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Penetrating trauma

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https://www.readbyqxmd.com/read/28542808/ascending-aortic-rupture-through-a-penetrating-atherosclerotic-ulcer-a-rare-cause-of-sudden-unexpected-death
#1
Supawon Srettabunjong
Spontaneous rupture of the aorta through an atherosclerotic lesion without preexisting aortic aneurysm, dissection, or history of trauma is very rare. Without prompt aortic repair, all cases result in sudden death with a definitive diagnosis made only intraoperatively or during autopsy. The phenomenon has been uniformly found in individuals with hypertension. The author reports a sudden unexpected death caused by spontaneous rupture of the ascending aorta in a 57-year-old man with a history of hypertension...
May 23, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28541852/the-pennsylvania-trauma-outcomes-study-risk-adjusted-mortality-model-results-of-a-statewide-benchmarking-program
#2
Douglas J Wiebe, Daniel N Holena, M Kit Delgado, Nathan McWilliams, Juliet Altenburg, Brendan G Carr
Trauma centers need objective feedback on performance to inform quality improvement efforts. The Trauma Quality Improvement Program recently published recommended methodology for case mix adjustment and benchmarking performance. We tested the feasibility of applying this methodology to develop risk-adjusted mortality models for a statewide trauma system. We performed a retrospective cohort study of patients ≥16 years old at Pennsylvania trauma centers from 2011 to 2013 (n = 100,278). Our main outcome measure was observed-to-expected mortality ratios (overall and within blunt, penetrating, multisystem, isolated head, and geriatric subgroups)...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28541848/penetrating-chest-trauma-and-pericarditis
#3
Theadore Hufford, Jonathan Rubin, Elizabeth Gwinn, Samuel Kingsley
No abstract text is available yet for this article.
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28538646/defining-the-ge-junction-in-trauma-epidemiology-and-management-of-a-challenging-injury
#4
Morgan Schellenberg, Kenji Inaba, James M Bardes, Daniel OʼBrien, Lydia Lam, Elizabeth Benjamin, Daniel Grabo, Demetrios Demetriades
INTRODUCTION: Injuries to the gastroesophageal (GE) junction are infrequently encountered because of the high mortality of associated injuries. Consequently, there is a paucity of literature on the patient demographics and treatment options. The aim of this study was to examine the epidemiology, surgical management, and outcomes of these rare injuries. METHODS: Patients presenting to LAC+USC Medical Center (01/2008-08/2016) with traumatic esophageal or gastric injury (ICD-9 and -10 codes) were extracted from the trauma registry...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538639/development-of-the-emergency-preservation-and-resuscitation-for-cardiac-arrest-from-trauma-epr-cat-clinical-trial
#5
Samuel A Tisherman, Hasan B Alam, Peter M Rhee, Thomas M Scalea, Tomas Drabek, Raquel M Forsythe, Patrick M Kochanek McCm
BACKGROUND: Patients who suffer a cardiac arrest from trauma rarely survive, even with aggressive resuscitation attempts, including an Emergency Department (ED) thoracotomy. Emergency Preservation and Resuscitation (EPR) was developed to utilize hypothermia to buy time to obtain hemostasis before irreversible organ damage occurs. Large animal studies have demonstrated that cooling to tympanic membrane temperature 10°C during exsanguination cardiac arrest can allow up to 2 hours of circulatory arrest and repair of simulated injuries with normal neurologic recovery...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538632/implications-of-the-tqip-inclusion-of-non-survivable-injuries-in-performance-benchmarking-tqip-inclusion-of-non-survivable-injuries
#6
Jiselle B Heaney, Rebecca Schroll, Jennifer Turney, Lance Stuke, Alan B Marr, Patrick Greiffenstein, Rosemarie Robledo, Amanda Theriot, Juan Duchesne, John Hunt
BACKGROUND: The Trauma Quality Improvement Project (TQIP) uses an injury prediction model for performance benchmarking. We hypothesize that at a level 1 high-volume penetrating trauma center, performance outcomes will be biased due to inclusion of patients with non-survivable injuries. METHODS: Retrospective chart review was conducted for all patients included in the institutional TQIP analysis from 2013-2014 with length of stay (LOS) < 1 day to determine survivability of the injuries...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538629/outcomes-following-traumatic-injury-in-patients-with-preexisting-psychiatric-illness
#7
Erika Falsgraf, Kenji Inaba, Amory de Roulet, Megan Johnson, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Aaron Strumwasser, Demetrios Demetriades
BACKGROUND: Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness following traumatic injury. METHODS: This is a retrospective study of trauma patients ≥18 years old admitted to LAC+USC Medical Center between January 2008 and March 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538329/perioperative-care-for-pediatric-patients-with-penetrating-brain-injury-a-review
#8
Marco Mikhael, Elizabeth Frost, Maria Cristancho
Traumatic brain injury (TBI) continues to be the leading cause of death and acquired disability in young children and adolescents, due to blunt or penetrating trauma, the latter being less common but more lethal. Penetrating brain injury (PBI) has not been studied extensively, mainly reported as case reports or case series, due to the assumption that both types of brain injury have common pathophysiology and consequently common management. However, recommendations and guidelines for the management of PBI differ from those of blunt TBI in regards to neuroimaging, intracranial pressure (ICP) monitoring, and surgical management including those pertaining to vascular injury...
May 19, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28536882/penetrating-chest-trauma-caused-by-a-blank-cartridge-actuated-rubber-ball-projectile-case-presentation-and-ballistic-investigation-of-an-uncommon-weapon-type
#9
Matthias Frank, Dieter Peters, Wolfram Klemm, Rico Grossjohann, Axel Ekkernkamp, Britta Bockholdt, Julia Seifert
Recently, an increasing number of an uncommon weapon type based on a caliber 6-mm Flobert blank cartridge actuated revolver which discharges 10-mm-diameter rubber ball projectiles has been confiscated by police authorities following criminal offenses. A recent trauma case presenting with a penetrating chest injury occasioned an investigation into the basic ballistic parameters of this type of weapon. Kinetic energy E of the test projectiles was calculated between 5.8 and 12.5 J. Energy density ED of the test projectiles was close to or higher than the threshold energy density of human skin...
May 23, 2017: International Journal of Legal Medicine
https://www.readbyqxmd.com/read/28531301/a-political-case-of-penetrating-cranial-trauma-the-injury-of-james-scott-brady
#10
Richard Menger, Piyush Kalakoti, Rimal Hanif, Osama Ahmed, Anil Nanda, Bharat Guthikonda
James Brady, the White House press secretary during President Ronald Reagan's first term in office, was 1 of 4 people (including the President) wounded during an attempted assassination attempt on President Reagan's life on March 30, 1981. John Hinckley, Jr. was found not guilty of this attempt by reason of insanity. The assassination attempt was a ploy by Hinckley, Jr. to impress the actress Jodie Foster. Brady was the most seriously injured of the 4 who were wounded. He suffered a gunshot wound to the left forehead that traveled through the left frontal lobe, corpus callosum, and then into the right frontal and temporal lobes...
May 22, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28530785/anti-edematous-anti-inflammatory-and-neuroprotective-effect-of-etanercept-in-acute-stage-in-experimental-head-injury
#11
Ömer Aykanat, Durmuş Oğuz Karakoyun, Mehmet Erhan Türkoğlu, Cem Dinç
BACKGROUND: To study the anti-edematous, anti-inflammatory, and neuroprotective effect of etanercept in the model of experimental head injury. METHODS: In this study, 40 male-adult Spraque-Dawley rats, with weight ranging from 250g to 300g, were used. The rats are divided into groups as control; non-penetrating trauma; trauma +NS; post-traumatic normal saline; trauma + D; post-traumatic dexamethasone and trauma + E. All medicines were given into peritoneum. After applying trauma and medicine, rats were decapitated in the 24th hour and the samples were studied histopathologically...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28526897/the-impact-of-pre-injury-direct-oral-anticoagulants-compared-to-warfarin-in-geriatric-g-60-trauma-patients
#12
J F Barletta, S Hall, J F Sucher, J K Dzandu, M Haley, A J Mangram
PURPOSE: Pre-injury oral anticoagulants are associated with worse outcomes in geriatric (G-60) trauma patients, but there are limited data comparing warfarin with direct oral anticoagulants (DOAC). We sought to compare outcomes in G-60 trauma patients taking pre-injury DOACs vs. warfarin. METHODS: All trauma patients, age ≥60 who were admitted to the hospital and taking an oral anticoagulant pre-injury were retrospectively identified. Patients were excluded if their reason for admission was a suicide attempt or penetrating extremity injury...
May 19, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28523090/penetrating-craniomaxillofacial-injury-caused-by-a-pneumatic-nail-gun
#13
Kevin Jae Choi, Marisa Ann Ryan, Tracy Cheng, David Powers
Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities. He did not present in extremis but required elective endotracheal intubation for intraoperative assessment and treatment. Airway management was enhanced by the use of lingual nerve and inferior alveolar nerve blocks via the Vazirani-Akinosi technique to maintain spontaneous respiration while the tongue was distracted from the palate...
June 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/28522784/penetrating-trauma-of-the-face-and-facial-skeleton-a-case-series-of-six-patients
#14
Aneta Neskoromna-Jędrzejczak, Katarzyna Bogusiak, Aleksander Przygoński, Bogusław Antoszewski
Penetrating traumas of the facial skeleton are relatively rare; however, they can be dangerous and even life-threatening. The epidemiology of facial skeleton trauma is diverse and depends on the affected region, age, and the kind of foreign body that caused the injury. In Poland, the most common cause of penetrating traumas are accidents and assaults, and only rarely accidents are related to improper use of firecrackers or fireworks. The aim of this study is to present a literature review and our own experience with penetrating traumas of the face and the facial part of the cranium...
February 28, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/28521330/pediatric-penetrating-neck-trauma-hard-signs-of-injury-and-selective-neck-exploration
#15
Rober A Tessler, Huong Nguyen, Christoper Newton, James Betts
BACKGROUND: Selective neck exploration and computed tomography angiography (CTA) in penetrating neck trauma have been well described in adults. However, data in the pediatric population are sparse. The extent to which these practices have been adopted in pediatric patients is unknown. METHODS: Retrospective, single-center cohort study of pediatric penetrating neck trauma for the years 2001 to 2014 in a dedicated children's hospital/Level 1 pediatric trauma center...
June 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28515606/gender-based-assessment-of-survival-in-trauma-hemorrhagic-shock-a-retrospective-analysis-of-indian-population
#16
Pankaj Verma, Sanjeev Bhoi, Upendra Baitha, Tej Prakash Sinha, Prakash Ranjan Mishra
INTRODUCTION: Trauma-hemorrhagic shock (THS) is a leading cause of death. Female rats and women experience better outcomes in terms of survival after major trauma as compared to males. There are limited data in Indian population. Authors studied the gender-based outcome of patients with Class IV hemorrhagic shock due to blunt trauma and the distribution of factors among males and females which are known to affect outcome. MATERIALS AND METHODS: It was a retrospective study with data of trauma victims between January 2008 and July 2013...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28515545/traumatic-brain-injury-and-neuropsychiatric-complications
#17
REVIEW
Saeed Ahmed, Hema Venigalla, Hema Madhuri Mekala, Sara Dar, Mudasar Hassan, Shahana Ayub
Traumatic brain injury (TBI) occurs when a blow or jolt to the head or a penetrating injury results in damage to the brain. It is the most frequent cause of hospitalization in young people with a higher prevalence in men. TBI is the leading cause of disability and mortality between the ages 1 and 45. TBI can be caused either by the direct result of trauma or due to a complication of the primary injury. The most common etiological factors for TBI are falls, road traffic accidents, violent physical assaults, and injuries associated with athletic activities...
March 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28508098/patient-mortality-following-alcohol-use-and-trauma-a-propensity-matched-analysis
#18
N Ahmed, P Greenberg
OBJECTIVE: To examine the outcomes of trauma patients who tested positive for alcohol at the time of hospital arrival versus those who tested negative. METHODS: Data were pulled from the National Trauma Data Bank (2007-2010). All injured patients who were ≥14 years of age, sustained a "blunt" or "penetrating" injury, had complete systolic blood pressure (SBP) and heart rate (HR) records, were taken to a level 1 or 2 trauma center, and who received a confirmed blood alcohol test were included in the study...
May 15, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28506479/the-spectrum-and-management-of-noniatrogenic-vascular-trauma-in-the-pediatric-population
#19
Ahmed Kayssi, Maged Metias, Jacob C Langer, Graham Roche-Nagle, Augusto Zani, Thomas L Forbes, Paul Wales, Sebastian K King
BACKGROUND: To describe the spectrum of noniatrogenic pediatric vascular injuries and their outcomes at a large tertiary pediatric hospital. METHODS: Retrospective review of a prospectively-maintained trauma database, identifying children with noniatrogenic vascular injuries managed between 1994 and 2014. RESULTS: A total of 198 patients were identified. Those patients with a digital or intracerebral vascular injury (92/198) were excluded from further analysis...
April 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28501568/polytrauma-induced-hepatic-stress-response-and-the-development-of-liver-insulin-resistance
#20
Robert M Akscyn, J Lee Franklin, Tatyana A Gavrikova, Joseph L Messina
Insulin resistance and metabolic dysfunction are common following injury. Polytrauma is defined as combined injuries to more than one body part or organ system, and is common in modern warfare, as well as automobile and industrial accidents. Polytrauma can include any combination of burn injury, fracture, hemorrhage, trauma to the extremities, and blunt or penetrating trauma. Multiple minor injuries are often more deleterious than a more severe single injury. To investigate the mechanisms of development of insulin resistance following injury, we have developed a rat model of polytrauma which combined soft tissue trauma with burn injury and penetrating gastrointestinal (GI) trauma...
May 10, 2017: Biochimica et Biophysica Acta
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