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https://www.readbyqxmd.com/read/29346235/posttraumatic-stress-in-children-after-injury-the-role-of-acute-pain-and-opioid-medication-use
#1
Aimee K Hildenbrand, Nancy Kassam-Adams, Lamia P Barakat, Kristen L Kohser, Jeffrey A Ciesla, Douglas L Delahanty, Joel A Fein, Lindsay B Ragsdale, Meghan L Marsac
OBJECTIVES: After injury, many children experience posttraumatic stress symptoms (PTSS) that negatively impact recovery. Acute pain and PTSS share neurobiological pathways, and acute dosage of morphine has been linked to reduced PTSS in naturalistic studies. However, the complex interactions between pain, morphine and other opioid use, and PTSS have yet to be investigated in robust pediatric samples.This prospective, longitudinal study examined relationships between acute pain, opioid medications, and PTSS after pediatric injury...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29346234/a-qualitative-study-of-multidisciplinary-providers-experiences-with-the-transfer-process-for-injured-children-and-ideas-for-improvement
#2
Marcie Gawel, Beth Emerson, John S Giuliano, Alana Rosenberg, Karl E Minges, Shelli Feder, Pina Violano, Patricia Morrell, Judy Petersen, Emily Christison-Lagay, Marc Auerbach
OBJECTIVE: Most injured children initially present to a community hospital, and many will require transfer to a regional pediatric trauma center. The purpose of this study was 1) to explore multidisciplinary providers' experiences with the process of transferring injured children and 2) to describe proposed ideas for process improvement. METHODS: This qualitative study involved 26 semistructured interviews. Subjects were recruited from 6 community hospital emergency departments and the trauma and transport teams of a level I pediatric trauma center in New Haven, Conn...
January 16, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#3
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29342420/-use-of-bronchial-blocker-in-emergent-thoracotomy-in-presence-of-upper-airway-hemorrhage-and-cervical-spine-fracture-a-difficult-decision
#4
Carlos Almeida, Maria João Freitas, Diogo Brandão, José Pedro Assunção
Female, 85 y.o., weighting 60kg, multiple trauma patient. After an initial laparotomy, an emergent thoracotomy was performed using a bronchial blocker for lung isolation (initial active suction was applied). During surgery, bronchial cuff was deflated, causing a self-limited tracheal blood flooding. A second lung isolation was attempted but it was not as effective as initially. Probably, a lung collapse with the same bronchial blocker was impaired in the second attempt because of the obstruction of bronchial blocker lumen by intraoperative endobronchial hemorrhage...
January 13, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29340725/decision-making-in-management-of-the-complex-trauma-patient-changing-the-mindset-of-the-non-trauma-surgeon
#5
Linda Sonesson, Kenneth Boffard, Lars Lundberg, Martin Rydmark, Klas Karlgren
BACKGROUND: European surgeons are frequently subspecialized and trained primarily in elective surgical techniques. As trauma leaders, they may occasionally have to deal with complex polytrauma, advanced management techniques, differing priorities, and the need for multidisciplinary care. There is a lack of expertise, experience, and a low trauma volume, as well as a lack of research, with limited support as to the decision-making and teaching challenges present. We studied what experienced trauma experts describe as the challenges that are specific to the advanced surgical decision-making required, whether civilian, humanitarian, or military...
January 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29339840/complex-knee-injury-scenario-in-tertiary-level-care-in-north-india-an-epidemiological-study
#6
Mukul Kaushal, Devendra K Chouhan, Gaurav Sharma, Rajendra K Kanojia
Floating knee injury has been considered as one of the severe orthopedic injury, and is often associated with major systemic trauma involving other organs. Objective: To identify the incidence of floating knee injury, severity of injury and associated orthopaedic and non-orthopaedic injury. Methods: Epidemiologic study conducted from 1 Jan 2014 to 31 Dec 2014. Results: A total of 136 cases with floating knee injury were registered. Modified Fraser classification showed 58 patients had type 1, 74 had type 2 and 4 had type 3 floating knees...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29338852/simulation-based-multidisciplinary-team-training-decreases-time-to-critical-operations-for-trauma-patients
#7
Margaret Murphy, Kate Curtis, Mary K Lam, Cameron S Palmer, Jeremy Hsu, Andrea McCloughen
BACKGROUND: Simulation has been promoted as a platform for training trauma teams. However, it is not clear if this training has an impact on health service delivery and patient outcomes. This study evaluates the association between implementation of a simulation based multidisciplinary trauma team training program at a metropolitan trauma centre and subsequent patient outcomes. METHOD: This was a retrospective review of trauma registry data collected at an 850-bed Level 1 Adult Trauma Centre in Sydney, Australia...
January 8, 2018: Injury
https://www.readbyqxmd.com/read/29335475/discontinuous-ventilator-weaning-of-patients-with-acute-sci
#8
Wout Füssenich, Sven Hirschfeld Araujo, Birgitt Kowald, Allard Hosman, Marc Auerswald, Roland Thietje
STUDY DESIGN: Retrospective, single centre cohort study. OBJECTIVES: To determine factors associated with ventilator weaning success and failure in patients with acute spinal cord injury (SCI); determine length of time and attempts required to wean from the ventilator successfully and determine the incidence of pneumonia. SETTING: BG Klinikum Hamburg, Level 1 trauma centre, SCI Department, Germany. METHODS: From 2010 until 2017, 165 consecutive patients with cervical SCI, initially dependent on a ventilator, were included and weaned discontinuously via tracheal cannula...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29334642/examining-the-latent-structure-mechanisms-for-comorbid-posttraumatic-stress-disorder-and-major-depressive-disorder
#9
Margo C Hurlocker, Desirae N Vidaurri, Lisa-Ann J Cuccurullo, Kelly Maieritsch, C Laurel Franklin
BACKGROUND: Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD...
January 8, 2018: Journal of Affective Disorders
https://www.readbyqxmd.com/read/29332557/evaluation-of-a-victim-centered-trauma-informed-victim-notification-protocol-for-untested-sexual-assault-kits-saks
#10
Rebecca Campbell, Jessica Shaw, Giannina Fehler-Cabral
Throughout the United States, hundreds of thousands of sexual assault kits (SAKs) have not been submitted by the police for forensic DNA testing, which raises complex issues regarding how victims ought to be notified about what happened to their kits. In this project, we evaluated a victim-centered, trauma-informed victim notification protocol that was implemented in Detroit, Michigan. Most victims (84%) did not have a strong negative emotional reaction to notification, and most (57%) decided to reengage with the criminal justice system...
April 1, 2017: Violence Against Women
https://www.readbyqxmd.com/read/29331353/mechanisms-of-sex-differences-in-fear-and-posttraumatic-stress-disorder
#11
REVIEW
Teniel Sonya Ramikie, Kerry James Ressler
Following sexual maturity, females disproportionately have higher rates of posttraumatic stress disorder (PTSD) and experience greater symptom severity and chronicity as compared with males. This observation has led many to examine sex differences in PTSD risk factors. Though relatively few, these studies reveal that the root causes of PTSD sex differences are complex, and partly represent interactions between sex-specific nonbiological and biological risk factors, which differentially shape PTSD vulnerability...
November 21, 2017: Biological Psychiatry
https://www.readbyqxmd.com/read/29327945/the-gas-bubble-sign-a-reliable-indicator-of-laryngeal-fractures-in-hanging-on-postmortem-computed-tomography
#12
Katja Schulze, Lars Christian Ebert, Thomas Daniel Ruder, Barbara Fliss, Sebastian Alexander Poschmann, Dominic Gascho, Michael Josef Thali, Patricia Mildred Flach
OBJECTIVE: The purpose was to evaluate the presence of gas in the tissue adjacent to the laryngeal structures, "the gas bubble sign", in cases of hanging as a diagnostic indicator of neck trauma. METHODS: In this study, postmortem computed tomography scans and autopsies of 35 victims of hanging were examined to reveal age-dependent changes, laryngeal fracture, fracture location, and the presence of gas. A matched group with cardiac arrest or intoxication was used as controls (n = 35)...
January 12, 2018: British Journal of Radiology
https://www.readbyqxmd.com/read/29327206/brain-photobiomodulation-therapy-a-narrative-review
#13
REVIEW
Farzad Salehpour, Javad Mahmoudi, Farzin Kamari, Saeed Sadigh-Eteghad, Seyed Hossein Rasta, Michael R Hamblin
Brain photobiomodulation (PBM) therapy using red to near-infrared (NIR) light is an innovative treatment for a wide range of neurological and psychological conditions. Red/NIR light is able to stimulate complex IV of the mitochondrial respiratory chain (cytochrome c oxidase) and increase ATP synthesis. Moreover, light absorption by ion channels results in release of Ca2+ and leads to activation of transcription factors and gene expression. Brain PBM therapy enhances the metabolic capacity of neurons and stimulates anti-inflammatory, anti-apoptotic, and antioxidant responses, as well as neurogenesis and synaptogenesis...
January 11, 2018: Molecular Neurobiology
https://www.readbyqxmd.com/read/29326456/case-report-coronectomy-of-an-impacted-and-submerged-second-deciduous-molar
#14
M G Hussain, S K Sah, I McHenry
Coronectomy is a widely-accepted technique available for the treatment of impacted wisdom teeth. The fundamental principle is to prevent trauma to the inferior dental nerve (IDN). Many publications have demonstrated its positive outcomes but there is no literature available regarding coronectomy of deciduous teeth. This case report highlights the complex approach to managing a severely infraoccluded 85 in the mixed dentition of a 10-year-old female. The report demonstrates and discusses the combined orthodontic and oral surgical approach to prevent damage to the IDN and to allow space for orthodontic movement...
January 12, 2018: British Dental Journal
https://www.readbyqxmd.com/read/29325763/clinical-experience-with-three-dimensional-printing-techniques-in-orthopedic-trauma
#15
Ji Wan Kim, Yongkoo Lee, Joonho Seo, Jai Hyung Park, Yong Min Seo, Sung Soo Kim, Hyun Chul Shon
BACKGROUND: To report our experiences with the use of three-dimensional (3D) printing in the field of orthopedic trauma. METHODS: This retrospective study enrolled 24 patients from three university teaching hospitals in whom 3D printing technique was applied: 14 patients with acetabular fractures and 10 patients with clavicular shaft fractures. We summarized our experiences with 3D printed bone models. RESULTS: Three-dimensional printed acetabular models improved understanding of complex acetabular anatomy and fracture pattern to plan the optimal positioning of a reduction clamp and the trajectory of screws...
January 8, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29324486/fibrinolysis-and-antifibrinolytic-treatment-in-the-trauma-patient
#16
Lewis S Gall, Ross A Davenport
PURPOSE OF REVIEW: The role of antifibrinolytics in trauma haemorrhage and early coagulopathy remains controversial with respect to patient selection, dosage, timing of treatment, and risk of thrombotic complications. This review presents our current understanding of the mechanisms of fibrinolysis in trauma, diagnostic evaluation, and the evidence base for treatment. RECENT FINDINGS: Excessive fibrinolysis following severe injury is a major component of acute traumatic coagulopathy and contributes to the high mortality from trauma haemorrhage...
January 10, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29323835/recurring-vivid-dreams-in-an-older-hmong-man-with-complex-trauma-experience-and-cognitive-impairment
#17
Wajih Askar, Ariba Khan, Soo Borson, Michael L Malone
INTRODUCTION: Health care workers need to consider the culture and ethnic preferences prevalent in the Hmong community in order to provide optimal care. We describe an older Hmong man to illustrate the challenges faced and competencies needed by primary care. CASE PRESENTATION: An 80-year-old non-English speaking Hmong man with diabetes, nerve sheath tumor, and hypertension presented to the outpatient clinic with his grandson complaining of sleep problems. He had had 2 vivid recurring dreams during the previous few months...
August 2017: WMJ: Official Publication of the State Medical Society of Wisconsin
https://www.readbyqxmd.com/read/29322159/interpersonal-violence-among-the-chalcolithic-and-bronze-ages-inhabitants-living-on-the-central-plateau-of-iran-a-voice-from-tepe-hissar
#18
Zahra Afshar, Charlotte Roberts, Andrew Millard
The site of Tepe Hissar (Iran) experienced widespread cultural and economic changes during the Chalcolithic and Bronze Ages (5th to the 2nd millennium B.C.). The discovery of evidence of burning, including charred human remains, the destruction of buildings (Periods II and III), and the presence of several mass-burials with comingling of human skeletal remains consisting of ten or more individuals (Period III), suggests interpersonal violence during these periods. The original excavator of Tepe Hissar, Erich Schmidt, suggested that phenomena such as war, massacres, epidemics, or similar catastrophes, may have been responsible for the excavated archaeological evidence...
January 10, 2018: Anthropologischer Anzeiger; Bericht über die Biologisch-anthropologische Literatur
https://www.readbyqxmd.com/read/29320322/multidetector-ct-of-midfacial-fractures-classification-systems-principles-of-reduction-and-common-complications
#19
David Dreizin, Arthur J Nam, Silviu C Diaconu, Mark P Bernstein, Uttam K Bodanapally, Felipe Munera
The advent of titanium hardware, which provides firm three-dimensional positional control, and the exquisite bone detail afforded by multidetector computed tomography (CT) have spurred the evolution of subunit-specific midfacial fracture management principles. The structural, diagnostic, and therapeutic complexity of the individual midfacial subunits, including the nose, the naso-orbito-ethmoidal region, the internal orbits, the zygomaticomaxillary complex, and the maxillary occlusion-bearing segment, are not adequately reflected in the Le Fort classification system, which provides only a general framework and has become less relevant in contemporary practice...
January 2018: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29319719/a-new-low-cost-negative-pressure-wound-therapy-versus-a-commercially-available-therapy-device-widely-used-to-treat-complex-traumatic-injuries-a-prospective-randomized-non-inferiority-trial
#20
Fabio Kamamoto, Ana Lucia Munhoz Lima, Marcelo Rosa de Rezende, Rames Mattar-Junior, Marcos de Camargo Leonhardt, Kodi Edson Kojima, Carla Chineze Dos Santos
OBJECTIVES: Negative-pressure wound therapy has been widely adopted to reduce the complexity of treating a broad range of acute and chronic wounds. However, its cost is high. The objective of this study was to evaluate the following two different methods of negative-pressure wound therapy in terms of healing time: a low-cost method of negative-pressure wound therapy (a pressure stabilizer device connected to a hospital wall-vacuum system with a gauze-sealed dressing, USP) and the standard of care (vacuum-assisted closure, VAC)...
December 2017: Clinics
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