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Trauma in elderly

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https://www.readbyqxmd.com/read/28716132/a-patient-safety-and-professional-perspective-on-non-conveyance-in-ambulance-care-a-systematic-review
#1
REVIEW
Remco H A Ebben, Lilian C M Vloet, Renate F Speijers, Nico W Tönjes, Jorik Loef, Thomas Pelgrim, Margreet Hoogeveen, Sivera A A Berben
BACKGROUND: This systematic review aimed to describe non-conveyance in ambulance care from patient-safety and ambulance professional perspectives. The review specifically focussed at describing (1) ambulance non-conveyance rates, (2) characteristics of non-conveyed patients, (3) follow-up care after non-conveyance, (4) existing guidelines or protocols, and (5) influencing factors during the non-conveyance decision making process. METHODS: We systematically searched MEDLINE, PubMed, CINAHL, EMBASE, and reference lists of included articles, in June 2016...
July 17, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28711594/hepatic-mitochondrial-bioenergetics-in-aged-c57bl-6-mice-exhibit-delayed-recovery-from-severe-burn-injury
#2
Christopher Auger, Thibacg Sivayoganathan, Abdikarim Abdullahi, Alexandra Parousis, Marc G Jeschke
Severe burn injuries initiate a cascade of downstream events, culminating in multiple organ dysfunction, sepsis, and even death. The elderly are in particular vulnerable to such outcomes, due primarily to a scarcity of knowledge on trauma progression at the biomolecular level in this population. Mitochondria, the cellular powerhouses, have been increasingly scrutinized recently for their contribution to trauma outcomes. We hypothesized that elderly have a worse outcome compared to adult patients due to failed recovery of hepatic mitochondria...
July 12, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28706764/neuroradiological-endovascular-intervention-for-diplopia-in-a-case-of-aneurysmal-aberrant-regeneration-of-the-third-nerve
#3
Anupam C A Rao, Saumil A Shah, Benjamin W C Sim, Steven T H Yun, Neeranjali S Jain, Yashar Kalani, Ian C Francis
Aberrant regeneration of the third nerve occurs as a result of synkinetic 'miswiring' of the third nerve following its injury, such as in third cranial nerve palsy due to tumor, trauma, or aneurysm. The case presented is an elderly woman with new vertical diplopia, which led to a diagnosis of a third cranial nerve palsy, thought to be caused by a 5 mm blister aneurysm of the posterior communicating artery. However, neuro-ophthalmological evaluation diagnosed aberrant regeneration of the third nerve, with the cause of her new vertical diplopia being an ipsilateral fourth nerve palsy...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28706089/evaluation-of-the-geriatric-co-management-for-patients-with-fragility-fractures-of-the-proximal-femur-geriatric-fracture-centre-gfc-concept-protocol-for-a-prospective-multicentre-cohort-study
#4
Alexander Joeris, Anahí Hurtado-Chong, Denise Hess, Vasiliki Kalampoki, Michael Blauth
INTRODUCTION: Treatment of fractures in the elderly population is a clinical challenge due partly to the presence of comorbidities. In a Geriatric Fracture Centre (GFC), patients are co-managed by a geriatrician in an attempt to improve clinical outcomes and reduce morbidity and mortality. Until now the beneficial effect of orthogeriatric co-management has not been definitively proven. The primary objective of this study is to determine the effect of GFC on predefined major adverse events related to a hip fracture compared to usual care centres (UCC)...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28704554/trends-in-the-incidence-and-outcomes-of-bicycle-related-injury-in-the-emergency-department-a-nationwide-population-based-study-in-south-korea-2012-2014
#5
Youn-Jung Kim, Dong-Woo Seo, Jae-Ho Lee, Yoon-Seon Lee, Bum-Jin Oh, Kyoung-Soo Lim, Won Young Kim
OBJECTIVE: This study aimed to examine trends in the incidence and outcomes of bicycle-related injuries in emergency departments (ED) in South Korea. METHODS: We analysed data from the National Emergency Department Information System database for adult patients (≥20 years) with bicycle-related injuries presenting to EDs in South Korea between January 2012 and December 2014. Riders and bicycle passengers whose injuries were associated with bicycle use were included...
2017: PloS One
https://www.readbyqxmd.com/read/28702399/bilateral-simultaneous-neck-femur-fracture-following-domestic-fall-in-an-elderly-patient-a-rare-case-report
#6
Mayank Vijayvargiya, Vivek Shetty, Kiran Makwana, Nitesh Agarwal
Simultaneous bilateral neck femur fracture is a rare entity that has been associated with underlying bone disease, various metabolic diseases, high-energy trauma, and seizure disorders. Its occurrence following minimal trauma is very rare. This article presents the case of a 66-year-old female who sustained bilateral intracapsular fracture neck femur following a slip and fall at home. Single-stage bilateral cemented total hip replacement was done using a direct lateral approach with alternate right and left lateral positions...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28702382/epidemiology-of-pelvic-ring-fractures-and-injuries
#7
Gilberto José Cação Pereira, Erick Ribeiro Damasceno, Daniel Innocenti Dinhane, Francisco Marques Bueno, Jaqueline Bartelega Rodrigues Leite, Bruno da Costa Ancheschi
OBJECTIVE: This study evaluated the pelvic ring fractures and injuries in patients admitted to and treated at this ward between August, 2012 and January, 2014. METHODS: 66 patients were submitted to treatment protocols according to their age, gender, skin color, injury mechanism, location of the trauma, classification of their injuries, emergency intervention, associated injuries, injured side of the body, treatment, and mortality. The most relevant data were classified according to statistic procedures, such as Goodman's association test...
May 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28697401/fatigue-failure-of-plated-osteoporotic-proximal-humerus-fractures-is-predicted-by-the-strain-around-the-proximal-screws
#8
Peter Varga, Leonard Grünwald, Jason A Inzana, Markus Windolf
The high rate of required reoperation indicates that treatment of fragility fractures at the proximal humerus still remains a major challenge in trauma surgery. Improved fixation approaches are needed. Several limitations of the conventional implant development process involving experimental testing could be overcome by using computer models that would allow systematic and efficient analyses. However, such models require experimental validation. This study investigated if linear elastic continuum finite element (FE) models can predict experimental fatigue failure in locking plate fixation of osteoporotic proximal humerus fractures...
July 4, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28694618/single-parietal-burr-hole-craniostomy-with-irrigation-and-drainage-for-unilateral-chronic-subdural-hematoma-in-young-adults-40-years-a-rationale-behind-the-procedure
#9
Raj S Chandran, Milesh Nagar, M S Sharmad, Rajmohan B Prabhakar, Anil K Peethambaran, Shailesh Kumar, Saurabh Sharma, Sourabh K Jain
BACKGROUND: Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. It is mostly a disease of elderly population with very little data about the young patients. There is also the debate regarding treatment strategies. We decided to determine the overall efficacy of the single burr-hole craniostomy (SBHC) for unilateral CSDH in young adults <40 years. SUBJECTS AND METHODS: We performed a retrospective study of young patients undergoing SBHC for unilateral CSDH between January 2013 and June 2016 at our institution...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28692621/challenges-in-the-management-of-geriatric-trauma-a-case-report
#10
Ashley Gaebel, Megan Keiser
This article describes geriatric trauma and commonly associated difficulties emphasizing both the epidemiology and assessment of geriatric trauma. There is little data guiding decisions for trauma patients 65 years or older, as there are many unique characteristics to the geriatric population, including comorbidities, medications, and the aging physiology. The geriatric population in the United States has been steadily climbing for the last 20 years and is projected to continue on this trend. Although each patient presents differently, there remains a need for the consistent utilization of standard guidelines to help dictate care for geriatric patients, particularly for patients not receiving care at a trauma center...
July 2017: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
https://www.readbyqxmd.com/read/28692451/the-value-of-musculoskeletal-ultrasound-in-geriatric-care-and-rehabilitation
#11
Büşra Can, Murat Kara, Özgür Kara, Zekeriya Ülger, Walter Frontera, Levent Özçakar
The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions)...
July 7, 2017: International Journal of Rehabilitation Research. Revue Internationale de Recherches de Réadaptation
https://www.readbyqxmd.com/read/28691669/spontaneous-chronic-subdural-hematoma-in-young-adult-the-role-of-missing-coagulation-facto
#12
M Dobran, M Iacoangeli, A R Scortichini, F Mancini, R Benigni, D Nasi, M Gladi, M Scerrati
AIM: Chronic subdural hematoma (CSDH) is typically in elderly and rarely in young people. To prevent complications and re-bleeding after surgical treatment of CSDH it is important to assess the risk factors as coagulation disorders especially in young patients (below 65 years) with no history of head trauma, alcohol abuse or anticoagulant therapy. PATIENTS AND METHODS: This study consists of 16 patients (12 males, 4 females) with age ranging from 27 to 59 years (median 48,25 years) operated for CSDH...
March 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28689879/nonstandard-lumbar-region-in-predicting-fracture-risk
#13
Dima Alajlouni, Dana Bliuc, Thach Tran, Nicholas Pocock, Tuan V Nguyen, John A Eisman, Jacqueline R Center
Femoral neck (FN) bone mineral density (BMD) is the most commonly used skeletal site to estimate fracture risk. The role of lumbar spine (LS) BMD in fracture risk prediction is less clear due to osteophytes that spuriously increase LS BMD, particularly at lower levels. The aim of this study was to compare fracture predictive ability of upper L1-L2 BMD with standard L2-L4 BMD and assess whether the addition of either LS site could improve fracture prediction over FN BMD. This study comprised a prospective cohort of 3016 women and men over 60 yr from the Dubbo Osteoporosis Epidemiology Study followed up for occurrence of minimal trauma fractures from 1989 to 2014...
July 6, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28689367/rapidly-progressive-osteoarthritis-a-review-of-the-clinical-and-radiologic-presentation
#14
REVIEW
Donald J Flemming, Cristy N Gustas-French
PURPOSE OF REVIEW: The purpose of this paper is to review the distinct clinical and radiographic features that may lead to prompt diagnosis of rapidly progressive osteoarthritis (RPOA) and thus obviate unnecessary and costly diagnostic workup. RECENT FINDINGS: RPOA is uncommon but is more frequently seen in practice because of the aging population. RPOA is a destructive arthropathy that occurs most commonly in elderly women but can also be seen in patients that have sustained trauma...
July 2017: Current Rheumatology Reports
https://www.readbyqxmd.com/read/28681229/late-reconstruction-of-severe-open-book-deformities-of-the-pelvis-tips-and-tricks
#15
Christian Fang, Hatem Alabdulrahman, Roman Pfeifer, Ivan S Tarkin, Hans-Christoph Pape
BACKGROUND: The primary goal of treatment for open book pelvic injuries after high-energy trauma is to control haemorrhage and to close the pelvic ring anatomically. Less commonly, patients may present late with malunion or non-union. METHODS: We reviewed five operatively treated patients with delayed severe open book deformities who had a diastasis of more than 6 cm. We describe the pre-operative workup, surgical strategy and challenges experienced. They specifically include: extensive scar and contracture formation, malunion, urogenital prolapse and difficult reduction of vertical shear element...
July 5, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28667524/low-evaluation-rate-for-osteoporosis-among-patients-presenting-with-a-rib-fracture
#16
Whang Kim, Hyun Sik Gong, Seung Hoo Lee, Jin Woo Park, Kahyun Kim, Goo Hyun Baek
This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. INTRODUCTION: Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28666147/sudden-unexpected-death-in-early-parkinson-s-disease-neurogenic-or-cardiac-death
#17
Naoki Nishida, Koji Yoshida, Yukiko Hata
We present two cases of sudden unexpected death (SUD) in elderly individuals in whom autopsy unexpectedly showed Lewy pathology, a hallmark of Parkinson's disease. Both individuals were 68-year-old men who were found dead in their homes without lethal trauma or poisoning. Inquests into their deaths suggested that nonmotor cardiovascular signs of Parkinson's disease might have appeared just before their deaths, although few typical motor signs were present. Autopsy showed Lewy pathology in the heart and peripheral autonomic nervous system in addition to lesser involvement of the brainstem that was consistent with Braak stage 3...
June 15, 2017: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/28663404/outcomes-after-early-return-to-theatre-following-hip-hemiarthroplasty-for-intracapsular-fracture-of-the-femoral-neck
#18
G Mamarelis, S Key, J Snook, C Aldam
AIMS: Hip hemiarthroplasty is a standard treatment for intracapsular proximal femoral fractures in the frail elderly. In this study we have explored the implications of early return to theatre, within 30 days, on patient outcome following hip hemiarthroplasty. PATIENTS AND METHODS: We retrospectively reviewed the hospital records of all hip hemiarthroplasties performed in our unit between January 2010 and January 2015. Demographic details, medical backround, details of the primary procedure, complications, subsequent procedures requiring return to theatre, re-admissions, discharge destination and death were collected...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28663403/-modern-distal-femoral-locking-plates-allow-safe-early-weight-bearing-with-a-high-rate-of-union-and-low-rate-of-failure-five-year-experience-from-a-united-kingdom-major-trauma-centre
#19
W E C Poole, D G G Wilson, H C Guthrie, S F Bellringer, R Freeman, E Guryel, S G Nicol
AIMS: Fractures of the distal femur can be challenging to manage and are on the increase in the elderly osteoporotic population. Management with casting or bracing can unacceptably limit a patient's ability to bear weight, but historically, operative fixation has been associated with a high rate of re-operation. In this study, we describe the outcomes of fixation using modern implants within a strategy of early return to function. PATIENTS AND METHODS: All patients treated at our centre with lateral distal femoral locking plates (LDFLP) between 2009 and 2014 were identified...
July 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28659981/effectiveness-of-cognitive-behavioral-therapy-on-spiritual-well-being-and-emotional-intelligence-of-the-elderly-mourners
#20
Abas Solaimani Khashab, Hosain Ghamari Kivi, Davod Fathi
Objective: Grief is one of the most painful experiences of the humans after linking emotions. In the literature of trauma, grief and mourning can be seen on many topics. Intervention and treatment of grief seems necessary as the period of mourning is prolonged. Thus, this study aimed at understanding the effectiveness of cognitive behavioral therapy on spiritual well-being and emotional intelligence in the elderly bereavement. Method: This was an experimental study with pre-and posttest design, and control group...
April 2017: Iranian Journal of Psychiatry
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