issue of the Journal. (1) I do have some questions. The key to marker discovery studies is a precise and accurate description of how the population was identified, including controls. I have significant concerns about the control population in the manuscript. In the presentation the characteristics of the control group are unclear, described only as "not patients in the ED" and with the same exclusion criteria of the other cohorts...
October 18, 2016: Journal of Neurotrauma
Julia Schellong, Franziska Epple, Kerstin Weidner, Andrea Möllering
A non-neglectable portion of people that have fled to Germany have been subjected to expulsion, violence, torture and grave human loss. In some of them, signs of secondary mental problems are obvious. In the light of the efforts at integration, these diseases must not be neglected. Outlined are the federal legal requirements and how the cost coverage, as well as the admission to health care system, is structured. Additionally, 2 exemplary regional models for psychosomatic health care are being introduced: Dresden's "Stepped Care Model for Psychologically Vulnerable Refugees" includes phased offers for prevention and treatment of acute mental crises, as well as somatoform disorders in refugees and their volunteer helpers...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Noor-Ahmad Latifi, Hamid Karimi
BACKGROUND: Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital. MATERIALS AND METHODS: For 2 years, we prospectively surveyed the burn patients referred to a tertiary teaching burn hospital. Data for the following variables were collected and analyzed with SPSS software V21.0: causes of burn; age; gender; total body surface area (TBSA) measured at the referring center; TBSA measured at the receiving center; concomitant diseases and traumas; the reason for referral; condition of patients before and during the transportation; transportation time; presence of infection; presence of inhalation injury, electrical injury, and chemical injury; child abuse; insurance coverage; and results and outcomes of patients...
October 12, 2016: Burns: Journal of the International Society for Burn Injuries
Lori A Stolz, Uwe Stolz, J Matthew Fields, Turandot Saul, Michael Secko, Matthew J Flannigan, Johnathan M Sheele, Robert P Rifenburg, Anthony J Weekes, Elaine B Josephson, John Bedolla, Dana M Resop, Jonathan Dela Cruz, Megan Boysen-Osborn, Terrell Caffery, Charlotte Derr, Rimon Bengiamin, Gerardo Chiricolo, Brandon Backlund, Jagdipak Heer, Robert J Hyde, Srikar Adhikari
OBJECTIVES: Emergency ultrasound (EUS) has been recognized as integral to the training and practice of emergency medicine (EM). The Council of Emergency Medicine Residency-Academy of Emergency Ultrasound (CORD-AEUS) consensus document provides guidelines for resident assessment and progression. The Accredited Council for Graduate Medical Education (ACGME) has adopted the EM Milestones for assessment of residents' progress during their residency training which includes demonstration of procedural competency in bedside ultrasound...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Joel M Fahling, L Kendall McKenzie
BACKGROUND: The oculocardiac reflex is a decrease in heart rate caused by ocular compression or traction upon the extraocular musculature. Multiple instances of this phenomenon have been described in anesthesia, trauma, craniofacial, and ophthalmology literature, but there is a sparsity of documentation in the emergency medicine literature. CASE REPORT: We describe the observation and management of the oculocardiac reflex in a 26-year-old man with retrobulbar hematoma and intraocular trauma caused by a self-inflicted gunshot wound...
October 8, 2016: Journal of Emergency Medicine
Nils Kunze-Szikszay, Lennart A Krack, Pauline Wildenauer, Saskia Wand, Tim Heyne, Karoline Walliser, Christopher Spering, Martin Bauer, Michael Quintel, Markus Roessler
BACKGROUND: Hyperfibrinolysis (HF) is a major contributor to coagulopathy and mortality in trauma patients. This study investigated (i) the rate of HF during the pre-hospital management of patients with multiple injuries and (ii) the effects of pre-hospital tranexamic acid (TxA) administration on the coagulation system. METHODS: From 27 trauma patients with pre-hospital an estimated injury severity score (ISS) ≥16 points blood was obtained at the scene and on admission to the emergency department (ED)...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Bonnie L Green, Pamela A Saunders, Elizabeth Power, Priscilla Dass-Brailsford, Kavitha Bhat Schelbert, Esther Giller, Larry Wissow, Alejandra Hurtado de Mendoza, Mihriye Mete
Trauma exposure predicts mental disorders and health outcomes; yet there is little training of primary care providers about trauma's effects, and how to better interact with trauma survivors. This study adapted a theory-based approach to working with trauma survivors, Risking Connection, into a 6-hour CME course, Trauma-Informed Medical Care (TI-Med), to evaluate its feasibility and preliminary efficacy. We randomized four primary care sites to training or wait-list conditions; PCPs at wait-list sites were trained after reassessment...
2016: Journal of Loss & Trauma
Gabriela Kopacheva-Barsova, Slavica Arsova
AIM: To prevent and to treat nasal trauma in children properly, because it can lead to displacement or depression of the nasal bones or septum. Second, our aim was, for the patient to recognise and create a mature decision for eventual nose changes which will be made with the operative intervention or they are not mature enough and the decisions were made by their parents. MATERIAL AND METHODS: Our retrospective study was made at University Clinic for Ear, Nose and Throat, Faculty of Medicine, Ss Cyril and Methodius University of Skopje in the period of 6 years (2005-2016)...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Gabriela Kopacheva-Barsova, Nikola Nikolovski
BACKGROUND: Nasal septal surgery and rhinoplasty are controversial in children. Traditionally, an attitude of restraint has been employed by most surgeons till an empirical age of 16 to 18 years. This is to avoid the possible adverse effects that the growth spurts may have on the nose and midface region. AIM: The aim of this paper was to present the results of rhinoplasty in children in order to restore the anatomy and function or to promote normal development and outgrowth of the nose...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
M Schiavon, M Francescon, D Drigo, G Salloum, R Baraziol, J Tesei, E Fraccalanza, F Barbone
BACKGROUND: INTEGRA(®) Dermal Regeneration Template is a well-known and widely used acellular dermal matrix. Although it helps to solve many challenging problems in reconstructive surgery, the product cost may make it an expensive alternative compared to other reconstruction procedures. This retrospective study aims at comparing INTEGRA-based treatment to flap surgery in terms of cost and benefit. PATIENTS AND METHODS: We considered only patients treated for scalp defects with bone exposure in order to obtain two groups as homogeneous as possible...
October 3, 2016: Aesthetic Plastic Surgery
O G Davies, L M Grover, M P Lewis, Y Liu
Heterotopic ossification (HO) is a debilitating condition defined by the rapid formation of bone in soft tissues. What makes HO fascinating is firstly the rate at which bone is deposited, and secondly the fact that this bone is structurally and compositionally similar to that of a healthy adult. If the mechanisms governing HO are understood, they have the potential to be exploited for the development of potent osteoinductive therapies. With this aim, we utilised a tissue engineered skeletal muscle model to better understand the role of inflammation on this debilitating phenomenon...
October 3, 2016: Journal of Tissue Engineering and Regenerative Medicine
Juan Antonio Llompart-Pou, Mario Chico-Fernández, Marcelino Sánchez-Casado, Fermín Alberdi-Odriozola, Francisco Guerrero-López, María Dolores Mayor-García, Javier González-Robledo, María Ángeles Ballesteros-Sanz, Rubén Herrán-Monge, Rafael León-López, Lucía López-Amor, Ana Bueno-González
BACKGROUND: Injury patterns may differ in trauma patients when age is considered. This information is relevant in the management of trauma patients and for planning preventive measures. METHODS: We included in the study all patients admitted for traumatic disease in the participating ICUs from November 23(rd), 2012 to July 31(st), 2015 with complete records. Data on epidemiology, injury patterns, severity scores, acute management, resources utilisation and outcome were recorded and compared in the following groups of age: ≤55years (young adults), 56-65 years (adults), 66-75 years (elderly), >75years (very elderly)...
September 2016: Injury
M Garetier, L Deloire, F Dédouit, E Dumousset, C Saccardy, D Ben Salem
Suicide is the eighth cause of mortality in France and the leading cause in people aged between 25 and 34 years. The most common methods of suicide are hanging, self-poisoning with medicines and firearms. Postmortem computed tomography (CT) is a useful adjunct to autopsy to confirm suicide and exclude other causes of death. At autopsy, fractures of the hyoid bone or thyroid cartilage, or both, are found in more than 50% of suicidal hangings. Cervical vertebra fractures are rare and only seen in suicide victims jumping from a great height...
September 26, 2016: Diagnostic and Interventional Imaging
C X Hua, Y F Cui
Due to the large surgical trauma and postoperative complications, the perioperative management of pancreaticoduodenectomy has been one of the urgent problems to be solved by the surgeons. With the development of modern medicine, enhanced recovery after surgery (ERAS) comes into being, basing on anti-stress mechanism and multi-disciplinary team, and the perioperative management of pancreaticoduodenectomy has been optimized and improved continuously. The surgeons through a range of measures that had evidence-based medicine basis to mitigate the extent of surgical trauma stress, reduce the incidence of postoperative complications, shorten patient recovery time previously healthy state, and achieve maximize benefit for patients...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Shayna Sarosiek, Denis Rybin, Janice Weinberg, Peter A Burke, George Kasotakis, J Mark Sloan
Importance: Trauma patients admitted to the hospital are at increased risk of bleeding and thrombosis. The use of inferior vena cava (IVC) filters in this population has been increasing, despite a lack of high-quality evidence to demonstrate their efficacy. Objective: To determine if IVC filter insertion in trauma patients affects overall mortality. Design, Setting, and Participants: This retrospective cohort study used stratified 3:1 propensity matching to select a control population similar to patients who underwent IVC filter insertion at Boston Medical Center (a level I trauma center at Boston University School of Medicine) between August 1, 2003, and December 31, 2012...
September 28, 2016: JAMA Surgery
Jennifer M Sabino, Julia Slater, Ian L Valerio
Scope and Significance: Reconstruction of traumatic injuries requiring tissue transfer begins with aggressive resuscitation and stabilization. Systematic advances in acute casualty care at the point of injury have improved survival and allowed for increasingly complex treatment before definitive reconstruction at tertiary medical facilities outside the combat zone. As a result, the complexity of the limb salvage algorithm has increased over 14 years of combat activities in Iraq and Afghanistan. Problem: Severe poly-extremity trauma in combat casualties has led to a large number of extremity salvage cases...
September 1, 2016: Advances in Wound Care
Khawla Achour, Eya Mersni, Bassem Krifa, Emna Bahlouli, Sonia Lebib, Catherine Dziri
OBJECTIVE: The aim of this work is to determine the epidemiological and characteristics and the therapeutic modalities of heterotopic ossification in brain injury. MATERIAL/PATIENTS AND METHODS: Retrospective study conducted between January 2010 and January 2016, including patients hospitalized for management of sequelae of an isolated head injury or associated with multiple trauma, and in whom the diagnosis of of heterotopic ossification (HO) was increased. A review of epidemiological data (including age, sex, occupation, type of neurological injury, discovering circumstances of HO), clinical data, the therapeutic choice and evolutivity...
September 2016: Annals of Physical and Rehabilitation Medicine
Sana Salah, Houda Migaou, Zied Belaaj, Soumaya Boudokhane, Anis Jellad, Abderrazak Abid, Zohra Ben Salah Frih
OBJECTIVE: Winging of the scapula has a variety of causes and a variable prognosis. It contributes to a disruption of the scapulohumeral rhythm with a decreased flexion and abduction of the upper extremity and a source of a considerable pain. This condition can affect the ability to perform activities of daily living. The most common cause of scapula winging is serratus anterior paralysis resulting from a lesion of the long thoracic nerve. The rupture of the muscle itself remains uncommon...
September 2016: Annals of Physical and Rehabilitation Medicine
Richard J Miron, Masako Fujioka-Kobayashi, Mark Bishara, Yufeng Zhang, Maria Hernandez, Joseph Choukroun
The growing multidisciplinary field of tissue engineering aims at predictably regenerating, enhancing, or replacing damaged or missing tissues for a variety of conditions caused by trauma, disease, and old age. One area of research that has gained tremendous awareness in recent years is that of platelet-rich fibrin (PRF), which has been utilized across a wide variety of medical fields for the regeneration of soft tissues. This systematic review gathered all the currently available in vitro, in vivo, and clinical literature utilizing PRF for soft tissue regeneration, augmentation, and/or wound healing...
October 10, 2016: Tissue Engineering. Part B, Reviews
Paul T Engels, Mete Erdogan, Sandy L Widder, Michael B Butler, Nelofar Kureshi, Kate Martin, Robert S Green
BACKGROUND: Although used primarily in the pediatric population for decades, the use of intraosseous (IO) devices in the resuscitation of severely injured adult trauma patients has recently become more commonplace. The objective of this study was to determine the experience level, beliefs and attitudes of trauma practitioners in Canada, Australia and New Zealand regarding the use of IO devices in adult trauma patients. METHODS: We administered a web-based survey to all members of 4 national trauma and emergency medicine organizations in Canada, Australia and New Zealand...
October 1, 2016: Canadian Journal of Surgery. Journal Canadien de Chirurgie
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