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https://www.readbyqxmd.com/read/28345069/an-uncommon-case-mimicking-cervical-trauma-os-odontoideum
#1
Idiris Altun, Kasim Zafer Yuksel
Os odontoideum is a separate odontoid process from the body of the axis. It is the most common anomaly of the odontoid process. Patients with this condition can be asymptomatic or present with a wide range of neurological dysfunctions. It may cause cervical instability, atlantoaxial dislocation and myelopathy. This anomaly can mimic Type I and II odontoid fractures. There is a role for conservative treatment of an asymptomatic incidentally found, radiologically stable and non-compressive os odontoideum. However, surgical treatment has a definitive role in symptomatic cases...
March 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#2
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28339769/incidence-and-potential-risk-factors-for-hospital-acquired-pneumonia-in-an-emergency-department-of-surgery
#3
Marie Stenlund, Rune Sjödahl, R N Pia Yngman-Uhlin
Objective: Hospital-acquired pneumonia (HAP) is associated with high mortality and is the second most common nosocomial infection. The aim of this study was to calculate the incidence and to identify potential risk factors for HAP in an emergency ward for surgical patients admitted because of acute abdomen or trauma. Design: A structured review of medical records was conducted. Patients diagnosed with pneumonia >48 h after admittance, were compared with a randomly chosen age-matched reference group...
February 23, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28328684/eastern-association-for-the-surgery-of-trauma-society-of-trauma-nurses-advanced-practitioner-position-paper-optimizing-the-integration-of-advanced-practitioners-in-trauma-and-critical-care
#4
Jonathan Messing, Jasmine Garces-King, Dennis Taylor, Jonathan Van Horn, Babak Sarani, A Britton Christmas
Nurse Practitioners and Physician Assistants, collectively known as advanced practitioners (APs), enhance the provision of care for the acutely injured patient. Despite their prevalence, institutions employ, train, and utilize these providers with significant variability. The Eastern Association for the Surgery of Trauma (EAST), the Society of Trauma Nurses (STN), and the American Association of Surgical Physicians Assistants (AASPA) acknowledge the value of APs and support their utilization in the management of injured and critically ill patients...
March 21, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28327940/the-nationwide-burden-of-neurological-conditions-requiring-emergency-neurosurgery
#5
Rafael De la Garza Ramos, C Rory Goodwin, Jonathan Nakhla, Rani Nasser, Reza Yassari, Eugene S Flamm, Ali Bydon, Geoffrey Colby, Daniel M Sciubba
BACKGROUND: Neurosurgical emergencies are an important cause of disability and mortality. OBJECTIVE: To examine the nationwide burden of neurological conditions requiring emergency neurosurgery. METHODS: The Nationwide Inpatient Sample database (2002-2011) was queried to identify adult patients with a primary discharge diagnosis of a neurosurgical condition who were admitted urgently/emergently or through a trauma center and underwent surgical intervention within 2 days of admission...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28325461/neurocritical-care-of-acute-subdural-hemorrhage
#6
REVIEW
Fawaz Al-Mufti, Stephan A Mayer
Although urgent surgical hematoma evacuation is necessary for most patients with subdural hematoma (SDH), well-orchestrated, evidenced-based, multidisciplinary, postoperative critical care is essential to achieve the best possible outcome. Acute SDH complicates approximately 11% of mild to moderate traumatic brain injuries (TBIs) that require hospitalization, and approximately 20% of severe TBIs. Acute SDH usually is related to a clear traumatic event, but in some cases can occur spontaneously. Management of SDH in the setting of TBI typically conforms to the Advanced Trauma Life Support protocol with airway taking priority, and management breathing and circulation occurring in parallel rather than sequence...
April 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#7
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/28323644/pediatric-acute-compartment-syndrome
#8
Kristin S Livingston, Michael P Glotzbecker, Benjamin J Shore
Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS...
March 17, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28323290/incidence-and-risk-factors-for-delirium-development-in-icu-patients-a-prospective-observational-study
#9
Marcela Kanova, Peter Sklienka, Roman Kula, Michal Burda, Jana Janoutova
BACKGROUND AND AIMS: Delirium is an acute brain dysfunction and a frequent complication in critically ill patients. When present it significantly worsens the prognosis of patients. The aim of this study was to evaluate the incidence of delirium and risk factors for delirium in a mixed group of trauma, medical and surgical ICU patients. METHODS: A prospective observational study was conducted in one of the six-bed Intensive Care Units of the University Hospital Ostrava in the Czech Republic during a 12-month period...
March 14, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/28319547/methylprednisolone-therapy-in-acute-traumatic-spinal-cord-injury-analysis-of-a-regional-spinal-cord-model-systems-database
#10
Jacob E Sunshine, Armagan Dagal, Stephen P Burns, Richard J Bransford, Fangyi Zhang, Shu-Fang Newman, Bala G Nair, Sam R Sharar
BACKGROUND: The objective of this study was to assess the relationship between exposure to methylprednisolone (MP) and improvements in motor function among patients with acute traumatic spinal cord injury (TSCI). MP therapy for patients with TSCI is controversial because of the current conflicting evidence documenting its benefits and risks. METHODS: We conducted a retrospective cohort study from September 2007 to November 2014 of 311 patients with acute TSCI who were enrolled into a model systems database of a regional, level I trauma center...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28319470/symptomatic-acute-on-chronic-subdural-hematoma-a-clinicopathological-study
#11
Rudy J Castellani, Gruschenka Mojica-Sanchez, Gary Schwartzbauer, David S Hersh
The pathophysiology of acute-on-chronic subdural hematoma (ACSDH) is complex and incompletely understood. Evidence to date indicates that the overall process is initiated by rotational force with movement of the brain inside the skull, which exerts tensile strain and rupture of bridging veins, leading in turn to acute hemorrhage in the subdural potential space. This is followed by the proliferation of mesenchymal elements with angiogenesis and inflammation, which in turn becomes a substrate for repeated hemorrhage and expansion of the lesion...
March 18, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28317566/microbiology-of-acute-and-chronic-osteomyelitis-and-antibiotic-treatment
#12
REVIEW
Harry Dym, Joseph Zeidan
Osteomyelitis is an inflammation of bone marrow with a tendency for progression, involving the cortical plates and often periosteal tissues, with most cases occurring after trauma to bone or bone surgery or secondary to vascular insufficiency. Antimicrobial therapy and surgical débridement are the primary modalities of osteomyelitis treatment, although often it is associated with a prolonged course, requiring a large commitment between patient and clinician as well as sizable health care costs. Despite surgical and chemotherapeutic advancements, osteomyelitis remains difficult to treat, and no universally accepted protocol for treatment exists...
April 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28302282/traumatic-pelvic-fractures-in-children-and-adolescents
#13
Christopher J DeFrancesco, Wudbhav N Sankar
Although traumatic pelvic fractures in children are relatively rare, these injuries are identified in about 5% of children admitted to level 1 trauma centers after blunt trauma.(1-4) Such injuries differ from adult pelvic fractures in important ways and require distinct strategies for management. While the associated mortality rate for children with pelvic fractures is much lower than that for adults, the patient may require urgent surgical intervention for associated life-threatening injuries such as head trauma and abdominal injury...
February 2017: Seminars in Pediatric Surgery
https://www.readbyqxmd.com/read/28301395/increased-anatomic-severity-in-appendicitis-is-associated-with-outcomes-in-a-south-african-population
#14
Matthew C Hernandez, Victor Y Kong, Johnathon M Aho, John L Bruce, Stephanie F Polites, Grant L Laing, Martin D Zielinski, Damian L Clarke
BACKGROUND: Severity of emergency general surgery diseases (EGS) has not been standardized until recently. The American Association for the Surgery of Trauma (AAST) proposed an anatomic severity grading system for EGS diseases to facilitate communication and quality comparisons between providers and hospitals. Previous work has demonstrated validity of the system for appendicitis in the United States. In order to demonstrate generalizability, we aim to externally validate this grading system in South African patients with appendicitis...
March 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28301362/analysis-of-surfing-injuries-presenting-in-the-acute-trauma-setting
#15
Kevin T Jubbal, Charlie Chen, Todd Costantini, Fernando Herrera, Marek Dobke, Ahmed Suliman
BACKGROUND AND PURPOSE: Surfing is a rapidly growing major worldwide sport; however, little is understood regarding severe injuries and resulting hospital admissions. This study explores surfing-related injuries in the major surfing hub of San Diego presenting in the acute trauma setting. The purpose of this study is to address the void of information regarding severe surfing injuries in the trauma setting, including injury patterns, associated hospitalization course, and risk factors...
March 16, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28296811/new-onset-atrial-fibrillation-in-the-critically-ill
#16
Travis J Moss, James Forrest Calland, Kyle B Enfield, Diana C Gomez-Manjarres, Caroline Ruminski, John P DiMarco, Douglas E Lake, J Randall Moorman
OBJECTIVE: To determine the association of new-onset atrial fibrillation with outcomes, including ICU length of stay and survival. DESIGN: Retrospective cohort of ICU admissions. We found atrial fibrillation using automated detection (≥ 90s in 30 min) and classed as new-onset if there was no prior diagnosis of atrial fibrillation. We identified determinants of new-onset atrial fibrillation and, using propensity matching, characterized its impact on outcomes. SETTING: Tertiary care academic center...
March 14, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28295582/case-report-and-review-of-nonischemic-spontaneous-papillary-muscle-rupture-reports-between-2000-and-2015
#17
Pishoy Gouda, Lisa Weilovitch, Ronak Kanani, Bryan Har
Spontaneous papillary muscle rupture (PMR) is a rare cardiovascular emergency. We present a 63-year-old male who presents with acute dyspnea who was found to have an anterior PMR, with no evidence of coronary artery disease, infection, or trauma. A review of cases of nonischemic spontaneous PMR published in 2000-2015 identified 11 additional cases of spontaneous PMR. Posterior and anterior papillary muscles involvement was identified in 54.5% and 45.5% of cases, respectively. Rapid identification due to advances in imaging modalities and improved surgical management has led to optimal outcomes in patients with spontaneous PMR...
March 14, 2017: Echocardiography
https://www.readbyqxmd.com/read/28293996/effective-pain-management-in-patients-in-hospital
#18
Candy McCabe
Chronic pain is experienced by between one third and one half of the UK population. Nurses should ensure that patients' pain is assessed and managed when they present to hospital, including pre-existing chronic pain and acute pain as a result of trauma or surgical interventions. Acute pain that is inadequately managed may result in chronic pain, impeding the patient's return to normal function and daily activities. Depression and increasing age affect the likelihood of patients experiencing chronic pain. Nurses should be familiar with the pain assessment tools available for use with older people and be aware of the potential issues of polypharmacy and altered sensitivity to medication in older people...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28281120/transduodenal-transpapillary-endopancreatic-surgery-with-a-rigid-resectoscope-experiments-on-ex-vivo-in-vivo-animal-models-and-human-cadavers
#19
Philip C Müller, Daniel C Steinemann, Felix Nickel, Lukas Chinczewski, Beat P Müller-Stich, Georg R Linke, Kaspar Z'graggen
BACKGROUND: Surgery for chronic pancreatitis is afflicted with high morbidity. A novel transduodenal-transpapillary endopancreatic resection (EPR) may provide a less invasive alternative approach. MATERIALS AND METHODS: After laparoscopic duodenotomy the papilla was dilated and accessed with a rigid resectoscope. A resection of pancreatic head tissue was performed from inside the organ. First, the feasibility and resection volume were assessed in bovine pancreas...
March 9, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28280700/allograft-loss-from-acute-page-kidney-secondary-to-trauma-after-kidney-transplantation
#20
Kazuhiro Takahashi, Rohini Prashar, Krishna G Putchakayala, William J Kane, Jason E Denny, Dean Y Kim, Lauren E Malinzak
We report a rare case of allograft loss from acute Page kidney secondary to trauma that occurred 12 years after kidney transplantation. A 67-year-old Caucasian male with a past surgical history of kidney transplant presented to the emergency department at a local hospital with left lower abdominal tenderness. He recalled that his cat, which weighs 15 lbs, jumped on his abdomen 7 d prior. On physical examination, a small tender mass was noticed at the incisional site of the kidney transplant. He was producing a normal amount of urine without hematuria...
February 24, 2017: World Journal of Transplantation
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