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https://www.readbyqxmd.com/read/28650361/pharmacological-thromboembolic-prophylaxis-in-traumatic-brain-injuries-low-molecular-weight-heparin-is-superior-to-unfractionated-heparin
#1
Elizabeth Benjamin, Gustavo Recinos, Alberto Aiolfi, Kenji Inaba, Demetrios Demetriades
OBJECTIVE: We hypothesized that low molecular weight heparin (LMWH) is superior to unfractionated heparin (UH) for venous thromboembolism (VTE) prophylaxis in patients with severe traumatic brain injuries (TBI). SUMMARY BACKGROUND DATA: Pharmacological VTE prophylaxis with LMWH or UH is the current standard of care in TBI. Clinical work suggests that LMWH may be more effective than UH for VTE prophylaxis in trauma patients. Experimental work shows that heparinoids may have neuroprotective properties...
June 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28650356/trending-fibrinolytic-dysregulation-fibrinolysis-shutdown-in-the-days-after-injury-is-associated-with-poor-outcome-in-severely-injured-children
#2
Christine M Leeper, Matthew D Neal, Christine J McKenna, Barbara A Gaines
OBJECTIVE: To trend fibrinolysis after injury and determine the influence of traumatic brain injury (TBI) and massive transfusion on fibrinolysis status. BACKGROUND: Admission fibrinolytic derangement is common in injured children and adults, and is associated with poor outcome. No studies examine fibrinolysis days after injury. METHODS: Prospective study of severely injured children at a level 1 pediatric trauma center. Rapid thromboelastography was obtained on admission and daily for up to 7 days...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648782/traumatic-thoracic-burst-fracture-associated-with-bronchial-rupture
#3
Wei-Ting Lin, Shih-Yang Su, Cheng-Fang Hsieh, Chih-Cheng Lai, Chien-Ming Chao
BACKGROUND: Rupture of, or injury to, the tracheobronchial tree is a rare occurrence in blunt chest trauma. CASE REPORT: We present a case of bronchial rupture caused by fragmented bone from a spinal burst fracture after blunt chest trauma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although tracheobronchial injury is infrequent, clinicians should be aware of this possible complication after blunt chest trauma. Bronchoscopy can help in the diagnosis.
June 22, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28648409/management-of-esophageal-injuries-secondary-to-trauma
#4
REVIEW
Patrizio Petrone, Kawthar Kassimi, Marta Jiménez-Gómez, Alejandro Betancourt, Alexander Axelrad, Corrado P Marini
Traumatic esophageal injuries occur less than 10% of the time in the setting of blunt or penetrating trauma. The purpose of this literature review is to provide an update on the most recent changes involving the diagnosis and treatment of esophageal injuries. A literature search was conducted using PubMed, to identify articles written in English language with the terms "non- iatrogenic", "esophageal", "trauma", "diagnosis", "management", and "prognosis". Case reports and articles involving non-traumatic esophageal perforations were excluded...
June 19, 2017: Injury
https://www.readbyqxmd.com/read/28647095/increased-detection-of-blunt-carotid-and-vertebral-artery-injury-after-implementation-of-diagnostic-imaging-pathway-in-level-1-trauma-centre-in-western-australia
#5
Manimaran Sinnathamby, Sudhakar V Rao, Dieter G Weber
BACKGROUND: The incidence of Blunt Carotid Artery and Vertebral Artery Injury (BCVI) is relatively low in modern trauma practice. However, these injuries may be associated with severe neurological consequences. Following the introduction of a Diagnostic Imaging Pathway in Department of Health of Western Australia, we hypothesized that this injury would be less likely to be missed, and accordingly diagnosed more frequently. METHOD: A review of all major trauma (Injury Severity Scale>15) admissions at the State Major Trauma Centre in Royal Perth Hospital was undertaken from 1995 until 2013...
June 13, 2017: Injury
https://www.readbyqxmd.com/read/28645498/pulmonary-artery-embolization-after-blunt-trauma
#6
Jean-Michel Maury, Hani Saiedi, Didier Revel
No abstract text is available yet for this article.
July 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28644311/hemobilia-an-uncommon-but-notable-cause-of-upper-gastrointestinal-bleeding
#7
Scott Cathcart, John W Birk, Michael Tadros, Micheal Schuster
GOAL AND BACKGROUND: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. STUDY: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. RESULTS: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643720/inferior-subconjunctival-dislocation-of-posterior-chamber-intraocular-lens-after-blunt-trauma
#8
Amit Mohan, Navjot Kaur, Vinod Sharma
Traumatic subconjunctival dislocation of the posterior chamber intraocular lens (PCIOL) is a rare and emergency condition. Here, we report an interesting variation of rare case of inferior subconjuctival dislocation of PCIOL in a 75-year-old female patient following blunt trauma to her right eye with cow's head. All the previous literature with subconjuctival dislocation of PCIOL has reported the superior dislocation of intraocular lens. Inferior subconjunctival dislocation has never been reported in previous literature...
June 2017: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/28640779/nonoperative-management-rather-than-endovascular-repair-may-be-safe-for-grade-ii-blunt-traumatic-aortic-injuries-an-eleven-year-retrospective-analysis
#9
Stephen M Spencer, Karen Safcsak, Chadwick P Smith, Michael L Cheatham, Indermeet S Bhullar
BACKGROUND: The Society of Vascular Surgery (SVS) guidelines currently suggest thoracic endovascular aortic repair (TEVAR) for grade II-IV and non-operative management (NOM) for grade I blunt traumatic aortic injury (BTAI). However, there is increasing evidence that grade II may also be observed safely. The purpose of this study was to compare the outcome of TEVAR and NOM for grade I-IV BTAI and determine if grade II can be safely observed with NOM. METHODS: The records of patients with BTAI from 2004 to 2015 at a Level I trauma center were retrospectively reviewed...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28640778/a-cohort-study-of-blunt-cerebrovascular-injury-screening-in-children-are-they-just-little-adults
#10
Mackenzie R Cook, Cordelie E Witt, Robert H Bonow, Eileen M Bulger, Ken F Linnau, Saman Arbabi, Bryce R H Robinson, Joseph Cuschieri
BACKGROUND: Blunt cerebrovascular injuries (BCVI) are rare with nonspecific predictors, making optimal screening critical. Radiation concerns magnify these issues in children. The Eastern Association for the Surgery of Trauma (EAST) criteria, the Utah score (US) and the Denver criteria (DC) have been advocated for pediatric BCVI screening, though direct comparison is lacking. We hypothesized that current screening guidelines inaccurately identify pediatric BCVI. METHODS: This was a retrospective cohort study of pediatric trauma patients treated from 2005-2015 with radiographically confirmed BCVI...
June 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28639253/ultrasonography-in-trauma-a-nation-wide-cross-sectional-investigation
#11
Jesper Weile, Klaus Nielsen, Stine C Primdahl, Christian A Frederiksen, Christian B Laursen, Erik Sloth, Hans Kirkegaard
BACKGROUND: The Focused Assessment with Sonography in Trauma (FAST) protocol is considered beneficial in emergent evaluation of trauma patients with blunt or penetrating injury and has become integrated into the Advanced Trauma Life Support (ATLS) protocol. No guidelines exist as to the use of ultrasonography in trauma in Denmark. We aimed to determine the current use of ultrasonography for assessing trauma patients in Denmark. METHODS: We conducted a nation-wide cross-sectional investigation of ultrasonography usage in trauma care...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28637583/the-revised-trauma-score-plus-serum-albumin-level-improves-the-prediction-of-mortality-in-trauma-patients
#12
Seong Chun Kim, Dong Hoon Kim, Tae Yun Kim, Changwoo Kang, Soo Hoon Lee, Jin Hee Jeong, Yong Joo Park, Sang Bong Lee, Daesung Lim
INTRODUCTION: The Revised Trauma Score (RTS) is used worldwide in prehospital practice and in the emergency department (ED) settings to triage trauma patients. The main purpose of this study was to evaluate the value of the RTS plus serum albumin (RTS-A) and to compare it with other existing trauma scores as well as to compare the predictive performance of the Trauma and Injury Severity Score with the RTS-A (TRISS-A) with the original TRISS. METHODS: This was a single center, trauma registry based observational cohort study...
June 15, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28637560/despite-trauma-center-closures-trauma-system-regionalization-reduces-mortality-and-time-to-definitive-care-in-severely-injured-patients
#13
Jack C He, David Schechtman, Debra L Allen, Jillian J Cremona, Jeffrey A Claridge
The Northern Ohio Trauma System (NOTS), consisting of multiple hospital systems, was established in 2010 to improve trauma outcomes. This study assessed its impact on mortality and time to definitive care, focusing especially on the severely injured patients. NOTS trauma registry was queried for all trauma activations from 2008 to 2013. The years between 2008-2009 and 2011-2013 were designated as pre- and post-NOTS, respectively. Data from 2010 was excluded as a transitional year. Two trauma centers (TCs) closed in 2010...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28637555/overview-of-nonoperative-blunt-splenic-injury-management-with-associated-splenic-artery-pseudoaneurysm
#14
Chet A Morrison, Brian W Gross, Matthew Kauffman, Katelyn J Rittenhouse, Frederick B Rogers
The delayed development of splenic artery pseudoaneurysm (SAP) can complicate the nonoperative management of splenic injuries. We sought to determine the utility of repeat imaging in diagnosing SAP in patients managed nonoperatively without angioembolization. We hypothesized that a significant rate of SAPs would be found in this population on repeat imaging. Patients undergoing nonoperative splenic injury management from January 2011 to June 2015 were queried from the trauma registry. Rates of repeat imaging, angioembolization, readmission, and SAP development were analyzed...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28632646/the-utility-of-adding-magnetic-resonance-imaging-to-computed-tomography-alone-in-the-evaluation-of-cervical-spine-injury-a-propensity-matched-analysis
#15
Andrew J Schoenfeld, Daniel G Tobert, Hai V Le, Dana A Leonard, Allan L Yau, Prashant Rajan, Charles H Cho, James D Kang, Christopher M Bono, Mitchel B Harris
STUDY DESIGN: Adult patients who received CT alone or CT-MRI for the evaluation of cervical OBJECTIVE.: To evaluate the utility of CT-MRI in the diagnosis of cervical spine injury using propensity matched techniques. SUMMARY OF BACKGROUND DATA: The optimal evaluation (computed tomography [CT] alone vs CT and magnetic resonance imaging [MRI]) for patients with suspected cervical spine injury in the setting of blunt trauma remains controversial. METHODS: The primary outcome was the identification of a cervical spine injury, with decision for surgery and change in management considered secondarily...
June 19, 2017: Spine
https://www.readbyqxmd.com/read/28632581/multicenter-retrospective-study-of-noncompressible-torso-hemorrhage-anatomic-locations-of-bleeding-and-comparison-of-endovascular-versus-open-approach
#16
Ronald Chang, Erin E Fox, Thomas J Greene, Brian J Eastridge, Ramyar Gilani, Kevin K Chung, Stacia M DeSantis, Joseph J DuBose, Jeffrey S Tomasek, Gerald R Fortuna, Valerie G Sams, S Rob Todd, Jeanette M Podbielski, Charles E Wade, John B Holcomb
BACKGROUND: Rational development of technology for rapid control of noncompressible torso hemorrhage (NCTH) requires detailed understanding of what is bleeding. Our objectives were to describe the anatomic location of truncal bleeding in patients presenting with NCTH and compare endovascular (ENDO) management versus open (OPEN) management. METHODS: This is a retrospective study of adult trauma patients with NCTH admitted to four urban Level I trauma centers in the Houston and San Antonio metropolitan areas in 2008 to 2012...
July 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28632138/monitoring-lung-contusion-in-a-porcine-polytrauma-model-using-eit-an-application-study
#17
Susana Aguiar Santos, Carlos Castelar Wembers, Klemens Horst, Roman Pfeifer, Tim-Philipp Simon, Hans-Christoph Pape, Frank Hildebrand, Michael Czaplik, Steffen Leonhardt, Daniel Teichmann
Lung contusion is the most common lung injury following blunt chest trauma which, in turn, is associated with high mortality rates (Gavelli et al., 2002). Lung contusion is characterized by hemorrhage and edema with consecutively reduced compliance. In this study, unilateral lung contusion and other traumata were induced in 12 pigs by using a bolt gun machine. To investigate the pathophysiological consequences of lung contusion, information on clinical parameters was collected and monitored regularly while animals were additionally monitored with electrical impedance tomography (EIT) before trauma, and at 4, 24, 48 and 72 h after polytrauma...
June 20, 2017: Physiological Measurement
https://www.readbyqxmd.com/read/28631272/a-unique-fatal-moose-attack-mimicking-homicide
#18
Petur Gudmannsson, Johan Berge, Henrik Druid, Göran Ericsson, Anders Eriksson
Fatalities caused by animal attacks are rare, but have the potential to mimic homicide. We present a case in which a moose attacked and killed a woman who was walking her dog in a forest. Autopsy showed widespread blunt trauma with a large laceration on one leg in which blades of grass were embedded. Flail chest was the cause of death. The case was initially conceived as homicide by means of a riding lawn mower. A review of the case by moose experts and analyses of biological trace material that proved to originate from moose, established the true source of injury...
June 20, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28625972/prevalence-subtypes-severity-and-determinants-of-ocular-trauma-the-singapore-chinese-eye-study
#19
Mark Yz Wong, Ryan Ek Man, Preeti Gupta, Charumathi Sabanayagam, Tien Yin Wong, Ching-Yu Cheng, Ecosse Luc Lamoureux
PURPOSE: To describe the prevalence, subtypes, severity and determinants of ocular trauma (OT) in a population-based study in Singapore. METHODS: We included 3353 Chinese adults aged ≥40 years from the Singapore Chinese Eye Study, a population-based study, conducted between 2009 and 2011. OT was defined as self-reported history of any eye injury requiring medical attention with or without hospitalisation, and further classified as blunt object, sharp object or chemical burns related...
June 16, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28625692/implementation-of-clinical-effectiveness-guidelines-for-solid-organ-injury-after-trauma-10-year-experience-at-a-level-1-pediatric-trauma-center
#20
Christine M Leeper, Isam Nasr, Abigail Koff, Christine McKenna, Barbara A Gaines
BACKGROUND: Diagnostic imaging of pediatric blunt abdominal trauma is evolving in light of increased attention to radiation exposure. We hypothesize that the implementation of imaging guidelines has reduced total CT scans without missing clinically significant injury. METHODS: We retrospectively reviewed blunt trauma patients age 0-17 with solid organ injury who underwent CT scan at our academic level 1 pediatric trauma center between 2005 and 2014. Variables including total annual trauma admissions and CT scans, demographics, injury characteristics, and procedures were recorded...
June 6, 2017: Journal of Pediatric Surgery
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