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Acute surgical trauma

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https://www.readbyqxmd.com/read/29785926/intramedullary-nail-fixation-versus-locking-plate-fixation-for-adults-with-a-fracture-of-the-distal-tibia-the-uk-fixdt-rct
#1
Matthew L Costa, Juul Achten, Susie Hennings, Nafisa Boota, James Griffin, Stavros Petrou, Mandy Maredza, Melina Dritsaki, Thomas Wood, James Masters, Ian Pallister, Sarah E Lamb, Nick R Parsons
BACKGROUND: The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. OBJECTIVES: To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. DESIGN: This was a multicentre randomised trial...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29782303/clindamycin-induced-maculopapular-exanthema-with-preferential-involvement-of-striae-distensae-a-koebner-phenomenon
#2
Benigno Monteagudo, Miguel Cabanillas, Pilar Iriarte, Aquilina Ramírez-Santos, Elvira León-Muinos, Daniel González-Vilas, Óscar Suárez-Amor
Clindamycin is a lincomycin-derived antibiotic useful for the treatment of anaerobic and Gram-positive aerobic bacterial infections. Cutaneous adverse reactions are usually maculopapular exanthemas, although hypersensitivity syndrome, acute generalized exanthematous pustulosis, and Stevens-Johnson syndrome have also been reported (1). We report the case of a patient with a maculopapular rash triggered by clindamycin who developed cutaneous lesions on striae distensae (SD). A 47-year-old woman was referred to our clinic for pruritic cutaneous lesions which had started 6 days earlier...
April 2018: Acta Dermatovenerologica Croatica: ADC
https://www.readbyqxmd.com/read/29777670/the-impact-of-mitral-disease-etiology-on-operative-mortality-following-mitral-valve-operations
#3
J Scott Rankin, Maria Grau-Sepulveda, David M Shahian, A Marc Gillinov, Rakesh Suri, James S Gammie, Steven F Bolling, Patrick M McCarthy, Vinod H Thourani, Niv Ad, Sean M O'Brien, Jeffrey P Jacobs, Vinay Badhwar
BACKGROUND: The patho-etiology of mitral regurgitation (MR) has been suggested as a mediator of outcomes following mitral valve (MV) operations, particularly in ischemic functional mitral regurgitation (IMR). This study examined the independent association of MV etiology with mortality. METHODS: Using the Society of Thoracic Surgeons Database, all patients undergoing mitral valve replacement or repair from 2011-2014 were assessed. Patients who underwent concomitant surgical ablation, septal defect closure, tricuspid valve repair, or coronary artery bypass grafting were included...
May 16, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29777350/the-american-association-for-the-surgery-of-trauma-emergency-general-surgery-anatomic-severity-scoring-system-as-a-predictor-of-cost-in-appendicitis
#4
Eric J Finnesgard, Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski
BACKGROUND: The World Society for Emergency Surgery determined that for appendicitis managed with appendectomy, there is a paucity of evidence evaluating costs with respect to disease severity. The American Association for the Surgery of Trauma (AAST) disease severity grading system is valid and generalizable for appendicitis. We aimed to evaluate hospitalization costs incurred by patients with increasing disease severity as defined by the AAST. We hypothesized that increasing disease severity would be associated with greater cost...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29777269/pediatric-appendicitis-severity-in-kwazulu-natal-south-africa-a-retrospective-cohort-analysis
#5
Matthew C Hernandez, Victor Y Kong, John L Bruce, Johnathon M Aho, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Acute appendicitis is a common pediatric surgical emergency; however, there are few grading systems to assign disease severity. The American Association for the Surgery of Trauma (AAST) recently developed a grading system for a variety of emergency surgical conditions, including appendicitis. The severity of acute appendicitis in younger patients in KwaZulu-Natal (South Africa) is unknown. We aimed to describe the disease severity in this patient population using the AAST grading system hypothesizing that the AAST grade would correlate with morbidity, management type, and duration of stay...
May 17, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29766138/risk-stratification-tools-in-emergency-general-surgery
#6
REVIEW
Joaquim Michael Havens, Alexandra B Columbus, Anupamaa J Seshadri, Carlos V R Brown, Gail T Tominaga, Nathan T Mowery, Marie Crandall
The use of risk stratification tools (RST) aids in clinical triage, decision making and quality assessment in a wide variety of medical fields. Although emergency general surgery (EGS) is characterized by a comorbid, physiologically acute patient population with disparately high rates of perioperative morbidity and mortality, few RST have been explicitly examined in this setting. We examined the available RST with the intent of identifying a tool that comprehensively reflects an EGS patients perioperative risk for death or complication...
2018: Trauma surgery & acute care open
https://www.readbyqxmd.com/read/29757663/bicipital-tendinopathy-and-carpal-valgus-following-a-distant-direct-thoracoabdominal-skin-flap-in-a-german-shepherd-with-necrotizing-fasciitis
#7
Benjamin Mielke, Nicola Kulendra, Zoe Halfacree, Elvin Kulendra
A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Surgical closure was achieved with an axillary fold flap and distant direct single-pedicle thoracoabdominal flap. Three mo later, following deterioration of the lameness that was associated with carpal valgus, carpal subluxation, and tendinopathy of the distal radial insertion of the biceps brachii tendon, a closing wedge pancarpal arthrodesis and tenotomy of the biceps brachii tendon was performed...
May 14, 2018: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/29751949/platelet-storage-lesions-what-more-do-we-know-now
#8
REVIEW
Monica Suet Ying Ng, John-Paul Tung, John Francis Fraser
Platelet concentrate (PC) transfusions are a lifesaving adjunct to control and prevent bleeding in cancer, hematologic, surgical, and trauma patients. Platelet concentrate availability and safety are limited by the development of platelet storage lesions (PSLs) and risk of bacterial contamination. Platelet storage lesions are a series of biochemical, structural, and functional changes that occur from blood collection to transfusion. Understanding of PSLs is key for devising interventions that prolong PC shelf life to improve PC access and wastage...
April 17, 2018: Transfusion Medicine Reviews
https://www.readbyqxmd.com/read/29738399/cost-determinants-in-the-90-day-management-of-isolated-ankle-fractures-at-a-large-urban-academic-hospital
#9
Matthew Varacallo, Patrick Mattern, Jonathan Acosta, Nader Toossi, Kevin Denehy, Susan Harding
OBJECTIVES: To determine the independent risk factors associated with increasing costs and unplanned hospital readmissions in the 90-day episode of care (EOC) for isolated operative ankle fractures at our institution. DESIGN: Retrospective cohort study SETTING:: Level I Trauma Center PATIENTS:: Two hundred ninety-nine patients undergoing open reduction internal fixation (ORIF) for the treatment of an acute, isolated ankle fracture between 2010 and 2015. INTERVENTION: none MAIN OUTCOME MEASUREMENTS:: Independent risk factors for increasing 90-day EOC costs and unplanned hospital readmission rates...
May 3, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29734868/para-anal-lipoma-as-a-rare-consequence-to-perineal-trauma-case-report-and-review-of-the-literature
#10
Ewelina Uscilowska, Nora Abbes Orabi, Daniel Léonard, Anne Mourin-Jouret, Louis Libbrecht, Pierre Trefois, Marie-Armelle Denis, Radu Bachmann, Christophe Remue, Alex Kartheuser
INTRODUCTION: Lipomas are the most common benign mesenchymal tumors which can be found in any part of the body. Nevertheless, their etiology and pathogenesis remain unknown. It is hypothesized that some of these lesions could result from an acute or chronic trauma. PATIENTS AND METHODS: We report a case of a 54-year-old man presenting a perineal lipoma which volume grew rapidly after he fell on his buttock, in the context of inaugural epileptic seizure. Pelvic MRI showed a voluminous fatty mass, measuring 6...
May 7, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29725765/treatment-of-acute-achilles-tendon-rupture-with-a-standardised-protocol
#11
Heidi Haapasalo, Ulla Peltoniemi, Heikki-Jussi Laine, Pekka Kannus, Ville M Mattila
INTRODUCTION: A treatment protocol favouring non-operative treatment and based on early weight-bearing and early range-of-motion exercises was implemented in standard clinical care of a level I trauma clinic. MATERIALS AND METHODS: All patients treated due to acute Achilles tendon rupture between 2008 and 2014 were included in the study (n = 411). The patient records were retrospectively evaluated. RESULTS: The mean age of patients was 47 (range 17-88) years...
May 3, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29718818/use-of-viable-cryopreserved-umbilical-tissue-for-soft-tissue-defects-in-patients-with-gas-gangrene-a-case-series
#12
Kristen McGinness, Dorothy H Kurtz Phelan
INTRODUCTION: Gas gangrene is a rapidly progressive bacterial infection leading to necrosis that usually develops as a result of trauma or postoperative complications. This condition requires early diagnosis with immediate surgical intervention. With a poor prognosis, a high incidence of amputation, and comorbidities such as diabetes and peripheral vascular disease, patients with gas gangrene are put at further risk for surgical complications. OBJECTIVE: This case series reports the clinical outcomes of using a commercially available viable cryopreserved umbilical tissue (vCUT) in the surgical management of 10 patients (9 males, 1 female) with acute lower extremity gas gangrene...
April 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29712534/a-scoping-review-on-health-economics-in-neurosurgery-for-acute-spine-trauma
#13
Brian C F Chan, B Catharine Craven, Julio C Furlan
OBJECTIVE Acute spine trauma (AST) has a relatively low incidence, but it often results in substantial individual impairments and societal economic burden resulting from the associated disability. Given the key role of neurosurgeons in the decision-making regarding operative management of individuals with AST, the authors performed a systematic search with scoping synthesis of relevant literature to review current knowledge regarding the economic burden of AST. METHODS This systematic review with scoping synthesis included original articles reporting cost-effectiveness, cost-utility, cost-benefit, cost-minimization, cost-comparison, and economic analyses related to surgical management of AST, whereby AST is defined as trauma to the spine that may result in spinal cord injury with motor, sensory, and/or autonomic impairment...
May 2018: Neurosurgical Focus
https://www.readbyqxmd.com/read/29709757/rapid-recovery-of-spontaneous-spinal-epidural-hematoma-without-surgical-treatment-a-case-reportand-literature-review
#14
Shu Baozhang, Fengyang Geng, Jiyue Wang, Zhiti Zhang, Chigang Du
BACKGROUND: Spontaneousspinal epidural hematoma (SSEH) is a relatively uncommon yet potentially disabling neurological emergency.The classical presentation includes a severe acute attack, sometimes radiating pain at the back,interscapular, or neckareas, followed by neurological deficits. The main treatment is surgical,and self-healing cases are rare. CASE DESCRIPTION: A 17-year-old female was admitted to the department of neurosurgery with neck pain, myasthenia of the limbs, and difficulty moving...
April 27, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29701403/hostile-thoracic-aortic-aneurysm-treated-by-fenestrated-thoracic-stentgraft-with-proximal-sealing-in-ishimaru-zone-0
#15
Joel Sousa, João Neves, Vicente Riambau, José Teixeira
INTRODUCTION: Thoracic endovascular aortic aneurysm repair (TEVAR) is an established treatment for thoracic aortic disease in both the acute and elective setting, with such a widespread use that almost 50% of all thoracic aortic surgery in Europe is performed by these means. Nonetheless, the feasibility of TEVAR is determined by several anatomic factors, and the suitability of the proximal and distal landing zones remain one of the main limitations to its use. The advent of custom-made thoracic stent grafts widened the endovascular options in some challenging anatomies...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29696130/intraperitoneally-located-tip-of-femoral-vein-catheter-clinical-suspicion-for-avoidance-of-unnecessary-laparotomy
#16
Hamed Shafiee, Saeid Safari, Reza Aminnejad
Central venous catheterization is a common procedure in critical care and trauma patients. Complications are not rare and in some studies more than 15% incidence has been reported (1). Femoral vein is one of the commonest site for this purpose yet it carries complications, such as infection and misplacement. The current study reports an unexpected secondary malposition of right femoral CVC in the peritoneal cavity. It was concluded that in any case of acute abdominal issues, following insertion of femoral venous catheter, evaluation of catheter misplacement by the means of contrast injection through it can be helpful for better diagnosis, and may help avoid unnecessary surgical interventions...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29691616/lars-synthetic-ligaments-for-the-acute-management-of-111-acute-knee-dislocations-effective-surgical-treatment-for-most-ligaments
#17
Pierre Ranger, Andréa Senay, Geneviève Rochette Gratton, Marc Lacelle, Josée Delisle
PURPOSE: The purpose of this study was to describe the longitudinal outcomes of acute repair and augmentation for the reconstruction of dislocated knees, using LARS synthetic ligaments. METHODS: Patients with a knee dislocation surgically treated using LARS synthetic ligament augmentation, with a minimum follow-up of 24 months, were enrolled between 1996 and 2014. Range of motion, Lachman, pivot shift, posterior drawer, step off sign, valgus, varus, KT-1000 arthrometer, Telos technique, IKDC, Lysholm, Tegner, and Meyers scores were obtained every 2 years up to 10 years...
April 24, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29683734/six-year-review-of-traumatic-brain-injury-in-a-regional-trauma-unit-demographics-contributing-factors-and-service-provision-in-ireland
#18
Patrick W Owens, Noel P Lynch, Donal P O'Leary, Aoife J Lowery, Michael J Kerin
BACKGROUND: Traumatic brain injury (TBI) represents a significant burden of care for acute surgical services, particularly in the absence of on-site neurosurgical cover or sufficient post-acute rehabilitation facilities. We examine factors contributing to TBI, prolonged lengths of stay (LoS) and implications for hospital resources. Long-term outcomes are assessed. METHODS: This is a retrospective cohort study of patients admitted to a regional trauma unit with TBI from 2008 to 2013...
April 23, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29679723/comparison-of-hook-plate-with-versus-without-double-tunnel-coracoclavicular-ligament-reconstruction-for-repair-of-acute-acromioclavicular-joint-dislocations-a-prospective-randomized-controlled-clinical-trial
#19
Jian Yin, Zhaoyang Yin, Ge Gong, Chao Zhu, Chao Sun, Xinhui Liu
PURPOSE: This study was designed to compare the surgical outcomes of a hook plate with double-tunnel coracoclavicular (CC) ligament reconstruction by conjoined tendon transfer versus single hook plate surgery for the repair of acute type of Rockwood type III and V acromioclavicular (AC) joint dislocations. METHODS: The study cohort included 62 patients with acute (within 6 weeks after trauma) Rockwood type III and V AC joint dislocations who underwent surgery from February 2012 to September 2015...
April 18, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29668604/sonographic-and-ct-imaging-features-of-intestinal-perforation-from-a-pill-and-packing-a-case-report
#20
Ze-Hui Gou, Yulan Peng, Kun Yang
RATIONALE: Sharp foreign bodies such as toothpicks or chicken bones can lead to intestinal perforation. Small intestinal perforation secondary to foreign body ingestion is usually manifested as an acute abdomen without a history of trauma. Here we describe the diagnosis and treatment of a case of small bowel perforation caused by an ingested pill and its outer packing. PATIENT CONCERNS: An 84 years old male patient complained of right lower abdominal pain for 4 days and the pain was becoming progressively worse...
April 2018: Medicine (Baltimore)
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