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Acute surgical trauma

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https://www.readbyqxmd.com/read/28930954/acute-procedural-interventions-after-pediatric-blunt-abdominal-trauma-a-prospective-multicenter-evaluation
#1
Chase A Arbra, Adam M Vogel, Jingwen Zhang, Patrick D Mauldin, Eunice Y Huang, Kate B Savoie, Matthew T Santore, KuoJen Tsao, Tiffany G Ostovar-Kermani, Richard A Falcone, M Sidney Dassinger, John Recicar, Jeffrey H Haynes, Martin L Blakely, Robert T Russell, Bindi J Naik-Mathuria, Shawn D St Peter, David P Mooney, Chinwendu Onwubiko, Jeffrey S Upperman, Christian J Streck
BACKGROUND: Pediatric intra-abdominal injuries (IAI) from blunt abdominal trauma (BAT) rarely require emergent intervention. For those children undergoing procedural intervention, our aim was to understand the timing and indications for operation and angiographic embolization. METHODS: We prospectively enrolled children younger than 16 years after BAT at 14 Level I Pediatric Trauma Centers over a 1-year period. Patients with IAI who received an intervention (IAI-I) were compared with those who did not receive an intervention using descriptive statistics and univariate analysis; p less than 0...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28924066/-factors-contributing-to-surgical-intervention-for-subacute-subdural-hematoma-enlargement-in-patients-with-mild-head-injuries
#2
Yosuke Akamatsu, Tohru Sasaki, Masayuki Kanamori, Shinsuke Suzuki, Hiroshi Uenohara, Teiji Tominaga
Delayed neurological deterioration following mild head injury(MHI)usually occurs within 24 hours. However, some cases require delayed surgical evacuation of an acute subdural hematoma(ASDH), owing to subacute progressive hematoma enlargement. This study aimed to determine radiological or clinical parameters associated with surgical intervention in ASDH cases in which surgery was not initially considered necessary. From 2010 to 2015, 64 patients were non-surgically treated for ASDH following MHI. We evaluated the various outcomes of eventual surgical ASDH evacuation after the first 48 hours following injury, due to hematoma enlargement and clinical deterioration...
September 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28918531/penetrating-orbital-trauma-leading-to-trans-orbital-brain-herniation
#3
Siddharth Vankipuram, Chittij Srivastava, B K Ojha, Sushant Sahoo
INTRODUCTION: Development of a posttraumatic herniation of brain parenchyma through the orbit is a rare complication of orbital roof fracture. Mostly, the injury is due to a direct impact to the frontal region resulting in orbital roof fracture with dural defect and herniation of cerebrospinal fluid or brain parenchyma. These patients present with acute or gradually progressive proptosis with impending risk of loss of vision and mandate surgical decompression of optic nerve with watertight closure of the dural defect...
September 16, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28899769/incidence-and-predictors-of-complications-due-to-urethral-stricture-in-patients-awaiting-urethroplasty
#4
Nathan Y Hoy, David W Chapman, Nicholas Dean, Keith F Rourke
PURPOSE: The purpose of this study is to examine the incidence and predictors of complications due to urethral stricture in patients awaiting urethroplasty. METHODS AND METHODS: A retrospective chart review of patients undergoing urethroplasty from 2009-2013 was performed. The primary outcome was complications, defined as any unplanned interaction with the health care system due to the urethral stricture during the period between decision for surgery and urethroplasty...
September 9, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28899559/emergency-general-surgery-and-trauma-outcomes-from-the-first-consultant-led-service-in-singapore
#5
Sachin Mathur, Woan Wui Lim, Tiong Thye Goo
INTRODUCTION: There is a significant burden on public health systems from emergency surgical and trauma (ESAT) patients. In Western countries, the response has been to separate acute and elective surgery with the creation of a new sub-specialty: acute care surgery. Dedicated acute units have shown improvements in efficiency and clinical outcomes for patients. The aim of this study was to assess the results of the first such unit in Singapore. MATERIALS AND METHODS: A retrospective analysis was performed of a 12-month period of acute admissions between May 2014 and April 2015, with comparison of 6-months before and after the creation of the ESAT service...
September 5, 2017: Injury
https://www.readbyqxmd.com/read/28887864/oral-maxillofacial-trauma-of-a-geriatric-population-in-a-super-ageing-country
#6
Ryohei Ito, Kosei Kubota, Akinari Inui, Hiroshi Nakagawa, Takao Kon, Norihiko Narita, Yoshihiro Tamura, Toshiaki Oyama, Anna Satake, Ken Furudate, Wataru Kobayashi
BACKGROUND/AIM: World population has been aging and oral-maxillofacial trauma of geriatric population is expected to increase. The aim of this study was to analyze the characteristic features of oral-maxillofacial trauma in the geriatric population. MATERIALS AND METHODS: Data from 127 patients aged 65 years old or older, who were treated for oral-maxillofacial trauma at the Department of Oral and Maxillofacial Surgery, Hirosaki University, from 2000 to 2014, were retrospectively analyzed...
September 8, 2017: Dental Traumatology: Official Publication of International Association for Dental Traumatology
https://www.readbyqxmd.com/read/28882359/integrating-technical-and-non-technical-skills-coaching-in-an-acute-trauma-surgery-team-training-is-it-too-much
#7
Alexander Alken, Jan-Maarten Luursema, Mariska Weenk, Simon Yauw, Cornelia Fluit, Harry van Goor
OBJECTIVE: Research on effective integration of technical and non-technical skills in surgery team training is sparse. In a previous study we found that surgical teachers predominantly coached on technical and hardly on non-technical skills during the Definitive Surgical and Anesthetic Trauma Care (DSATC) integrated acute trauma surgery team training. This study aims to investigate whether the priming of teachers could increase the amount of non-technical skills coaching during such a training...
August 25, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28876570/cohort-study-on-emergency-general-surgery-patients-and-an-observation-unit
#8
M Dickfos, H Ibrahim, A Evans, R Franz
BACKGROUND: Medium-sized, non-trauma hospitals experience many of the same difficulties as tertiary centres do when it comes to managing emergency general surgery patients. However, acute surgical units are not a financially viable option in these hospitals. To improve the care of emergency general surgery patients at one such hospital, a Rapid Assessment Medical Surgical (RAMS) unit was developed to decrease the time to review and increase the efficiency in caring for these patients...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28871936/xanthoma-like-skin-changes-in-an-elderly-woman-with-a-normal-lipid-profile
#9
Piotr Nockowski, Zdzisław Woźniak, Adam Reich, Joanna Maj
Dear Editor, An 83-year-old woman developed yellow-brownish infiltrates, nodules, and tumors mimicking xanthomas, mostly involving the periorbital and chest area within three months (Figure 1). She had no abnormalities in serum cholesterol or triglycerides levels. A detailed laboratory analysis revealed the presence of mild monoclonal gammopathy with a presence of immunoglobulin G (IgG) kappa light chains; however, according to hematologist consultation, it did not require medical intervention. Imaging assessment and ultrasound examination did not show any specific involvement of internal organs...
July 2017: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/28871333/-thermal-injuries-clinical-and-acute-management-in-pediatric-practice
#10
REVIEW
K Schriek, M Sinnig
BACKGROUND: Each year 30,000 children suffer from burn injuries in Germany and 2000 of these children must be treated in special pediatric burn centers. Approximately two thirds of these children are less than 4 years old, 70% of thermal injuries are due to scalding with hot liquids. OBJECTIVES: The aim of this article is to give an overview of the characteristics of pediatric burn trauma with recommendations for initial treatment, surgical therapy as well as follow-up treatment...
September 4, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28869997/-surgical-refixation-after-proximal-hamstring-tendon-avulsion-injuries-does-the-time-of-surgery-influence-functional-outcomes
#11
Raymond Best, Julia Eberle, Florian Beck, Jochen Huth, Ulrich Becker
Background Proximal hamstring tendon avulsion injuries are rare. If they do occur, surgical treatment with tendon refixation is regarded as the method of choice. Surgical outcome measurements have been investigated heterogeneously and, therefore, are difficult to compare. Hence, the possibility for correlations between postoperative outcomes and surgical methods or time of surgery is limited. Objective Using the new, validated and injury-specific Perth Hamstring Assessment Tool (PHAT), we aimed to investigate a population of own patients in order to compare the results in relation to the time of surgery after trauma...
September 2017: Sportverletzung Sportschaden: Organ der Gesellschaft Für Orthopädisch-Traumatologische Sportmedizin
https://www.readbyqxmd.com/read/28869383/experience-with-integra%C3%A2-at-the-prague-burns-centre-2002-2016
#12
R Zajíček, I Grossová, H Šuca, R Kubok, I Pafčuga
INTRODUCTION: Integra® dermal replacement has a wide spectrum of use both in burn medicine as well as in reconstructive plastic surgery and traumatology. Since 2002, it has been a part of surgical treatment of patients at Prague Burns Centre of the Královské Vinohrady Teaching Hospital. STUDY GROUP: Integra® was used in 47 patients in total between years 2002 and 2016. In this group there were 28 paediatric patients and 19 adult patients. Eleven children were operated during the reconstructive period, 8 children had an acute injury...
2017: Acta Chirurgiae Plasticae
https://www.readbyqxmd.com/read/28866061/staged-trapping-of-traumatic-basilar-trunk-pseudoaneurysm-a-case-report-and-review-of-literature
#13
Nanthiya Sujijantarat, Matthew Pierson, Joanna Kemp, Jeroen Coppens
BACKGROUND: Traumatic intracranial aneurysms (TICAs) of the posterior circulation in the pediatric populations are rare. Only a few reports in literature document basilar artery TICA in the pediatric population. These cases were typically associated with a clival fracture and commonly diagnosed weeks to months after trauma. We present a case of a patient with a basilar TICA diagnosed after a motor vehicle collision treated with staged trapping and review of the literature. CASE DESCRIPTION: We present a case of a 14-year-old boy who sustained a high speed motor vehicle collision and developed a basilar trunk TICA identified on admission...
August 30, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28858739/spontaneous-non-traumatic-mediastinal-hematoma-associated-with-oral-anticoagulant-therapy-a-case-report-and-literature-review
#14
Masashi Mikubo, Dai Sonoda, Hirotsugu Yamazaki, Masahito Naito, Yoshio Matsui, Kazu Shiomi, Yukitoshi Satoh
INTRODUCTION: Mediastinal hematoma is usually caused by thoracic trauma or a ruptured aortic aneurysm. Spontaneous non-traumatic mediastinal hematomas are rare but potentially life-threatening conditions that can occur in patients taking anticoagulants. PRESENTATION OF CASE: We report a case of 72-year-old man with a massive mediastinal hematoma associated with anticoagulant therapy. He had complained of acute chest discomfort and subsequent tarry diarrhea. Because he had been taking warfarin for paroxysmal atrial fibrillation, an upper gastrointestinal hemorrhage was initially suspected, but no bleeding was detected by upper endoscopy...
August 23, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28844909/regression-of-pineal-lesions-spontaneous-or-iatrogenic-a-case-report-and-systematic-literature-review
#15
REVIEW
Stephanie Schipmann, Dennis Keurhorst, Michaela Köchling, Michael Schwake, Katharina Heß, Benedikt Sundermann, Walter Stummer, Angela Brentrup
Tumours arising from the pineal region account for approximately 1% of intracranial neoplasms. We present a case of a previously healthy five-year-old boy with an acute onset of headache. An MRI scan revealed a pineal mass with aqueduct compression. The patient was scheduled for tumour resection. An endoscopic third ventriculostomy was performed in advance for the treatment of hydrocephalus. Afterwards a MRI showed a relevant regression of the pineal mass without specific treatment. Consequently, surgery was cancelled and further MRI follow-up revealed a regression of the mass and a constant tumour mass over a period of 30 month...
August 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28842761/inflammatory-response-and-peritoneal-contamination-after-transrectal-natural-orifice-specimen-extraction-nose-versus-mini-laparotomy-a-porcine-in-vivo-study
#16
Jonas D Senft, Tilman Dröscher, Philip Gath, Philip C Müller, Adrian Billeter, Beat P Müller-Stich, Georg R Linke
BACKGROUND: Transrectal natural orifice specimen extraction (NOSE) avoids abdominal organ retrieval during laparoscopic procedures and may reduce surgical trauma. However, this has not been proven clinically and transrectal peritoneal contamination is feared to cause infectious complications. This experimental study was designed to evaluate inflammatory response and peritoneal contamination after transrectal NOSE versus mini-laparotomy. METHODS: 24 German Landrace pigs underwent transrectal NOSE (N = 12) or mini-laparotomy (N = 12) for standardized extraction of water-instilled balloon...
August 25, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28839885/emergency-general-surgery-hot-clinics-reduce-admission-rates-and-duration-of-inpatient-stay
#17
Francesca Th'ng, Christos Skouras, Alice Paterson-Brown, Rajan Ravindran, Peter Lamb, Andrew de Beaux, Simon Paterson-Brown, Damian J Mole
OBJECTIVE: To determine the impact of a 'Hot Clinic' (HC) on emergency general surgery patient flow-through. DESIGN: Prospective service evaluation study. SETTING: HC is a four-bedded area coordinated by a specialist nurse. The HC consultant sees emergency patients referred from the emergency department, general practitioners or those in preceding 24 h considered suitable for interim discharge while awaiting investigations and HC reassessment...
January 2017: Frontline Gastroenterology
https://www.readbyqxmd.com/read/28831330/impact-of-traumatic-lower-extremity-injuries-beyond-acute-care-movement-based-considerations-for-resultant-longer-term-secondary-health-conditions
#18
REVIEW
Courtney M Butowicz, Christopher L Dearth, Brad D Hendershot
Significance: Advances in field-based trauma care, surgical techniques, and protective equipment have collectively facilitated the survival of a historically large number of service members (SMs) following combat trauma, although many sustained significant composite tissue injuries to the extremities, including limb loss (LL) and limb salvage (LS). Beyond the acute surgical and rehabilitative efforts that focus primarily on wound care and restoring mobility, traumatic LL and LS are associated with several debilitating longer term secondary health conditions (e...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28827507/presentation-coagulopathy-and-persistent-acidosis-predict-complications-in-orthopaedic-trauma-patients
#19
Benjamin R Childs, Daniel R Verhotz, Timothy A Moore, Heather A Vallier
OBJECTIVES: To evaluate the ability of measures of coagulopathy and acidosis to predict complications. We hypothesize that increased coagulopathy and acidosis over the first 60 hours of hospitalization will result in increased rates of infection and mortality. DESIGN: Prospective, observational. SETTING: Level 1 trauma center. PATIENTS: Three hundred and seventy-six skeletally mature patients with an Injury Severity Score (ISS) greater than 16 who were surgically treated for high energy fractures of the femur, pelvic ring, acetabulum, and/or spine...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28815690/treatment-of-individuals-who-cannot-receive-blood-products-for-religious-or-other-reasons
#20
REVIEW
Carlton D Scharman, Joseph J Shatzel, Edward Kim, Thomas G DeLoughery
By virtue of their religious principles, Jehovah's Witnesses (JWs) generally object to receiving blood products, raising numerous ethical, legal, and medical challenges for providers who care for these patients, especially in the emergent setting. In this review, we discuss several areas relevant to the care of JWs, including the current literature on "bloodless" medical care in the setting of peri- and intra-operative management, acute blood loss, trauma, pregnancy, and malignancy. We have found that medical and administrative efforts in the form of bloodless medicine and surgery programs can be instrumental in helping to reduce risks of morbidity and mortality in these patients...
August 17, 2017: American Journal of Hematology
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