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Multitrauma

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https://www.readbyqxmd.com/read/28694703/secondary-sclerosing-cholangitis-in-critically-ill-patients-current-perspectives
#1
REVIEW
Hafsteinn O Gudnason, Einar S Björnsson
Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU)...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/28670821/pain-intensity-and-pain-self-management-strategies-following-discharge-after-surgery-an-australian-prospective-observational-study
#2
F C Veal, A J Thompson, L J Perry, L R Bereznicki, G M Peterson
WHAT IS KNOWN AND OBJECTIVE: Up to 80% of patients experience acute pain following surgery. This study aimed to improve the current understanding about the strategies individuals use to self-manage pain following discharge after surgery, stratified by pain intensity. METHODS: A prospective observational study conducted at the Royal Hobart Hospital, Australia, between November 2014 and March 2015. Eligible participants were 18 years or older and had undergone surgery requiring an incision...
July 2, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28665985/early-decreased-neutrophil-responsiveness-is-related-to-late-onset-sepsis-in-multitrauma-patients-an-international-cohort-study
#3
Kathelijne M Groeneveld, Leo Koenderman, Brian L Warren, Saskia Jol, Luke P H Leenen, Falco Hietbrink
BACKGROUND: Severe trauma can lead to the development of infectious complications after several days, such as sepsis. Early identification of patients at risk will aid anticipating these complications. The aim of this study was to test the relation between the acute (<24 hours) inflammatory response after injury measured by neutrophil responsiveness and the late (>5 days) development of septic complications and validate this in different trauma populations. METHODS AND FINDINGS: Two prospective, observational, cohort series in the Netherlands and South Africa, consisting of severely injured trauma patients...
2017: PloS One
https://www.readbyqxmd.com/read/28616615/the-predictive-value-of-biochemical-parameters-in-evaluating-patients-with-abdominal-trauma-the-new-scoring-system
#4
Ekrem Musalar, Murat Ersel, Funda Karbek Akarca, Güçlü Selahattin Kıyan, Özge Can
AIM: The aim of this study was to investigate the contribution of non-invasively and rapidly obtained biochemical parameter results to the diagnosis and follow-up of intraabdominal injuries in multitrauma patients. MATERIAL AND METHODS: A total of 2604 multitrauma patients who were treated following their referral to our emergency department between January 2009 and January 2012 were retrospectively reviewed. A logistic regression analysis was used in the risk assessment...
June 2017: Turkish Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28614864/-the-patient-with-chest-trauma-surgical-management
#5
Patrick Zardo, Henning Busk, Stefan Piatek, Norman Zinne, Irina Kropivnitskaya, Ingo Kutschka
Even though isolated cases of penetrating chest wounds are exceptionally rare in Germany, chest trauma accounts for major morbidity and mortality in over 18 0000 multitrauma patients encountered every year. Injuries range from immediately fatal cardiac wounds and major vessel lacerations to intercostal bleeding, parenchymal damage, chronic haematothorax and secondary empyema. Placement of large-bore chest tubes constitutes a sufficient treatment for most of these pathologies. In select cases further treatment either by minimally invasive techniques (VATS) or conventional thoracotomy is warranted...
June 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28486263/predicting-thoracic-injury-in-children-with-multitrauma
#6
Kirstin D Weerdenburg, Paul W Wales, Derek Stephens, Suzanne Beno, Jessica Gantz, Jessie Alsop, Suzanne Schuh
OBJECTIVES: Previous pediatric trauma studies focused on predictors of abnormal chest radiographs or included patients with low injury severity. This study identified predictors of thoracic injury (TI) diagnoses in a high-risk population and determined TI rate without predictors. METHODS: This study was a retrospective trauma registry analysis of previously healthy children aged 0 to 17 years with multisystem blunt trauma requiring trauma team activation and chest radiography who were divided into those with and without TI...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28416071/-acute-upper-airway-obstruction-caused-by-a-multinodular-goitre-after-tracheotomy
#7
Chadi Nimeh Abdel-Halim, Bibi Lange
This case report illustrates how a multinodular goitre caused acute airway obstruction in a multitrauma 66-year-old male after tracheotomy. The patient had no symptoms of the goitre before the tracheotomy but developed subglottic airway obstruction at the time of decannulation. He underwent a subacute total thyroidectomy which removed the obstructive symptoms. A weakening of the tracheal tube followed by the tracheotomy possibly caused the tracheal stenosis in combination with the goitre.
April 3, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/27849322/the-effect-of-body-mass-index-on-trauma-severity-and-prognosis-in-trauma-patients
#8
Hasan Mansur Durgun, Recep Dursun, Yılmaz Zengin, Ayhan Özhasenekler, Murat Orak, Mehmet Üstündağ, Cahfer Güloğlu
BACKGROUND: As in the rest of the world, the prevalence of obesity in Turkey has been increasing in recent years and has become a major public health issue. Although many trials have been conducted to study the effects of obesity on internal diseases, there are few studies investigating the effects of obesity on prognosis of trauma patients. The present study analyzed the effects of body mass index (BMI) on trauma severity and prognosis in trauma patients. METHODS: This study was prospectively conducted with trauma patients older than 15 years of age who presented at the Dicle University Faculty of Medicine emergency medicine department trauma unit between June 1, 2013 and May 31, 2014...
September 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27682431/closed-head-experimental-traumatic-brain-injury-increases-size-and-bone-volume-of-callus-in-mice-with-concomitant-tibial-fracture
#9
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
https://www.readbyqxmd.com/read/27604350/utility-of-neuron-specific-enolase-in-traumatic-brain-injury-relations-to-s100b-levels-outcome-and-extracranial-injury-severity
#10
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
https://www.readbyqxmd.com/read/27595259/-the-radiologist-physician-in-major-trauma-evaluation
#11
REVIEW
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
https://www.readbyqxmd.com/read/27453432/staff-perceptions-of-best-practice-for-information-transfer-about-multitrauma-patients-on-discharge-from-the-emergency-department-a-focus-group-study
#12
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
https://www.readbyqxmd.com/read/27289917/evaluation-of-early-immune-response-in-multitrauma-patients-admitted-in-icu-the-effect-of-age
#13
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
https://www.readbyqxmd.com/read/27274302/impaired-bone-healing-in-multitrauma-patients-is-associated-with-altered-leukocyte-kinetics-after-major-trauma
#14
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
https://www.readbyqxmd.com/read/27117191/the-effect-of-concomitant-peripheral-injury-on-traumatic-brain-injury-pathobiology-and-outcome
#15
REVIEW
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...
April 26, 2016: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/26356215/lessons-from-the-boston-marathon-bombing-an-orthopaedic-perspective-on-preparing-for-high-volume-trauma-in-an-urban-academic-center
#16
REVIEW
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
https://www.readbyqxmd.com/read/26316813/regional-anesthesia-for-the-trauma-patient-improving-patient-outcomes
#17
REVIEW
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
https://www.readbyqxmd.com/read/26312958/opioid-prescriptions-before-and-after-high-energy-trauma
#18
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
https://www.readbyqxmd.com/read/26217386/cervical-sagittal-alignment-parameters-of-patients-admitted-to-neurosurgery-and-emergency-clinics-in-a-state-hospital-at-eastern-part-of-turkey
#19
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
https://www.readbyqxmd.com/read/26126250/clearing-the-cervical-spine-in-a-war-zone-what-other-injuries-matter
#20
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
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