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Rhys D Brady, Brian L Grills, Jarrod E Church, Nicole C Walsh, Aaron C McDonald, Denes V Agoston, Mujun Sun, Terence J O'Brien, Sandy R Shultz, Stuart J McDonald
Concomitant traumatic brain injury (TBI) and long bone fracture are commonly observed in multitrauma and polytrauma. Despite clinical observations of enhanced bone healing in patients with TBI, the relationship between TBI and fracture healing remains poorly understood, with clinical data limited by the presence of several confounding variables. Here we developed a novel trauma model featuring closed-skull weight-drop TBI and concomitant tibial fracture in order to investigate the effect of TBI on fracture healing...
September 29, 2016: Scientific Reports
Eric Peter Thelin, Emma Jeppsson, Arvid Frostell, Mikael Svensson, Stefania Mondello, Bo-Michael Bellander, David W Nelson
BACKGROUND: In order to improve assessment and outcome prediction in patients suffering from traumatic brain injury (TBI), cerebral protein levels in serum have been suggested as biomarkers of injury. However, despite much investigation, biomarkers have yet to reach broad clinical utility in TBI. This study is a 9-year follow-up and clinical experience of the two most studied proteins, neuron-specific enolase (NSE) and S100B, in a neuro-intensive care TBI population. Our aims were to investigate to what extent NSE and S100B, independently and in combination, could predict outcome, assess injury severity, and to investigate if the biomarker levels were influenced by extracranial factors...
September 8, 2016: Critical Care: the Official Journal of the Critical Care Forum
Gaspar Alberto Motta-Ramírez
BACKGROUND: Trauma is the most common cause of death in young adults. A multidisciplinary trauma team consists of at least a surgical team, an anesthesiology team, radiologic team, and an emergency department team. OBJECTIVE: Recognize the integration of multidisciplinary medical team in managing the trauma patient and which must include the radiologist physician responsible for the institutional approach to the systematization of the trauma patient regarding any radiological and imaging study with emphasis on the FAST (del inglés, Focused Assessment with Sonography in Trauma)/USTA, Whole body computed tomography...
July 2016: Gaceta Médica de México
Pauline Calleja, Leanne Aitken, Marie Cooke
AIMS AND OBJECTIVES: To understand: (1) staff perceptions of best practice for information transfer for multitrauma patients on discharge from the emergency department; (2) what information should be conveyed at transfer and (3) how information is transferred. BACKGROUND: Information transfer for multitrauma patients is an integral factor for continuity of care, safety, quality assurance and patient outcomes; however, this has not been the focus of previous studies...
October 2016: Journal of Clinical Nursing
D Markopoulou, K Venetsanou, V Kaldis, D Chatzilia, D Chroni, S Stratouli, I Alamanos
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Okan W Bastian, Anne Kuijer, Leo Koenderman, Rebecca K Stellato, Wouter W van Solinge, Luke Ph Leenen, Taco J Blokhuis
Animal studies have shown that the systemic inflammatory response to major injury impairs bone regeneration. It remains unclear whether the systemic immune response contributes to impairment of fracture healing in multitrauma patients. It is well known that systemic inflammatory changes after major trauma affect leukocyte kinetics. We therefore retrospectively compared the cellular composition of peripheral blood during the first 2 weeks after injury between multitrauma patients with normal (n=48) and impaired (n=32) fracture healing of the tibia...
2016: Journal of Inflammation Research
Stuart J McDonald, Mujun Sun, Denes V Agoston, Sandy R Shultz
BACKGROUND: Traumatic injuries are physical insults to the body that are prevalent worldwide. Many individuals involved in accidents suffer injuries affecting a number of extremities and organs, otherwise known as multitrauma or polytrauma. Traumatic brain injury is one of the most serious forms of the trauma-induced injuries and is a leading cause of death and long-term disability. Despite over dozens of phase III clinical trials, there are currently no specific treatments known to improve traumatic brain injury outcomes...
2016: Journal of Neuroinflammation
Daniel Tobert, Arvind von Keudell, Edward K Rodriguez
The 2013 Boston Marathon bombing resulted in a mass casualty event that tested the limits of Boston-area trauma centers. The explosions, 12 seconds apart, led to the rapid influx of 124 patients with primarily lower extremity injuries in 5 different adult level 1 trauma centers. This study aimed to examine the existing hospital systems in place for disaster scenarios at the time of the event and identify areas for improvement. Preparation before the Boston Marathon bombing included coordinating the delivery of patients to area facilities and creating a framework for response at an institutional level...
October 2015: Journal of Orthopaedic Trauma
Jeff Gadsden, Alicia Warlick
Trauma is a significant health problem and a leading cause of death in all age groups. Pain related to trauma is frequently severe, but is often undertreated in the trauma population. Opioids are widely used to treat pain in injured patients but have a broad range of undesirable effects in a multitrauma patient such as neurologic and respiratory impairment and delirium. In contrast, regional analgesia confers excellent site-specific pain relief that is free from major side effects, reduces opioid requirement in trauma patients, and is safe and easy to perform...
2015: Local and Regional Anesthesia
Stine T Zwisler, Jesper Hallas, Morten S Larsen, Gitte Handberg, Soeren Mikkelsen, Thomas P Enggaard
OBJECTIVE: To describe the legal use of opioids in adult patients before and after high-energy trauma. DESIGN: The study was a retrospective database study. SETTING: Clinical care outside hospitals. PATIENTS: All patients who suffered high-energy trauma and were brought to Odense University Hospital (OUH), Denmark, in 2007 and 2008 were retrieved from the trauma database. These patients were linked with data on opioid use from the regional prescription database...
July 2015: Journal of Opioid Management
Sümeyye Çoruh Kaplan, Murat Şakir Ekşi
OBJECTIVE: Cervical spine encompasses a bridge role between the head and the lower parts of the spine and therefore has unique properties. Our aim in this study was to evaluate the cervical sagittal alignment parameters in pediatric and adult non-surgical patients and to find any differences in respect of age, sex and admission type. METHODS: All patients who were admitted to emergency and neurosurgery clinics of Diyarbakir Bismil State Hospital due to cervical spine problems (trauma, radiculopathy, paraspinal pain) in 2014 were enrolled retrospectively into the study...
June 2015: Korean Journal of Spine
Jennifer Drew, Victoria B Chou, Catriona Miller, Bryson Borg, Nichole Ingalls, Stacy Shackelford
BACKGROUND: Cervical spine clearance requires clinicians to assess the reliability of physical examination based on a patient's mental status and distracting injuries. Distracting injuries have never been clearly defined in military casualties. METHODS: Retrospective review was conducted of patients entered into Department of Defense Trauma Registry January 2008 to August 2013, identifying blunt trauma patients with cervical spine injury and Glasgow Coma Score ≥ 14...
July 2015: Military Medicine
William R Thompson, Benjamin V Keller, Matthew L Davis, Laurence E Dahners, Paul S Weinhold
BACKGROUND: Low-magnitude, high-frequency vibration accelerates fracture and wound healing and prevents disuse atrophy in musculoskeletal tissues. PURPOSE: To investigate the role of low-magnitude, high-frequency vibration as a treatment to accelerate healing of an acute ligament injury and to examine gene expression in the intact Achilles tendon of the injured limb after low-magnitude, high-frequency vibration. STUDY DESIGN: Controlled laboratory study...
May 2015: Orthopaedic Journal of Sports Medicine
Finn H Andersen, Hans Flaatten, Pål Klepstad, Ulla Romild, Reidar Kvåle
BACKGROUND: Comparison of survival and quality of life in a mixed ICU population of patients 80 years of age or older with a matched segment of the general population. METHODS: We retrospectively analyzed survival of ICU patients ≥80 years admitted to the Haukeland University Hospital in 2000-2012. We prospectively used the EuroQol-5D to compare the health-related quality of life (HRQOL) between survivors at follow-up and an age- and gender-matched general population...
December 2015: Annals of Intensive Care
Sandy R Shultz, Mujun Sun, David K Wright, Rhys D Brady, Shijie Liu, Sinead Beynon, Shannon F Schmidt, Andrew H Kaye, John A Hamilton, Terence J O'Brien, Brian L Grills, Stuart J McDonald
Multitrauma is a common medical problem worldwide, and often involves concurrent traumatic brain injury (TBI) and bone fracture. Despite the high incidence of combined TBI and fracture, preclinical TBI research commonly employs independent injury models that fail to incorporate the pathophysiologic interactions occurring in multitrauma. Here, we developed a novel mouse model of multitrauma, and investigated whether bone fracture worsened TBI outcomes. Male mice were assigned into four groups: sham-TBI+sham-fracture (SHAM); sham-TBI+fracture (FX); TBI+sham-fracture (TBI); and TBI+fracture (MULTI)...
August 2015: Journal of Cerebral Blood Flow and Metabolism
Sean Huang, Ashray Vohora, Matthias K Russ, Joseph K Mathew, Cecil S Johnny, Jeremy Stevens, Mark C Fitzgerald
This article proposes a counter-argument to standard Advanced Trauma Life Support (ATLS) training--which advocates bladder catheterisation to be performed as an adjunct to the primary survey and resuscitation for early decompression of the bladder and urine output monitoring. We argue the case for delaying bladder catheterisation until after definitive truncal Computed Tomography (CT) imaging. To reduce pelvic volume and associated bleeding, our trauma team delay catheter insertion until after the initial CT scan...
2015: Injury
Pei-Hung Wen, Wai Hung Chan, Ying-Cheng Chen, Yao-Li Chen, Chien-Pin Chan, Ping-Yi Lin
Pulmonary contusion and acute respiratory distress syndrome (ARDS) is a common manifestation in polytraumatic patients. Although mechanical ventilation is still the first choice of treatment, a group of patients are still unable to maintain their oxygenation. The role of extracorporeal membrane oxygenation (ECMO) has been more clarified when the lung is extensively damaged and when conventional modality failed. ECMO provides the lung an opportunity to rest by permitting reduced ventilator settings and limiting further barotraumas...
2015: World Journal of Emergency Surgery: WJES
Iu A Shcherbuk, D Iu Madaĭ, S V Gavrilin, A Iu Shcherbok, K A Absava, O D Madaĭ
It is important to improve the medical care system and treatment of victims, introduce new methods of treatment and attract the multidisciplinary specialists in the cases of multitrauma. An integrated approach is required for the identification of different character and severity of multiple craniofacial injuries and the development of rational surgical strategy on this base. Different scales such as AIS, CRIS, ISS, PTS, TRISS, TRISSCAN, CRAMS, were created abroad. Another approach to medical strategy was developed in the department of military surgery of Kirov Military Academy in the late nineties...
2014: Vestnik Khirurgii Imeni I. I. Grekova
Jacob Steinmetz, Lars Bo Svendsen
Multitrauma is usually defined as injury to several organ systems. The more severe the injury, the higher is the mortality. It is essential that a trauma team assess and treat these patients using a rapid, structured approach in order to increase the survival. Damage control surgery and resuscitation should be applied in the very unstable patients. Following the initial treatment, an early activation and coordination of all involved specialties are very important.
July 7, 2014: Ugeskrift for Laeger
Nese C Oray, Semra Sivrikaya, Basak Bayram, Tufan Egeli, Oguz Dicle
Traumatic perforation of the esophagus due to blunt trauma is a rare thoracic emergency. The most common causes of esophageal perforation are iatrogenic, and the upper cervical esophageal region is the most often injured. Diagnosis is frequently determined late, and mortality is therefore high. This case report presents a young woman who was admitted to the emergency department (ED) with esophageal perforation after having fallen from a high elevation. Esophageal perforation was diagnosed via thoracoabdominal tomography with ingestion of oral contrast...
September 2014: Western Journal of Emergency Medicine
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