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Penetrating trauma

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https://www.readbyqxmd.com/read/28328676/correlation-between-factor-f-xia-fixa-and-tissue-factor-and-trauma-severity
#1
Shannon M Prior, Mitchell J Cohen, Amanda S Conroy, Mary F Nelson, Lucy Z Kornblith, Benjamin M Howard, Saulius Butenas
BACKGROUND: It has been observed that trauma patients often display elevated procoagulant activity that could be caused, in part, by tissue factor (TF). We previously observed that trauma patients with thermal, blunt and penetrating injuries have active FIXa and FXIa in their plasma. In the current study we evaluated the effect of injury severity, with or without accompanying shock, on the frequency and concentration of TF, FIXa and FXIa in plasma from trauma patients. METHODS: Eighty trauma patients were enrolled and divided equally into 4 groups based on their injury severity score (ISS) and base deficit (BD):Group 1: Non-severe injury, no shockGroup 2: Non-severe injury, with shockGroup 3: Severe injury, no shockGroup 4: Severe injury, with shockBlood was collected at a 0 time-point (first blood draw upon arrival at hospital) and citrate plasma was prepared, frozen and stored at -80C...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28326453/violent-trauma-recidivism-does-all-violence-escalate
#2
R M Nygaard, A P Marek, S R Daly, J M Van Camp
PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28324353/the-fast-d-protocol-a-simple-method-to-rule-out-traumatic-vascular-injuries-of-the-lower-extremities
#3
Miguel Angel Montorfano, Lisandro Miguel Montorfano, Federico Perez Quirante, Federico Rodríguez, Leonardo Vera, Luca Neri
BACKGROUND: The aim of this study is to assess the accuracy of a Fast Doppler protocol for the examination of an injured lower limb, namely 2-Point Fast Doppler (2PFD), in order to rapidly triage arterial lesions after penetrating trauma. METHODS: The presence of flow and the aspects of the Doppler waveform of the dorsalis pedis artery (DPA) and posterior tibial artery (PTA) of the injured lower limb (2PFD) were evaluated immediately before the execution of a standardized Color Duplex Doppler (SD) evaluation in 149 limbs of 140 patients with gunshot penetrating injuries...
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#4
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28320053/management-of-colorectal-trauma-a-review
#5
REVIEW
Ju Yong Cheong, Anil Keshava
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed...
March 20, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#6
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28318439/focused-assessment-with-sonography-in-trauma-fast-in-2017-what-radiologists-can-learn
#7
John R Richards, John P McGahan
Focused assessment with sonography in trauma (FAST) has been extensively utilized and studied in blunt and penetrating trauma for the past 3 decades. Prior to FAST, invasive procedures such as diagnostic peritoneal lavage and exploratory laparotomy were commonly utilized to diagnose intraabdominal injury. Today the FAST examination has evolved into a more comprehensive study of the abdomen, heart, chest, and inferior vena cava, and many variations in technique, protocols, and interpretation exist. Trauma management strategies such as laparotomy, laparoscopy, endoscopy, computed tomographic angiography, angiographic intervention, serial imaging, and clinical observation have also changed over the years...
April 2017: Radiology
https://www.readbyqxmd.com/read/28304388/pirfenidone-inhibits-post-traumatic-proliferative-vitreoretinopathy
#8
B N M K Khanum, R Guha, V P Sur, S Nandi, S K Basak, A Konar, S Hazra
PurposeThe purpose of the study was to evaluate the efficacy and safety of intravitreal pirfenidone for inhibition of proliferative vitreoretinopathy (PVR) in a model of penetrating ocular injury.Patients and methodsPenetrating trauma was induced on the retina of rabbit and treated either with 0.1 ml of phosphate-buffered saline (PBS) or 0.1 ml of 0.5% pirfenidone, and development of PVR was evaluated clinically and graded after 1 month. Histopathology and immunohistochemistry with transforming growth factor beta (TGFβ), alpha smooth muscle actin (αSMA), and collagen-1 were performed to assess the fibrotic changes...
March 17, 2017: Eye
https://www.readbyqxmd.com/read/28303330/ocular-trauma-score-as-prognostic-value-in-traumatic-ocular-injuries-due-to-rotating-wire-brushes
#9
Konstantine Purtskhvanidze, Florian Rüfer, Alexa Klettner, Christoph Borzikowsky, Johann Roider
PURPOSE: Rotating wire brushes are used, e.g., for rust removal. Detaching fragments can cause severe eye injuries. The purpose of this study was to investigate mechanism, severity, clinical outcome, validity of Ocular Trauma Score (OTS) and to assess the likelihood of final visual acuity. METHODS: Twenty patients with traumatic ocular injuries by rotating wire brushes were included. Location and type of injury, grade of injury according to OTS, surgical procedure, and development of visual acuity were evaluated...
March 16, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/28298316/paediatric-infectious-keratitis-a-case-series-of-107-children-presenting-to-a-tertiary-referral-centre
#10
Julia Dutra Rossetto, Kara M Cavuoto, Carla J Osigian, Ta Chen Peter Chang, Darlene Miller, Hilda Capo, Oriel Spierer
BACKGROUND/AIMS: Corneal ulcers can result in severe visual impairment in children. The recent trends of paediatric microbial ulcerative keratitis in the USA are unknown. The purpose of this study is to report the risk factors, microbiological profile and treatment outcomes of paediatric microbial keratitis in South Florida. METHODS: A university-based tertiary eye care centre retrospective case series between 1992 and 2015. Medical records of 107 paediatric patients (age <18 years) with the diagnosis of microbial ulcerative keratitis were analysed...
March 15, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/28292518/the-management-of-penetrating-rectal-and-anal-trauma-a-systematic-review
#11
Daniel P Ahern, Michael E Kelly, Danielle Courtney, Emanuele Rausa, Des C Winter
INTRODUCTION: Traumatic injuries to the lower gastrointestinal tract (rectum and anus) have been largely reported in the military setting with sparse publications from the civilian setting. Additionally, there remains a lack of international consensus regarding definitive treatment pathways. This systematic review aimed to assess the current literature and propose a standardised treatment algorithm to aid management in the civilian setting. METHODS: A systematic review of available literature from 1999 to 2016 that was performed...
March 7, 2017: Injury
https://www.readbyqxmd.com/read/28291503/regenerative-and-antibacterial-properties-of-acellular-fish-skin-grafts-and-human-amnion-chorion-membrane-implications-for-tissue-preservation-in-combat-casualty-care
#12
Skuli Magnusson, Baldur Tumi Baldursson, Hilmar Kjartansson, Ottar Rolfsson, Gudmundur Fertram Sigurjonsson
BACKGROUND: Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. OBJECTIVES: The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28291461/corneal-and-corneoscleral-injury-in-combat-ocular-trauma-from-operations-iraqi-freedom-and-enduring-freedom
#13
Anton Vlasov, Denise S Ryan, Spencer Ludlow, Andrew Coggin, Eric D Weichel, Richard D Stutzman, Kraig S Bower, Marcus H Colyer
OBJECTIVES: To examine the incidence and the etiology of corneal and corneoscleral injuries in the setting of combat ocular trauma, and to determine what effect these injuries have on overall visual impairment from combat ocular trauma. METHODS: Retrospective, noncomparative, interventional case series, analyzing U.S. service members who were evacuated to the former Walter Reed Army Medical Center (WRAMC). Primary outcome measures were types of corneal injuries, length of follow-up at WRAMC, globe survival, and anatomical causes of blindness...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28288588/siderotic-cataract-with-no-signs-of-intraocular-foreign-body
#14
Ke-Ke Zhang, Wen-Wen He, Yi Lu, Xiang-Jia Zhu
BACKGROUND: Ocular siderosis is a clinical condition induced by deposition of an iron-containing intraocular foreign body. We report a unique case of histopathologically proven lens siderosis in a young woman with a preceding history of trauma but no signs of retained intraocular foreign body. CASE PRESENTATION: A 32-year-old woman presented with an opacified lens showing brownish deposits on the anterior capsule and underwent cataract surgery. Preoperative ophthalmic examination did not show any retained intraocular foreign body...
March 14, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28286841/diagnostic-accuracy-of-abdominal-wall-ultrasonography-and-local-wound-exploration-in-predicting-the-need-for-laparotomy-following-stab-wound
#15
Ali Vafaei, Kamran Heidari, Afshin Saboorizadeh, Amin Shams Akhtari
INTRODUCTION: Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU) and local wound exploration (LWE) in this regard. METHODS: This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28272851/the-effect-of-emergency-medical-services-response-on-outcome-of-trauma-laparotomy-at-a-level-1-trauma-centre-in-south-africa
#16
S Chowdhury, P H Navsaria, S Edu, A J Nicol
BACKGROUND: Due to resource constrained pre-hospital emergency medical services (EMSs) there is a significant delay in injured patients arriving at Groote Schuur Hospital Trauma Centre (GSHTC). The aim of the study was to examine the effectiveness of EMSs in transferring trauma patients to GSHTC. The effect of any delay to laparotomy from injury was noted. METHOD: A prospective audit of patients presented directly from the scene to GSHTC following abdominal trauma over a four-month period was performed...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28272849/enhanced-recovery-after-surgery-eras-in-penetrating-abdominal-trauma-a-prospective-single-center-pilot-study
#17
M R Moydien, R Oodit, S Chowdhury, S Edu, A J Nicol, P H Navsaria
BACKGROUND: Enhanced recovery after surgery (ERAS) programmes employed in elective surgery have provided strong evidence for decreased lengths of hospital stay without increase in postoperative complications. The aim of this study was to explore the role and benefits of ERAS implemented in patients undergoing emergency laparotomy for penetrating abdominal trauma. METHOD: Institutional University of Cape Town Human Research Ethics Committee (UCT-HREC) approved study...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28272241/trauma-injury-in-adult-underweight-patients-a-cross-sectional-study-based-on-the-trauma-registry-system-of-a-level-i-trauma-center
#18
Ching-Hua Hsieh, Wei-Hung Lai, Shao-Chun Wu, Yi-Chun Chen, Pao-Jen Kuo, Shiun-Yuan Hsu, Hsiao-Yun Hsieh
The aim of this study was to investigate and compare the injury characteristics, severity, and outcome between underweight and normal-weight patients hospitalized for the treatment of all kinds of trauma injury.This study was based on a level I trauma center Taiwan.The detailed data of 640 underweight adult trauma patients with a body mass index (BMI) of <18.5 kg/m and 6497 normal-weight adult patients (25 > BMI ≥ 18.5 kg/m) were retrieved from the Trauma Registry System between January 1, 2009, and December 31, 2014...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28267078/pantoea-species-bacteremia-in-a-child-with-sickle-cell-disease-looking-for-a-culprit
#19
Marisa I Oliveira, Sara Batalha, Catarina Gouveia, Raquel Maia, Paula Kjöllerstrom
Pantoea agglomerans has been classically associated with cellulitis or synovitis secondary to penetrating trauma by vegetation. It is an infrequent cause of systemic infections. We describe the case of a 5-year-old girl with sickle cell disease with P. agglomerans bacteremia and review its potential causes.
March 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28264250/an-intradiscal-granuloma-due-to-a-retained-wooden-foreign-body
#20
Mehmet Arif Aladag, Mehmet Akif Durak
We report a patient with a wooden foreign body granuloma in the intervertebral disc space being symptomatic 17 years after a paraspinal penetrant trauma. According to the our result of the search for wooden foreign body granulomas, this is the first case suffered from a wooden foreign body granuloma in the intervertebral disc space that reported in the literature. In this report, we emphasized the importance of rigorous examination and follow up in paraspinal wooden penetrant traumas.
March 2017: Journal of Korean Neurosurgical Society
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