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https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#1
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28080207/laparoscopic-gastropleural-fistula-repair-a-minimally-invasive-solution-for-a-complex-problem
#2
Ran B Luo, Shanglei Liu, Jonathan C DeLong, Garth R Jacobsen, Bryan J Sandler, Santiago Horgan
INTRODUCTION: Gastropleural fistula (GPF) is a complex pathology that can present as a result of surgery, trauma, peptic ulcer disease, malignancies, radiation, or chemotherapy. Management typically includes endoscopic or surgical intervention along with intraabdominal or intrathoracic drainage of pre-existing infection. Traditionally, surgical approaches have been through exploratory laparotomy or thoracotomy, subjecting already ill patients to additional morbidity. CASE REPORT: We describe and demonstrate a laparoscopic minimally invasive approach to the management of a GPF with a wedge resection of the stomach, along with a review of the current literature regarding GPF treatment...
January 12, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28076441/effects-of-an-integrated-fast-track-rehabilitation-service-for-multi-trauma-patients-a-non-randomized-clinical-trial-in-the-netherlands
#3
Ans I E Bouman, Bea Hemmen, Silvia M A A Evers, Henk van de Meent, Ton Ambergen, Pieter E Vos, Peter R G Brink, Henk A M Seelen
OBJECTIVES: The effects on health related outcomes of a newly-developed rehabilitation program, called 'supported Fast Track multi-trauma rehabilitation service' (Fast Track), were evaluated in comparison with conventional trauma rehabilitation service (Care as Usual). METHODS: Prospective, multi-center, non-randomized controlled study. Between 2009 and 2012, 132 adult multi-trauma patients were included: 65 Fast Track and 67 Care as Usual patients with an Injury Severity Score ≥16, complex multiple injuries in several extremities or complex pelvic and/or acetabulum fractures...
2017: PloS One
https://www.readbyqxmd.com/read/28073202/pseudoaneurysm-with-arteriovenous-fistula-of-the-prostate-after-pelvic-trauma-ultrasound-imaging
#4
Andrea B Galosi, Camilla Capretti, Luca Leone, Marco Tiroli, Daniele Cantoro, Massimo Polito
Pseudoaneurysm (PA) associated with an arteriovenous fistula (AVF) of the internal pudendal artery branches are very uncommon. We report a case of post-traumatic PA with AVF connected to Santorini plexus. Diagnosis was made with trans-rectal ultrasound (TRUS) after recurrent hematuria. TRUS reported a 1.7 × 1.4 × 1.5 cm anechoic area, on anterior prostate apex close to Santorini plexus. The use of color Doppler in this area revealed high flow velocity that was indicative for AVF. The feeding artery was a distal branch of the left pudenda artery...
December 30, 2016: Archivio Italiano di Urologia, Andrologia
https://www.readbyqxmd.com/read/28072651/relationship-of-sacral-fractures-to-nerve-injury-is-the-denis-classification-still-accurate
#5
Jannat M Khan, Alejandro Marquez-Lara, Anna N Miller
OBJECTIVE: Use modern computed tomographic imaging to reassess neurological injury risks associated with zone I-III sacral fractures as originally described by Denis, et al. DESIGN: Restrospective Case-control study. SETTING: University Level I Trauma Center. PATIENTS/PARTICIPANTS: 1507 consecutive patients who presented with sacral fractures between January 2000 and August 2012. MAIN OUTCOME MEASUREMENTS: Patients were stratified based on the diagnosis of acute neurological injury...
December 28, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28070029/the-relationship-between-scores-and-outcomes-for-polytrauma-patients-in-the-emergency-department-a-case-study
#6
Maria Gioffre-Florio, Letizia Maria Murabito, Carmela Visalli, Alessandra Villari, Floriana Lauritano, Carla Bramanti, Fausto Fama
AIM: Traumas are one of the most relevant pathological events in health care, because of clinical and prognostic relevance. Morbidity and mortality rates are strongly affected by the timely and correct approach to the patient (golden hour). The objective of this study was to investigate the possible influence of the diagnostic time and of the Injury Severity Score (ISS) on outcomes in trauma patients. MATERIAL OF STUDY: Out of a total of 240,833 emergency patients, we observed, 447 polytrauma...
December 29, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28068498/adapting-dialectical-behavior-therapy-for-the-treatment-of-dissociative-identity-disorder
#7
Brad Foote, Kim Van Orden
Dialectical Behavior Therapy (DBT), created by Marsha Linehan, has been shown to be an effective therapy for the treatment of borderline personality disorder (BPD) and for suicidal and self-harming behavior. Dissociative identity disorder (DID) is a complex post-traumatic disorder which is highly comorbid with BPD, shares a number of clinical features with BPD, and which like BPD features a high degree of suicidality. The DID treatment literature emphasizes the importance of a staged approach, beginning with the creation of a safe therapeutic frame prior to addressing traumatic material; DBT is also a staged treatment, in which behavioral and safety issues are addressed in Stage 1, and trauma work reserved for Stage 2...
December 31, 2016: American Journal of Psychotherapy
https://www.readbyqxmd.com/read/28065372/dynamic-high-resolution-ultrasound-of-intrinsic-and-extrinsic-ligaments-of-the-wrist-how-to-make-it-simple
#8
REVIEW
Salvatore Gitto, Carmelo Messina, Giovanni Mauri, Alberto Aliprandi, Francesco Sardanelli, Luca Maria Sconfienza
Wrist ligaments are crucial structures for the maintenance of carpal stability. They are classified into extrinsic ligaments, connecting the carpus with the forearm bones or distal radioulnar ligaments, and intrinsic ligaments, entirely situated within the carpus. Lesions of intrinsic and extrinsic ligaments of the wrist have been demonstrated to occur largely, mostly in patients with history of trauma and carpal instability, or rheumatoid arthritis. Ultrasound allows for rapid, cost-effective, non-invasive and dynamic evaluation of the wrist, and may represent a valuable diagnostic tool...
February 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28064352/pipeline-embolization-device-for-the-treatment-of-a-traumatic-intracranial-aneurysm-in-a-child
#9
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Luiz Venâncio Fonseca, Lucas Eduardo Bonadio, Alexandre Cordeiro Ulhôa, Daniel Giansante Abud
INTRODUCTION: Traumatic intracranial aneurysms in children are rare and may occur as the result of closed or penetrating head trauma. Their natural history seems to be more aggressive. Most traumatic aneurysms have complex shape, tending to have a large neck or even a fusiform morphology. CASE REPORT: We present a case of a traumatic carotid artery aneurysm in a 9-year-old girl that was successfully treated with pipeline embolization device. DISCUSSION: Due to its dissecting nature, wall friability and lack of a substantial neck can make surgical clipping and selective coiling difficult and risky...
January 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28063742/all-or-nothing-thinking-the-processing-of-emotional-expressions-in-traumatized-post-deployment-soldiers
#10
Claudia Gebhardt, Christina Alliger-Horn, Kristin Mitte, Heide Glaesmer
The exposure to trauma is a dramatic life event with complex consequences among those like changes in information processing. Dysfunctional cognitions like a negative interpretation of information are a risk factor for the development of trauma-related disorders. The aim of the present study was to test whether post-deployment soldiers with trauma differ in their interpretation of emotional expressions from member of a control group. Interpretation of emotional expressions was assessed in a sample of 106 males (n=53 soldiers, n=53 controls) with the Similarity Rating Task (simtask) and analyzed with a multidimensional scaling (MDS) approach...
December 21, 2016: Journal of Anxiety Disorders
https://www.readbyqxmd.com/read/28062601/bleeding-disorders-in-congenital-syndromes
#11
REVIEW
Susmita N Sarangi, Suchitra S Acharya
Pediatricians provide a medical home for children with congenital syndromes who often need complex multidisciplinary care. There are some syndromes associated with thrombocytopenia, inherited platelet disorders, factor deficiencies, connective tissue disorders, and vascular abnormalities, which pose a real risk of bleeding in affected children associated with trauma or surgeries. The risk of bleeding is not often an obvious feature of the syndrome and not well documented in the literature. This makes it especially hard for pediatricians who may care for a handful of children with these rare congenital syndromes in their lifetime...
January 6, 2017: Pediatrics
https://www.readbyqxmd.com/read/28062308/spinal-reorganization-after-bone-fracture-in-mice
#12
Silke Hirsch, Alaa Ibrahim, Laura Krämer, Fabiola Escolano-Lozano, Tanja Schlereth, Frank Birklein
: Bone fracture with subsequent immobilization of the injured limb can cause Complex Regional Pain Syndrome (CRPS) in humans. Mechanisms of CRPS are still not completely understood but bone fracture with casting in mice leads to a similar posttraumatic inflammation as seen in humans and might therefore be an analogue to human CRPS. Here we report behavioral and spinal electrophysiological changes in mice that developed swelling of the paw, warming of the skin and pain in the injured limb after bone fracture...
January 3, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28058475/strategies-for-intravenous-fluid-resuscitation-in-trauma-patients
#13
Robert Wise, Michael Faurie, Manu L N G Malbrain, Eric Hodgson
Intravenous fluid management of trauma patients is fraught with complex decisions that are often complicated by coagulopathy and blood loss. This review discusses the fluid management in trauma patients from the perspective of the developing world. In addition, the article describes an approach to specific circumstances in trauma fluid decision-making and provides recommendations for the resource-limited environment.
January 5, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28056260/-research-progress-of-hoffa-fracture
#14
Y B Zhou, Q X Wang, W Chen
Hoffa fracture is a rare type of fracture confined to the coronal plane of the femoral condyle. High-energy is a common reason of Hoffa fracture, and low-energy trauma and iatrogenic injury can also cause Hoffa fracture in some cases. The commonly used classifications include Letenneur classification, CT classification, AO classification and modified AO classification. X-ray is the first choice to diagnose Hoffa fractures, fracture lines can be found. If the X-ray is negative, CT scan and MRI should be performed...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28054978/hemoglobin-based-blood-substitutes-and-the-treatment-of-sickle-cell-disease-more-harm-than-help
#15
REVIEW
Abdu I Alayash
Intense efforts have been made by both industry and academia over the last three decades to produce viable hemoglobin (Hb)-based oxygen carriers (HBOCs), also known as "blood substitutes". Human trials conducted so far by several manufactures in a variety of clinical indications, including trauma, and elective surgeries have failed and no product has gained the Food and Drug Administration approval for human use. Safety concerns due to frequent incidences of hemodynamic, cardiac events, and even death led to the termination of some of these trials...
January 4, 2017: Biomolecules
https://www.readbyqxmd.com/read/28050441/blunt-cardiac-rupture-a-diagnostic-challenge
#16
Suraj Pinni, Vineet Kumar, Satish Balkrishna Dharap
Blunt Cardiac Rupture (BCR) is a life threatening injury. Majority of patients do not reach the hospital and in those who reach the emergency department, timely diagnosis and treatment is a challenge. The case is about a patient with multiple blunt injuries who presented in shock. Cardiac tamponade was suspected on clinical grounds and on evidence of mediastinal widening on radiograph. In the absence of songography, the diagnosis was confirmed by subxiphoid pericardial window. Emergency thoracotomy revealed a right atrial appendage rupture which was surgically corrected...
November 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28041756/trauma-induced-acute-myocardial-infarction-due-to-delayed-dissection-of-the-left-anterior-descending-coronary-artery
#17
Magdalena Wilczynska-Golonka, Pawel Rostoff, Aleksander Siniarski, Agnieszka Skrzypek, Andrzej Gackowski, Ewa Konduracka, Jadwiga Nessler
Acute myocardial infarction is a very rare, life-threatening complication of blunt chest trauma. A 27-year-old man with no previous medical history was admitted to the emergency department due to multiple trauma following a car accident. After 48h following the accident, the patient's condition rapidly deteriorated, with severe dyspnea at rest, tachycardia, and increasing chest pain. A 12-lead ECG showed a sinus tachycardia at 120bpm with significant ST-segment elevation in leads V1 to V5, pathologic Q wave in I, aVL, and QS complex in leads V1 to V4...
December 27, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#18
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28032293/spatiotemporal-patterns-of-ring1-expression-after-rat-spinal-cord-injury
#19
Hanzhang Liu, Wei Ji, Peipei Gong, Chun Liu, Chengwei Duan, Yilu Gao, Xiaojuan Liu, Dongmei Zhang, Shunxing Zhu, Leilei Gong
Ring finger protein 1 (RING1) is a RING domain characterized protein belonging to the RING finger family. It is an E3 ubiquitin-protein ligase that mediated monoubiquitination of histone H2A and the core component of PRC1 complex, which is the repressive multiprotein complex of Polycomb group (PcG). Previous studies showed the important tumorigenic role of RING1 via promoting cell proliferation and the crucial function in maintaining transcriptional program stability during development. However, its mechanism for spinal cord injury (SCI) is still unknown...
December 28, 2016: Neurochemical Research
https://www.readbyqxmd.com/read/28031726/complex-regional-pain-syndrome-medical-and-legal-ramifications-of-clinical-variability-and-experience-and-perspective-of-a-practicing-clinician
#20
R P Lazaro
OBJECTIVE: The aim of this study was to demonstrate the ramifications of clinical variability of complex regional pain syndrome (CRPS) and how they can affect the various aspects of this condition, favorably or unfavorably, for both patients and participating medical and legal professionals. METHODS: Twelve patients diagnosed with CRPS at different times in the past 25 years were followed up, and their signs and symptoms were reviewed for variability. None had preexisting or ongoing medical disorders and prior injury to the peripheral nerves or musculoskeletal tissues...
2017: Journal of Pain Research
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