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Penetrating trauma

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https://www.readbyqxmd.com/read/28717905/analysis-of-injury-and-mortality-patterns-in-deceased-patients-with-road-traffic-injuries-an-autopsy-study
#1
Roman Pfeifer, Sylvia Schick, Christopher Holzmann, Matthias Graw, Michel Teuben, Hans-Christoph Pape
BACKGROUND: Despite improvements in prevention and rescue, mortality rates after severe blunt trauma continue to be a problem. The present study analyses mortality patterns in a representative blunt trauma population, specifically the influence of demographic, injury pattern, location and timing of death. METHODS: Patients that died between 1 January 2004 and 31 December 2005 were subjected to a standardised autopsy. INCLUSION CRITERIA: death from blunt trauma due to road traffic injuries (Injury Severity Score ≥ 16), patients from a defined geographical area and death on scene or in hospital...
July 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28706770/open-globe-injury-with-an-interesting-intra-ocular-foreign-body
#2
Ekjyot Gill, Matthew Shulman, Sid Schechet, Lawson Grumbine
Introduction: Cases of penetrating ocular trauma due to osseous material are limited, so reported incidents are valuable in determining outcomes and proper treatment courses. Case description: We report a case of an open globe injury of the left eye with an intraocular foreign body occurring after a firework exploded in the hand of a 22-year-old man. The patient presented with light perception vision in the injured eye with a full-thickness limbal laceration and dense hyphema obscuring fundoscopy. CT scan revealed a hyperdense foreign body juxtaposed to the lens...
2017: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/28706766/a-case-based-review-of-the-management-of-penetrating-brain-trauma
#3
Jason Milton, Alex Rugino, Kailash Narayan, Chris Karas, Victor Awuor
Principles of penetrating head trauma management were established by Harvey Cushing in relation to the management of penetrating brain injuries of World War One. Cushing radically debrided the scalp and skull and aggressively irrigated wound tracks to remove foreign bodies. He would then obtain water-tight closure. Cushing significantly decreased infection rates which reportedly limited the major cause of mortality due to penetrating head injuries. Many advances have been made by contributions from World War Two, Korean War, Vietnam War, and Iran/Iraq conflicts...
June 12, 2017: Curēus
https://www.readbyqxmd.com/read/28705344/-claude-bernard-horner-syndrome-revealing-spontaneous-aneurysm-of-the-vertebral-artery
#4
M Zoulati, T Bakkali, N Aghoutane, B Bensaid, Y Lyazidi, Y Ouharakat, H Chtata, M Taberkant
False aneurysms of the extracranial vertebral artery (FAVA) are rare because of the path of the artery at the level of the transverse holes. They can be secondary to penetrating cervical trauma, spontaneous in the course of an angiopathy such as Ehlers-Danlos syndrome, or iatrogenic. We report the case of a 31-year-old woman who presented a syndrome of Claude Bernard-Horner related to a spontaneous FAVA. The angioscanner confirmed the diagnosis and the patient underwent successful surgical treatment of the false aneurysm with ligature of the vertebral artery...
July 2017: J Med Vasc
https://www.readbyqxmd.com/read/28704207/the-adult-male-rape-victim-forensic-description-of-a-series-of-57-cases
#5
Michelangelo Bruno Casali, Elisa Palazzo, Alberto Blandino, Alessio Battistini, Francesca Motta, Alessandra Kustermann, Cristina Cattaneo
A retrospective analysis on 57 adult male victims of sexual violence has been performed. Age, nationality and anamnesis of the victims, location of the assault, type of violence, number and identity of the assailants, presence of physical injuries, lapse of time between the assault and the request of medical assistance, and toxicological and semen detection tests were analyzed. Victims were mostly in the 31- to 40-year age group. Ten victims referred themselves as either active homosexuals or bisexuals. Forced oral and/or anal penetration was registered in 86...
July 13, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28700412/parathyroid-hormone-as-a-marker-for-hypoperfusion-in-trauma-a-prospective-observational-study
#6
Scott C Fligor, Katie M Love, Bryan R Collier, Daniel I Lollar, Mark E Hamill, Andrew D Benson, Eric H Bradburn
BACKGROUND: Hyperparathyroidism is common in critical illness. Intact parathyroid hormone has a half-life of 3 to 5 minutes due to rapid clearance by the liver, kidneys, and bone. In hemorrhagic shock, decreased clearance may occur, thus making parathyroid hormone a potential early marker for hypoperfusion. We hypothesized that early hyperparathyroidism predicts mortality and transfusion in trauma patients. METHODS: A prospective observational study was performed at a Level 1 trauma center in consecutive adult patients receiving the highest level of trauma team activation...
July 12, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697023/clot-dynamics-and-mortality-the-ma-r-ratio
#7
Stephanie A Savage, Ben L Zarzaur, Timothy H Pohlman, Brian L Brewer, Louis J Magnotti, Martin A Croce, Garrett H Lim, Ali C Martin
INTRODUCTION: The coagulopathy of trauma, illustrated by a short R-time, is common and well understood. The physiology behind this may be early thrombin burst with rapid clot formation. Rapid consumption of fibrinogen, however, may result in weak clot and substrate depletion, resulting in low MA. While these characteristics are interesting, utilizing TEG to identify those at risk for subsequent bleeding diathesis, especially in those who do not demonstrate early signs of physiologic derangement, is challenging...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697019/outcome-differences-in-adolescent-blunt-severe-polytrauma-patients-managed-at-pediatric-versus-adult-trauma-centers
#8
Amelia T Rogers, Brian W Gross, Alan D Cook, Cole D Rinehart, Caitlin A Lynch, Eric H Bradburn, Colin C Heinle, Frederick B Rogers
BACKGROUND: Previous research suggests adolescent trauma patients can be managed equally effectively at pediatric and adult trauma centers. We sought to determine whether this association would be upheld for adolescent severe polytrauma patients. We hypothesized that no difference in adjusted outcomes would be observed between pediatric trauma centers (PTC) and adult trauma centers (ATC) for this population. METHODS: All severely injured adolescent (aged 12-17 years) polytrauma patients were extracted from the Pennsylvania Trauma Outcomes Study database from 2003-2015...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28692906/development-of-a-penetration-friction-apparatus-pfa-to-measure-the-frictional-performance-of-surgical-suture
#9
Gangqiang Zhang, Tianhui Ren, Walter Lette, Xiangqiong Zeng, Emile van der Heide
Nowadays there is a wide variety of surgical sutures available in the market. Surgical sutures have different sizes, structures, materials and coatings, whereas they are being used for various surgeries. The frictional performances of surgical sutures have been found to play a vital role in their functionality. The high friction force of surgical sutures in the suturing process may cause inflammation and pain to the person, leading to a longer recovery time, and the second trauma of soft or fragile tissue. Thus, the investigation into the frictional performance of surgical suture is essential...
June 26, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28690961/a-unique-presentation-of-an-intracranial-abscess-secondary-to-retained-projectile-after-debridement-with-dural-closure
#10
Jason Milton, Victor Awuor
Patients with penetrating head trauma with retained projectiles develop intracranial abscesses as a common complication. The most common presentation is a suddenly worsening headache. The most common pathogen identified is staphylococcus. Outcomes are related to adherence of Matson's tenets. This case study details the presentation of a 19-year-old patient that presented to the neurological surgery clinic without neurologic deficits. Further questioning revealed complaints of intermittent diffuse headaches with bilateral upper extremity shock-like sensation for two weeks...
June 9, 2017: Curēus
https://www.readbyqxmd.com/read/28689948/endovascular-treatment-of-penetrating-injury-to-the-vertebral-artery-by-a-stab-wound-case-report-and-literature-review
#11
Dafne Braga Diamante Leiderman, Antonio Eduardo Zerati, Nelson Wolosker, Henry Augusto Hoffmann Melo, Erasmo Simão Da Silva, Nelson De Luccia
BACKGROUND: We describe a unique case of a patient with penetration of the cervical region by a stab wound, who required emergency care for the controlled removal of the knife and for vertebral artery trauma (VAT) treatment. Although rare, VAT causes high morbidity and mortality. METHODS: A patient admitted for emergency care was diagnosed with traumatic complete section of the vertebral artery by a knife, and underwent to removal of the knife under radioscopic supervision and vertebral artery embolization with coils...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28689937/multiple-spontaneous-iliac-and-femoral-arteriovenous-fistulas
#12
Masahiko Fujii, Manabu Sakurai, Kenji Mogi, Anan Nomura, Tomoki Sakata, Yoshiharu Takahara
An arteriovenous fistula in a limb involves an abnormal connection between a limb artery and vein. It can be due to trauma or iatrogenic injury. Traumatic arteriovenous fistulas can be caused by penetrating or gunshot injuries to the limb, while iatrogenic causes include catheter intervention to the groins or open surgery of the inguinal space. By contrast, the occurrence of multiple spontaneous arteriovenous fistulas is rare. We report a case of endovascular therapy for multiple spontaneous arteriovenous fistulas between the iliac artery and the vein, common femoral artery and the vein, superficial artery and the saphenous vein, and deep femoral artery and the vein...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28688640/clinical-phenotypes-of-us-level-i-trauma-centers-use-of-clustering-methodology
#13
Joseph D Forrester, Thomas G Weiser, Paul Maggio, Timothy Browder, Lakshika Tennakoon, David A Spain, Kristan Staudenmayer
BACKGROUND: American College of Surgeons Level I Trauma Centers (ACSL1TCs) meet the same personnel and structural requirements but serve different populations. We hypothesized that these nuanced differences may amenable to description through mathematical clustering methodology. METHODS: The National Trauma Data Bank 2014 was used to derive information on ACSL1TCs. Explorative cluster hypothesis generation was performed using Ward's linkage to determine expected number of clusters based on patient and injury characteristics...
July 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28688519/comparative-assessment-of-in-hospital-trauma-mortality-at-a-south-african-trauma-center-and-matched-patients-treated-in-the-united-states
#14
Richard T Spence, John W Scott, Adil Haider, Pradeep H Navsaria, Andrew J Nicol
BACKGROUND: The unacceptably high rate of death and disability due to injury in Sub-Saharan Africa is alarming. The objective of this work was to compare mortality rates between severely injured trauma patients at a high-volume trauma center in South Africa with matched patients in the United States. METHODS: Clinical databases from the Groote Schuur Hospital for patients treated in Cape Town, South Africa and the American College of Surgeon's National Trauma Databank for patients treated at large academic trauma centers in the United States were used...
July 5, 2017: Surgery
https://www.readbyqxmd.com/read/28684079/a-comparison-of-base-deficit-and-vital-signs-in-the-early-assessment-of-patients-with-penetrating-trauma-in-a-high-burden-setting
#15
Mark Peter Dunham, Benn Sartorius, Grant Llewellyn Laing, John Lambert Bruce, Damian Luiz Clarke
INTRODUCTION: An assessment of physiological status is a key step in the early assessment of trauma patients with implications for triage, investigation and management. This has traditionally been done using vital signs. Previous work from large European trauma datasets has suggested that base deficit (BD) predicts clinically important outcomes better than vital signs (VS). A BD derived classification of haemorrhagic shock appeared superior to one based on VS derived from ATLS criteria in a population of predominantly blunt trauma patients...
June 20, 2017: Injury
https://www.readbyqxmd.com/read/28674910/diagnostic-imaging-in-pediatric-thoracic-trauma
#16
Claudia Lucia Piccolo, Stefania Ianniello, Margherita Trinci, Michele Galluzzo, Michele Tonerini, Massimo Zeccolini, Giuseppe Guglielmi, Vittorio Miele
Thoracic trauma accounts for approximately 14% of blunt force traumatic deaths, second only to head injuries. Chest trauma can be blunt (90% of cases) or penetrating. In young patients, between 60 and 80% of chest injuries result from blunt trauma, with over half as a consequence of impact with motor vehicles, whereas in adolescents and adults, penetrating trauma has a statistically more prominent role. Pulmonary contusions and rib fractures are the most frequent injuries occurring. Chest X-ray is the first imaging modality of choice to identify patients presenting with life-threatening conditions (i...
July 4, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28666242/thorn-in-my-spine-a-case-of-a-retained-intradural-extramedullary-foreign-body
#17
Nakul Reddy, Peter Fata, Anthony Balzer, Pedro Diaz-Marchan, Christie M Lincoln
Foreign bodies in the spine are most commonly traumatic and managed in an acute setting. A few case reports describe foreign bodies resulting in delayed neurologic dysfunction, most commonly iatrogenic or from penetrating injury. We present a 30-year old man with lower extremity weakness from an intradural extramedullary foreign body granuloma secondary to a thorn, which was initially thought to represent an aggressive malignant process with intra and extramedullary involvement on MR. Postoperatively, the patient endorsed a causative trauma several years prior...
May 18, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28661715/patient-characteristics-and-temporal-trends-in-police-transport-of-blunt-trauma-patients-a-multicenter-retrospective-cohort-study
#18
Elinore J Kaufman, Sara F Jacoby, Catherine E Sharoky, Brendan G Carr, M Kit Delgado, Patrick M Reilly, Daniel N Holena
BACKGROUND: Police transport (PT) of penetrating trauma patients has the potential to decrease prehospital times for patients with life-threatening hemorrhage and is part of official policy in Philadelphia, Pennsylvania. We hypothesized that rates of PT of bluntly injured patients have increased over the past decade. METHODS: We used Pennsylvania Trauma Outcomes Study registry data from 2006-15 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia...
June 29, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28661610/-durable-persistence-of-a-biocompatible-foreign-body-in-a-vertebral-channel-in-open-penetrating-trauma-of-a-spinal-cord-clinico-experimental-and-pathomorphological-peculiarities
#19
V I Tsymbalyuk, V V Medvedyev, V M Semenova, N Ya Grydina, Yu Ya Yaminskyi, Yu Yu Senchyk, N G Draguntsova, O A Rybachuk, S M Dychko, T I Petriv
Simulation model of open penetrating wound of a spinal cord (SC) with its durable com- pression by biocompatible foreign body, was tasted. Experimental animals - mature male rats (inbred line, descendent from a Wistar breed); the trauma simulation model - a left- sided transsection of the SC half on the Txi level; experimental groups: the main (a SC trau- ma + homotopic implantation of microporous hydrogel fragment - foreign body [n=10]), groups of comparison (the SC trauma [n=16]; the SC trauma + homotopic implantation of chemically identical analogue of hydrogel - NeuroGelTM [n=20])...
August 2016: Klinichna Khirurhiia
https://www.readbyqxmd.com/read/28660819/selective-non-operative-management-of-abdominal-stab-wounds-is-a-safe-and-cost-effective-strategy-a-south-african-experience
#20
Kss Dayananda, V Y Kong, J L Bruce, G V Oosthuizen, G L Laing, D L Clarke
INTRODUCTION Selective non-operative management (SNOM) of abdominal stab wounds is well established in South Africa. SNOM reduces the morbidity associated with negative laparotomies while being safe. Despite steady advances in technology (including laparoscopy, computed tomography [CT] and point-of-care sonography), our approach has remained clinically driven. Assessments of financial implications are limited in the literature. The aim of this study was to review isolated penetrating abdominal trauma and analyse associated incurred expenses...
July 2017: Annals of the Royal College of Surgeons of England
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