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Adult Trauma

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https://www.readbyqxmd.com/read/28437379/associations-of-lifetime-trauma-and-chronic-stress-with-c-reactive-protein-in-adults-ages-50-and-older-examining-the-moderating-role-of-perceived-control
#1
Ari J Elliot, Christopher J Mooney, Frank J Infurna, Benjamin P Chapman
OBJECTIVE: To investigate whether high perceived control mitigates systemic inflammatory risk associated with traumatic and chronic stress exposures in older adults. METHODS: A sample of community-dwelling adults ages 50 and older (N=4,779) was drawn from the Health and Retirement Study (HRS). Structural equation models tested interactions of lifetime trauma and chronic stress with mastery and perceived constraints predicting baseline levels and four-year change in C-reactive protein (CRP)...
April 21, 2017: Psychosomatic Medicine
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#2
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28435582/transient-osteoporosis-of-the-hip-a-case-report
#3
K Pande, T T Aung, J F Leong, I Bickle
Transient osteoporosis of the hip (TOH) is a benign, selflimiting condition characterised by acute onset groin pain in adults. Early diagnosis is important to differentiate it from progressive conditions such as osteonecrosis. We report on a middle-aged male who presented with right groin pain without any prior trauma. The diagnosis of transient osteoporosis of hip was confirmed by Magnetic Resonance Imaging (MRI) and he was successfully treated with a course of Alendronate sodium, anti-inflammatory analgesics and a period of non-weight bearing ambulation...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435490/correlation-of-physical-exam-findings-with-fever-in-patients-with-skin-and-soft-tissue-infections
#4
Jillian Mongelluzzo, Brian Tu, Barbara Grimes, Sharvina Ziyeh, Jonathan Fortman, Jersey Neilson, Robert M Rodriguez
INTRODUCTION: The objectives of this study were to determine the prevalence of fever in adult ED patients with skin and soft tissue infections (SSTI) and to determine which, if any, physical exam, radiograph and laboratory test findings were associated with fever. METHODS: We conducted a prospective, observational study at an urban county trauma center of adults who presented to the ED for evaluation of suspected SSTI. ED providers measured area of erythema and induration using a tape measure, and completed data sheets indicating comorbid conditions and the presence or absence of physical exam findings...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435418/-you-never-know-what-happens-next-young-adult-service-users-experience-with-mental-health-care-and-treatment-through-one-year
#5
Marian Ådnanes, Sissel Steihaug
Fragmented services are a well-known problem in the mental health sector. Mental health service users' experiences of treatment and care can provide knowledge for developing more user-oriented continuity of care. We followed nine young adults with mental health illnesses and complex needs, conducting four interviews with each informant in the course of a year. The aim was to capture their experiences and views about treatment and care, focusing on (dis)continuities and episodes occurring through that year. The users' experiences were affected by shifts and transitions between institutions, units and practitioners while their need was predictability and stability...
July 22, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28431416/caring-for-critically-injured-children-an-analysis-of-56-pediatric-damage-control-laparotomies
#6
Miguel A Villalobos, Joshua P Hazelton, Rachel L Choron, Lisa Capano-Wehrle, Krystal Hunter, John P Gaughan, Steven E Ross, Mark J Seamon
BACKGROUND: Injury is the leading cause of death in children under 18 years. Damage control principles have been extensively studied in adults but remain relatively unstudied in children. Our primary study objective was to evaluate the use of damage control laparotomy (DCL) in critically injured children. METHODS: An American College of Surgeons-verified Level 1 trauma center review (1996-2013) of pediatric trauma laparotomies was undertaken. Exclusion criteria included: age older than 18 years, laparotomy for abdominal compartment syndrome or delayed longer than 2 hours after admission...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28431415/potential-impact-of-affordable-care-act-related-insurance-expansion-on-trauma-care-reimbursement
#7
John W Scott, Pooja U Neiman, Peter A Najjar, Thomas C Tsai, Kirstin W Scott, Mark G Shrime, David M Cutler, Ali Salim, Adil H Haider
BACKGROUND: Nearly one quarter of trauma patients are uninsured and hospitals recoup less than 20% of inpatient costs for their care. This study examines changes to hospital reimbursement for inpatient trauma care if the full coverage expansion provisions of the Affordable Care Act (ACA) were in effect. METHODS: We abstracted nonelderly adults (ages 18-64 years) admitted for trauma from the Nationwide Inpatient Sample during 2010-the last year before most major ACA coverage expansion policies...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28431190/higher-levels-of-submissive-behaviors-at-the-onset-of-the-pairing-process-of-rhesus-macaques-macaca-mulatta-are-associated-with-lower-risk-of-wounding-following-introduction
#8
Ori Pomerantz, Kate C Baker
Social housing of rhesus macaques (Macaca mulatta) is considered to be the cornerstone of behavioral management programs in biomedical facilities. However, it also involves the risk of socially inflicted trauma. The ability to avoid such trauma would contribute to the animals' well-being and alleviate staff's concerns, thus paving the path for more introductions. Here, we sought to address the conflict between the need to socially house rhesus macaques and the need to bring social wounding to a minimum by identifying behaviors expressed early in social introductions, that may serve as predictors of later wounding events...
April 21, 2017: American Journal of Primatology
https://www.readbyqxmd.com/read/28430759/evaluation-of-guidelines-for-injured-children-at-high-risk-for-venous-thromboembolism-a-prospective-observational-study
#9
Rachel M Landisch, Sheila J Hanson, Laura D Cassidy, Kristin Braun, Rowena C Punzalan, David M Gourlay
BACKGROUND: Pharmacologic prophylaxis for venous thromboembolism (VTE) is a widely accepted practice in adult trauma patients to prevent associated morbidity and mortality. However, VTE prophylaxis has not been standardized in injured pediatric patients. Our institution identified factors potentially associated with a high risk of VTE in critically injured children that led to prospective implementation of VTE prophylaxis guidelines. We hypothesize that the guidelines are accurate in predicting children at risk for VTE...
May 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28429614/are-mothers-protective-attachment-strategies-related-to-their-children-s-strategies
#10
Patricia M Crittenden, Katrina Robson, Alison Tooby, Charles Fleming
AIMS: We explored the relation between mothers' protective attachment strategies and those of their school-age children. METHODS: In total, 49 child-mother dyads participated in a short longitudinal study when the children were 5.5 and 6.0 years old. Their strategies were first assessed with the Preschool Assessment of Attachment (PAA) and then with the School-age Assessment of Attachment (SAA). Mothers were assessed with the Adult Attachment Interview (AAI). The Dynamic-Maturational Model of Attachment and Adaptation (DMM) was used to classify the assessments...
April 1, 2017: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/28428037/conservative-treatment-of-displaced-distal-radius-fractures-leads-to-acceptable-functional-outcomes-however-at-the-expense-of-40-subsequent-surgeries
#11
Marjolein A M Mulders, Percy V van Eerten, J Carel Goslings, Niels W L Schep
BACKGROUND: Although secondary displacement following closed reduction and plaster immobilisation is high, several guidelines still recommend non-operative treatment for displaced distal radius fractures with an adequate closed reduction. PURPOSE: The purpose of this study was to evaluate functional outcomes, measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in non-operative treated patients with displaced distal radius fractures with an adequate closed reduction confirmed on radiograph...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28426562/asymptomatic-cervical-spine-fractures-current-guidelines-can-fail-older-patients
#12
Christopher D Healey, Sarah K Spilman, Bradley D King, Joseph E Sherrill, Carlos A Pelaez
BACKGROUND: Older adults represent a growing proportion of trauma patients treated in the United States, and cervical spine (c-spine) fracture is an injury that is increasingly common in this population. Neck pain is a major component of current clinical clearance guidelines, but some older adults with c-spine fractures report no neck pain after injury. The objective of this study was to investigate the frequency at which c-spine fractures were unassociated with neck pain in an aging population...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28426560/universal-screening-for-intimate-partner-and-sexual-violence-in-trauma-patients-an-east-multicenter-trial
#13
Tanya L Zakrison, Xiomara Ruiz, Rondi Gelbard, John Cline, David Turay, Xian Luo-Owen, Nicholas Namias, Marie Crandall, Jessica George, Brian H Williams
BACKGROUND: A single center trial recently demonstrated a prevalence of 14% of intimate partner and sexual violence (IPSV) amongst both male and female trauma patients, regardless of mechanism of injury. We aimed to determine if this phenomenon was similar to rates in other trauma centers by assessing the feasibility of universal screening, and determining the prevalence and association of IPSV with other trauma-associated comorbidities. METHODS: We designed an EAST- supported multicenter, prospective observational cohort study involving four Level I trauma centers throughout the United States...
April 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#14
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28424799/role-of-psychological-resilience-on-health-outcomes-in-hospitalized-patients-with-acute-illness-a-scoping-review
#15
Elen Marged Bradley-Roberts, Christian P Subbe
Recovery from Acute Illness is dependent on severity of illness. We aimed to investigate whether resilience as the 'ability to bounce back' might also affect recovery. We conducted a scoping review to identify gaps in the existing literature. We used emergency care, intensive care, critical care and trauma as surrogates for acute illness. We mapped synonyms for resilience and selected 'resilience' and 'robustness'. The search was limited to adult patients admitted to hospitals. We found strong evidence for psychological sequelae of acute illness but no research focusing specifically on the concepts of resilience or robustness and no interventional studies in the acute hospital setting...
2017: Acute Medicine
https://www.readbyqxmd.com/read/28424124/acute-respiratory-distress-syndrome-incidence-but-not-mortality-has-decreased-nationwide-a-national-trauma-data-bank-study
#16
Michael Fahr, Glenn Jones, Hollis O'Neal, Juan Duchesne, Danielle Tatum
Acute respiratory distress syndrome (ARDS) incidence is reported to have decreased in recent years. However, no large-scale study to date has exclusively examined ARDS in the critically injured. We sought to examine the national incidence of ARDS and its associated outcomes exclusively in adult trauma patients. The National Trauma Data Bank (NTDB) was queried to evaluate the incidence of ARDS and associated outcomes over a 6-year study period (2007-2012). Included patients were ≥18 years old, with at least one ventilator day, and complications recorded...
April 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28422922/the-spatial-epidemiology-of-pediatric-trauma-a-statewide-assessment
#17
Allison Ertl, Kirsten Beyer, Sergey Tarima, Yuhong Zhou, Jonathan I Groner, Laura D Cassidy
INTRODUCTION: Despite significant advances in the prevention and treatment of pediatric trauma, preventable injuries continue to burden the lives of millions of children. In order to target prevention strategies, it is critical to identify areas with high burdens of pediatric trauma. Therefore, this study analyzed statewide data from the Ohio Trauma Registry (OTR) from 2007-2012 to identify geographical patterns in pediatric injury. METHODS: Data from the first hospital of care for 16,330 pediatric trauma patients under 16 years old were analyzed using the disease mapping method adaptive spatial filtering to estimate a series of maps that display age- and sex-adjusted rates of pediatric trauma, severe trauma, and standardized mortality ratios (SMR) while controlling for population size to create stable estimates throughout the study area...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422921/population-based-estimate-of-trauma-related-deaths-for-law-enforcement-personnel-risks-for-death-are-higher-and-increasing-over-time
#18
Alexander L Eastman, Michael W Cripps, Kareem R Abdelfattah, Kenji Inaba, Thomas G Weiser, David A Spain, Kristan L Staudenmayer
OBJECTIVE: Trauma-related deaths remain an important public health problem. One group susceptible to death due to traumatic mechanisms is U.S. Law Enforcement (LE). We hypothesized that LE officers experienced a higher chance of violent death compared to the general U.S. population and that risks have increased over time. METHODS: The National Institute on Occupational Safety and Health (NIOSH) National Occupational Mortality Surveillance (NOMS) is a population-based survey of occupational deaths...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28422907/adequacy-and-accuracy-of-non-trauma-center-computed-tomography-what-are-we-missing
#19
Morgan Bonds, Stephen Hersperger, Tabitha Garwe, Robert Fails, Sigrid Johannesen, Christina Kim, Ademola A Adeseye, Jason Lees, William Havron
BACKGROUND: Timely and appropriate use of computed tomography (CT) scans is critical to the evaluation of traumatic injuries. The objective of this study was to assess the adequacy of CT scans performed at non-trauma centers (NTCs) as they pertain to the management of trauma patients. METHODS: Adult patients transferred to our ACS-verified level 1 trauma center from any NTC between May and December 2012 were enrolled prospectively. Available CT images from NTCs were reviewed in a blinded fashion by our facility's trauma radiologist; his interpretations were compared with those from the NTC...
April 18, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28420470/-explore-objective-clinical-variables-for-detecting-delirium-in-icu-patients-a-prospective-case-control-study
#20
Xiaojiang Liu, Jie Lyu, Youzhong An
OBJECTIVE: The aim of this case-control study is to explore clinical objective variables for diagnosing delirium of intensive care unit (ICU) patients. METHODS: According to the method of prospective case-control study, critical adult postoperative patients who were transferred to ICU of Peking University People's Hospital from October 2015 to May 2016 and needed mechanical ventilation were included. After evaluating the Richmond agitation sedation scale score (RASS), the patients whose score were -2 or greater were sorted into two groups, delirium and non-delirium, according to the confusion assessment method for the ICU (CAM-ICU)...
April 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
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