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revised trauma score

Nina S Nnamani, Judson C Janak, Steven J Hudak, Jessica C Rivera, Eluned A Lewis, Douglas W Soderdahl, Jean A Orman
BACKGROUND: In Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF), genitourinary (GU) wounds have occurred in unprecedented numbers. Severe concomitant injuries, including extremity amputations, are common. The epidemiology of GU injury and extremity amputation in OEF/OIF has not been described. MATERIALS AND METHODS: The Department of Defense Trauma Registry was queried from October 2001 through August 2013 to identify all surviving US male service members with GU injuries sustained in OEF/OIF...
November 2016: Journal of Trauma and Acute Care Surgery
Kyle Lybrand, Anthony Bell, Deirdre Rodericks, David Templeman, Paul Tornetta
OBJECTIVE: To evaluate the influence of the symphyseal position at union, implant failure, and the type of posterior ring injury on validated outcome measures. DESIGN: Retrospective review with prospectively collected validated outcome data SETTING:: Two academic Level 1 trauma centersPatients/Participants: We evaluated 54 patients with operatively treated anterior-posterior compression (APC) type 2 and 3 injuries. INTERVENTION: Thirty-five APC type 2 and 19 APC type 3 injuries were reviewed at a minimum of 2 years after surgery...
October 7, 2016: Journal of Orthopaedic Trauma
Alan D Cook, Jeanette G Ward, Kristina M Chapple, Hassan Akinbiyi, Mark Garrett, Forrest O'Dell Moore
BACKGROUND: Representing 2 % of the general population, American Indians/Alaska Natives (AIs/ANs) were associated with 0.5 % (63) of the estimated 12,500 new cases of spinal cord injury (SCI) reported to the National Spinal Cord Injury Statistic Center in 2013. To date, the trend in health care disparities among AIs/ANs in the SCI community has not been examined. We sought to compare the rate of discharge to rehabilitation facilities (DRF) following traumatic SCI among adult AIs/ANs to other racial/ethnic groups for patients 15 to 64 years old...
December 2015: Injury Epidemiology
Nobhojit Roy, Martin Gerdin, Eric Schneider, Deepa K Kizhakke Veetil, Monty Khajanchi, Vineet Kumar, Makhal Lal Saha, Satish Dharap, Amit Gupta, Göran Tomson, Johan von Schreeb
INTRODUCTION: In the Lower-Middle Income Country setting, we validate trauma severity scoring systems, namely Injury Severity Score (ISS), New Injury Severity Scale (NISS) score, the Kampala Trauma Score (KTS), Revised Trauma Score (RTS) score and the TRauma Injury Severity Score (TRISS) using Indian trauma patients. PATIENTS AND METHODS: From 1 September 2013 to 28 February 2015, we conducted a prospective multi-centre observational cohort study of trauma patients in four Indian university hospitals, in three megacities, Kolkata, Mumbai and Delhi...
September 20, 2016: Injury
Onur Durmaz, Serkan Kemer, Tuba Mutluer, Elif Bütün
INTRODUCTION: The etiology of primary nocturnal enuresis (PNE) is not fully understood, but multifactorial factors have been associated with PNE. Parental factors, including attitudes to PNE, disciplinary behaviors, and psychiatric comorbidities in parents have been related to etiology of PNE, outcomes and the quality of life in children with enuresis. OBJECTIVE: We examined the psychopathology in mothers of children diagnosed with monosymptomatic PNE(MoPNE) compared with mothers of non-enuretic children (MoNEC) in terms of personality characteristics, early traumatic experiences, and psychiatric symptom evaluation...
August 24, 2016: Journal of Pediatric Urology
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
N A Johnson, C Uzoigwe, M Venkatesan, V Burgula, A Kulkarni, J N Davison, R U Ashford
INTRODUCTION Intramedullary nailing is a common treatment for proximal femoral fractures. Fracture of the nail is a rare but devastating complication that exposes often frail patients to complex revision surgery. We investigated which risk factors predict nail failure. METHODS We reviewed all cases of nail breakage seen over a 10-year period in a single busy trauma unit; 22 nail fractures were seen in 19 patients. Comparison was made with a group of 209 consecutive patients who underwent intramedullary fixation of a proximal femur fracture with no nail breakage over a 2-year period...
September 23, 2016: Annals of the Royal College of Surgeons of England
Axel Marx, Alexander Beier, Anne Richter, Christoph H Lohmann, Andreas M Halder
INTRODUCTION: Major bone defects are the greatest challenge in hip revision arthroplasty. METHODS: In a prospective, consecutive nonrandomised study we followed up 74 patients with Type III (AAOS) acetabular bone defects who underwent revision hip arthroplasty with bone grafting and implantation of a Burch-Schneider anti-protrusion cage (APC). The patients were examined pre- and postoperatively according to a standardised clinical and radiological protocol. No patient was lost to follow-up...
September 20, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
J Schmolders, S Koob, P Schepers, S Gravius, D C Wirtz, C Burger, P H Pennekamp, A C Strauss
Introduction/Background: With extended life expectancy, the number of primary joint arthroplasties has also increased. Revision surgery is also more often necessary, due to aseptic or septic loosening of the prosthesis or periprosthetic fracture. Large bone defects often occur in these patients and several non-modular, conventional implants are available to handle this difficult situation. Custom made implants offer an individually designed and defect-adapted shape with perfect covering of the lesion, but may delay the operation...
September 15, 2016: Zeitschrift Für Orthopädie und Unfallchirurgie
Zhi-Jie Hong, Cheng-Jueng Chen, Jyh-Cherng Yu, De-Chuan Chan, Yu-Ching Chou, Chia-Ming Liang, Sheng-Der Hsu
We aimed to evaluate the benefit of whole-body computed tomography (WBCT) scanning for unconscious adult patients suffering from high-energy multiple trauma compared with the conventional stepwise approach of organ-selective CT.Totally, 144 unconscious patients with high-energy multiple trauma from single level I trauma center in North Taiwan were enrolled from January 2009 to December 2013. All patients were managed by a well-trained trauma team and were suitable for CT examination. The enrolled patients are all transferred directly from the scene of an accident, not from other medical institutions with a definitive diagnosis...
September 2016: Medicine (Baltimore)
D Slullitel, H Galán, V F Della, F Ibañez
INTRODUCTION: The surgical treatment of acromioclavicular dislocation remains controversial. We describe herein a combined two-stage technique that includes an arthroscopic approach followed by a mini-invasive approach. MATERIAL AND METHODS: 41 patients with acromioclavicular dislocation grades III, IV and V. Acute and chronic lesions and revision surgeries were included during the follow-up. Patients with other shoulder conditions were excluded. Mean age was 28...
January 2016: Acta Ortopédica Mexicana
Clara Walker, Jason Thompson, Mark Stevenson
OBJECTIVE: To estimate the likely reduction in road trauma associated with the implementation of effective interventions to reduce road trauma among young Australians. METHODS: A desktop evaluation was conducted to model the likely reduction in road trauma (deaths and serious injuries resulting in hospitalisation) among young people aged 17-24 years residing in Queensland, NSW and Victoria. Potential interventions were identified using a rapid literature review and assigned a score based on evidence of effectiveness and implementation feasibility with the three highest scoring interventions included in the modelling...
August 30, 2016: Traffic Injury Prevention
Richard Trafford Spence, Eiman Zargaran, S Morad Hameed, Pradeep Navsaria, Andrew Nicol
BACKGROUND: The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. MATERIAL AND METHODS: Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected...
August 2016: Journal of Surgical Research
Trond Dehli, Svein Arne Monsen, Knut Fredriksen, Kristian Bartnes
BACKGROUND: Correct triage based on prehospital information contributes to a better outcome for potentially seriously injured patients. In 2011 we changed the trauma team activation (TTA) criteria in our center in order to improve the high over- and undertriage properties of the protocol. Five criteria that were unable to predict severe injury were removed. In the present study, we evaluated the protocol revision by comparing over- and undertriage in the former and present set of criteria...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Jinbing Zhao, Haodong Chen, Meijuan Zhang, Yuhai Zhang, Chunfa Qian, Yong Liu, Shengxue He, Yuanjie Zou, Hongyi Liu
PURPOSE: Intracranial bleeding and inflammatory reactions are common consequences of traumatic brain injury (TBI). Neutrophil gelatinase-associated lipocalin (NGAL), an iron-handling and acute phase protein, may participate in the pathogenesis of TBI. Therefore, we hypothesize that NGAL may be of high diagnostic and therapeutic relevance in the prognosis of TBI. METHODS: 74 subjects were recruited in this study. 30 TBI patients receiving emergent operation were designated as severe TBI group (sTBI), 24 TBI patients receiving conservative treatment as mild TBI group (mTBI), while 20 age-matched healthy volunteers as healthy controls (CNT)...
September 15, 2016: Journal of the Neurological Sciences
Hassan Alkhawam, Raef Madanieh, Mohammed El-Hunjul, Abed Madanieh, Umer Syed, Sumair Ahmad, Joseph J Lieber, Timothy J Vittorio
BACKGROUND: Cardiovascular morbidity and mortality in heart failure (HF) patients comprise a major health and economic burden, especially when readmission rate and length of stay (LOS) are considered. With increasing average life expectancy, HF prevalence continues to rise. Diseases such as diabetes mellitus, hypertension and ischemic heart disease continue to be the leading causes of HF. Current data suggest that HF is the most common cause for hospital admission in patients older than 65 years...
August 2016: American Journal of the Medical Sciences
Anne N Banducci, C W Lejuez, Lea R Dougherty, Laura MacPherson
Anxiety, the most common and impairing psychological problem experienced by youth, is associated with numerous individual and environmental factors. Two such factors include childhood emotional abuse (CEA) and low distress tolerance (DT). The current study aimed to understand how CEA and low DT impacted anxiety symptoms measured annually across 5 years among a community sample of youth. We hypothesized DT would moderate the relationship between CEA and anxiety, such that youth with higher levels of CEA and lower levels of DT would have elevated anxiety over time...
August 8, 2016: Prevention Science: the Official Journal of the Society for Prevention Research
Sigrid Narum, Odd Brørs, Olav Stokland, Marianne K Kringen
BACKGROUND: Bleeding represents the most well-known and the most feared complications caused by the use of antithrombotic agents. There is, however, limited documentation whether pre-injury use of antithrombotic agents affects outcome after head trauma. The aim of this study was to define the relationship between the use of preinjury antithrombotic agents and mortality among elderly people sustaining blunt head trauma. METHODS: A retrospective cohort analysis was performed on the hospital based trauma registry at Oslo University Hospital...
2016: BMC Emergency Medicine
Se Hee Kim, Sang Sik Choi, Mi Kyung Lee, Jung Eun Kin
Most cases of complex regional pain syndrome (CRPS) occur after some inciting injury. There are a few cases of CRPS after an operation for disc disease. CRPS from a mild herniated intervertebral disc (HIVD) without surgical intervention is even rarer than CRPS after an operation for disc disease.A 22-year-old man was transferred to a pain clinic. He had continuously complained about back and right leg pain. He presented with a skin color change in the right lower leg, intermittent resting tremor, stiffness, and swelling in the right leg...
July 2016: Pain Physician
Jürgen W Schmitt, Christian Benden, Claudio Dora, Clément M L Werner
BACKGROUND: In recent years, the number of lung transplants has increased rapidly, with higher quality of life and improved survival rates in transplant recipients, including patients with advanced age. This, in turn, means that more transplant recipients will seek musculoskeletal care to treat degenerative joint disease and also trauma incidents. Safety concerns regarding elective and posttraumatic hip arthroplasty in transplant patients include an increased risk of infection, wound healing problems, periprosthetic fractures and loosening of the implants...
2016: Patient Safety in Surgery
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