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https://www.readbyqxmd.com/read/29331842/predicting-1-year-disability-and-mortality-of-injured-older-adults
#1
Alvin D Jeffery, Mary S Dietrich, Cathy A Maxwell
PURPOSE: The growing incidence of elderly patients injured from falls, combined with a growing understanding of the contribution of cognition and frailty to mortality, prompted this work. Our objective was to develop a clinical risk prediction model for prognosticating disability and mortality among injured older adults 1 year after hospitalization. METHODS: Secondary analysis of prospective longitudinal data from an urban Level 1 trauma center. A proportional odds regression model was used to model mortality and functional status as ordinal outcomes...
January 6, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29331010/implants-for-extracapsular-neck-of-femur-fracture-dynamic-hip-screw-versus-intramedullary-nailing
#2
Faisal Farooq Butt, Adnan Shabbair Hussain, Ahmed Mushtaq Khan, Maria Sultan
Neck of femur fractures are the most prevalent type of injury in elderly trauma patients. Both intra and extra capsular type of fractures are equally distributed in the given population. Traditionally, Extra capsular fractures are fixed with Dynamic Hip screw or Intra medullary nailing based on the type of fracture. NICE (National Institute of Clinical Excellence) recommends fixing 31-A1 and 31-A2 fractures with DHS (Dynamic Hip Screw) whereas AO recommends fixing 31-A1 with DHS and 31-A2.1 subtype with DHS and 31-A2...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#3
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318084/how-does-frailty-factor-into-mortality-risk-assessment-of-a-middle-aged-and-geriatric-trauma-population
#4
Sanjit R Konda, Ariana Lott, Hesham Saleh, Sebastian Schubl, Jeffrey Chan, Kenneth A Egol
Introduction: Frailty in elderly trauma populations has been correlated with an increased risk of morbidity and mortality. The Score for Trauma Triage in the Geriatric and Middle-Aged (STTGMA) is a validated mortality risk score that evaluates 4 major physiologic criteria: age, comorbidities, vital signs, and anatomic injuries. The aim of this study was to investigate whether the addition of additional frailty variables to the STTGMA tool would improve risk stratification of a middle-aged and elderly trauma population...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29309952/application-of-tourniquet-in-civilian-trauma-systematic-review-of-the-literature
#5
Charlotte Beaucreux, Benoît Vivien, Ethan Miles, Sylvain Ausset, Pierre Pasquier
INTRODUCTION: The effectiveness of a tourniquet (TQ) in case of extremity haemorrhages is well recognised to prevent death on the battlefield. However, little is known about the usefulness of TQ in civilian trauma settings, including terrorist attack situations. The aim of this systematic review was to analyse the evidence-based medical literature in order to precise the use of TQ in the management of extremity haemorrhages in civilian setting. METHODS: Analysis of all studies published until 12/31/2016 on the Embase, Medline and Opengrey databases...
January 5, 2018: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29307734/persistent-injury-associated-anemia-in-aged-rats
#6
Tyler J Loftus, Kolenkode B Kannan, Christy S Carter, Jessica M Plazas, Juan C Mira, Scott C Brakenridge, Christiaan Leeuwenburgh, Philip A Efron, Alicia M Mohr
BACKGROUND: Hypercatecholaminemia and bone marrow dysfunction have been implicated in the pathophysiology of persistent-injury associated anemia. The elderly may be vulnerable to this phenomenon due to high basal and peak catecholamine levels, impaired erythroid progenitor growth, and baseline anemia. We hypothesized that aged F344-BN rats subjected to severe trauma and chronic stress would have persistent injury-associated anemia. METHODS: Male F344-BN rats age 25months were randomly allocated to: naïve (n=8), lung contusion (LC, n=9), LC followed by daily chronic restraint stress (LC/CS, n=9), LC followed immediately by hemorrhagic shock (LCHS, n=8), and LCHS followed by daily CS (LCHS/CS, n=8)...
January 4, 2018: Experimental Gerontology
https://www.readbyqxmd.com/read/29304054/injury-mechanisms-patterns-and-outcomes-of-older-polytrauma-patients-an-analysis-of-the-dutch-trauma-registry
#7
Rob de Vries, Inge H F Reininga, Oliver Pieske, Rolf Lefering, Mostafa El Moumni, Klaus Wendt
BACKGROUND: Polytrauma patients nowadays tend to be older due to the growth of the elderly population and its improved mobility. The aim of this study was to compare demographics, injury patterns, injury mechanisms and outcomes between younger and older polytrauma patients. METHODS: Data from polytrauma (ISS≥16) patients between 2009 and 2014 were extracted from the Dutch trauma registry (DTR). Younger (Group A: ages 18-59) and older (Group B: ages ≥60) polytrauma patients were compared...
2018: PloS One
https://www.readbyqxmd.com/read/29280129/-preliminary-discussion-of-therapeutic-strategies-in-persistent-inflammation-immunosuppression-catabolism-syndrome
#8
Heyi Su, Zhenhui Guo
So far, there is still lack of effective treatment to control persistent inflammation immunosuppression catabolism syndrome (PICS) appeared generally in those chronic critical illnesses (CCI) patients, restricted by the development of medicine and scientific research nowadays. Because the uncontrolled PICS aggravates continuously, ICU stay of the CCI patients has been obviously prolonging and the late mortality elevates greatly. So exploring effective therapeutic strategies is obviously pressing. With the characteristics in PICS such as that elderly with sepsis or severe trauma tops the list of morbidity, progressing illness is difficult to intervent and various pathology changes occur simultaneously, the fundamental principle of treatment, "Focal screening, early control, joint intervention" must be followed...
December 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29258561/a-pilot-investigation-on-dna-methylation-modifications-associated-with-complex-posttraumatic-symptoms-in-elderly-traumatized-in-childhood
#9
Zoya Marinova, Andreas Maercker, Edna Grünblatt, Tomasz K Wojdacz, Susanne Walitza
OBJECTIVE: Complex posttraumatic stress disorder (CPTSD) is a newly proposed diagnosis in the International Classification of Diseases-version 11, which is currently intensively investigated. Childhood trauma is regarded as main source of CPTSD symptoms, even in later life. Induction of DNA methylation changes by childhood trauma may contribute to its long-lasting adverse health consequences. The current study analyzed the correlation of genome-wide DNA methylation profiles with complex posttraumatic sequelae in buccal epithelial cells from 31 elderly former indentured child laborers (Verdingkinder) using the Infinium Illumina 450k Human DNA methylation chip...
December 19, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29251704/improved-outcomes-in-elderly-trauma-patients-with-the-implementation-of-two-innovative-geriatric-specific-protocols-final-report
#10
Eric H Bradburn, Brian W Gross, Shreya Jammula, William H Adams, Jo Ann Miller
INTRODUCTION: Elderly trauma care is challenging due to the unique physiology and comorbidities prevalent in this population. To improve the care of these patients, two practice management guidelines (PMG) were implemented: High Risk Geriatric Protocol (HRGP), which triages patients based on injury patterns and comorbid conditions for occult hypotension, and the Anticoagulation and Trauma Alert (ACT), which is designed to streamline the care of geriatric trauma patients on anticoagulants...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29248192/thoracolumbar-spine-loading-associated-with-kinematics-of-the-young-and-the-elderly-during-activities-of-daily-living
#11
Dominika Ignasiak, Andrea Rüeger, Ramona Sperr, Stephen J Ferguson
Excessive mechanical loading of the spine is a critical factor in vertebral fracture initiation. Most vertebral fractures develop spontaneously or due to mild trauma, as physiological loads during activities of daily living might exceed the failure load of osteoporotic vertebra. Spinal loading patterns are affected by vertebral kinematics, which differ between elderly and young individuals. In this study, the effects of age-related changes in spine kinematics on thoracolumbar spinal segmental loading during dynamic activities of daily living were investigated using combined experimental and modeling approach...
December 6, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/29247815/-over-the-hill-and-falling-down-can-the-nexus-criteria-be-applied-to-the-elderly-prospective-cohort-study
#12
Amani Jambhekar, Ryan Lindborg, Vincent Chan, Adriana Fulginiti, Bashar Fahoum, James Rucinski
INTRODUCTION: The National Emergency X-Radiography Utilization Study (NEXUS) criteria have been criticized due to the presumed unreliability of the clinical exam in elderly patients. The objective of this study was to determine if the NEXUS criteria can be safely applied to this vulnerable group of patients. METHODS: 596 trauma patients over the age of 65 were enrolled in a prospectively designed study between April 1, 2015 and October 1, 2016. The study was designed to encourage the use of the NEXUS criteria for all trauma patients including the elderly...
December 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29247259/effect-of-sarcopenia-on-clinical-and-surgical-outcome-in-elderly-patients-with-proximal-femur-fractures
#13
Ching-Di Chang, Jim S Wu, Jennifer Ni Mhuircheartaigh, Marry G Hochman, Edward K Rodriguez, Paul T Appleton, Colm J Mcmahon
PURPOSE: To investigate the relationship between sarcopenia with short-term surgical outcome in elderly patients with proximal femur fractures. METHODS AND MATERIALS: Following Institutional Review Board approval, a database of patients receiving a pelvis CT scan for acute trauma between January 2000-August 2016 was screened for an isolated proximal femur fracture. Patients were excluded if they were: < 50 years old, had conditions predisposing to sarcopenia (renal failure, congestive heart failure, muscular dystrophies), had undergone no surgical treatment, had other major traumatic injuries, or had a pathologic femur fracture...
December 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29239310/micrornas-as-diagnostic-markers-and-therapeutic-targets-for-traumatic-brain-injury
#14
REVIEW
Bridget Martinez, Philip V Peplow
Traumatic brain injury (TBI) is characterized by primary damage to the brain from the external mechanical force and by subsequent secondary injury due to various molecular and pathophysiological responses that eventually lead to neuronal cell death. Secondary brain injury events may occur minutes, hours, or even days after the trauma, and provide valuable therapeutic targets to prevent further neuronal degeneration. At the present time, there is no effective treatment for TBI due, in part, to the widespread impact of numerous complex secondary biochemical and pathophysiological events occurring at different time points following the initial injury...
November 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29233697/retrospective-analysis-of-471-surgically-treated-zygomaticomaxillary-complex-fractures
#15
Michael Blumer, Sabina Kumalic, Thomas Gander, Martin Lanzer, Claudio Rostetter, Martin Rücker, Heinz-Theo Lübbers
PURPOSE: Zygomaticomaxillary complex (ZMC) fractures are frequent in facial trauma; only fractures of the mandible are more common. Although the frequency of these fractures is geographically consistent, the aetiology differs widely among countries and even regions. Differences in socio-economic status and the ageing population seem to be two causes. This retrospective epidemiological study evaluates patients who were surgically treated for ZMC fractures at a Swiss university clinic. MATERIALS AND METHODS: This study included 471 patients who were surgically treated for ZMC fractures in an oral and maxillofacial surgery clinic at a Swiss university hospital between January 2004 and December 2012...
November 23, 2017: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/29232770/review-article-nexus-criteria-to-rule-out-cervical-spine-injury-among-older-patients-a-systematic-review
#16
REVIEW
Gabriel Paykin, Gerard O'Reilly, Helen Ackland, Biswadev Mitra
The National Emergency X-Radiography Utilization Study (NEXUS) criteria were derived from a heterogeneous group of adult blunt trauma patients, with the outcome measure assessed most commonly using plain X-ray radiographs. Recent observations have suggested inadequacy of these criteria for excluding injury in population subgroups such as the elderly. The aim of this systematic review was to determine the sensitivity of the NEXUS criteria in excluding cervical spine injury among older patients aged ≥65 years...
December 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29223594/femoral-neck-fractures-after-removal-of-hardware-in-healed-trochanteric-fractures
#17
REVIEW
Antonio Barquet, Peter V Giannoudis, Andrés Gelink
INTRODUCTION: Hardware removal in healed trochanteric fractures (TF) in the absence of infection or significant mechanical complications is rarely indicated. However, in patients with persistent pain, prominent material and discomfort in the activities of daily living, the implant is eventually removed. Publications of ipsilateral femoral neck fracture after removal of implants from healed trochanteric fractures (FNFARIHTF) just because of pain or discomfort are rare. The purpose of this systematic review of the literature is to report on the eventual risk factors, the mechanisms, the clinical presentation, and frequency, and to pay special emphasis in their prevention...
December 2017: Injury
https://www.readbyqxmd.com/read/29218819/a-conceptual-model-of-the-risk-of-elder-abuse-posed-by-incontinence-and-care-dependence
#18
Joan Ostaszkiewicz
AIMS AND OBJECTIVES: To describe and critically analyse the thinking that led to the concept of an association between incontinence, care dependence and elder abuse. BACKGROUND: Coercive or abusive continence care practices include chastising a person for their incontinence and overriding their attempts to resist continence care. Neglect in continence care is characterised by withholding or delaying responding to requests for help to maintain continence or to manage incontinence, and restricting a person's access to toileting assistance, incontinence aids or hygiene care...
December 8, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/29212692/the-impact-of-age-on-major-orthopaedic-trauma-an-analysis-of-the-united-kingdom-trauma-audit-research-network-database
#19
COMPARATIVE STUDY
J Herron, R Hutchinson, F Lecky, O Bouamra, A Edwards, M Woodford, W G P Eardley
AIMS: To compare the early management and mortality of older patients sustaining major orthopaedic trauma with that of a younger population with similar injuries. PATIENTS AND METHODS: The Trauma Audit Research Network database was reviewed to identify eligible patients admitted between April 2012 and June 2015. Distribution and severity of injury, interventions, comorbidity, critical care episodes and mortality were recorded. The population was divided into young (64 years or younger) and older (65 years and older) patients...
December 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29201960/demographics-of-fall-related-trauma-among-the-elderly-presenting-to-emergency-department-a-cross-sectional-study
#20
Hamid Reza Morteza Bagi, Sajjad Ahmadi, Maryam Hosseini
Introduction: Falling is reported to be the most common cause of mortality due to trauma in individuals over the age of 75 years. The present study is designed with the aim of determining the demographics of fall-related trauma among the elderly presenting to emergency department (ED). Methods: The present prospective cross-sectional study was carried out on all elderly patients ≥ 60 years old presenting to ED of a major referral trauma center in North West of Iran during 1 year...
2017: Emergency (Tehran, Iran)
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