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Adult Trauma

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https://www.readbyqxmd.com/read/29454228/obturator-internus-muscle-abscess-caused-by-methicillin-resistant-staphylococcus-aureus-in-an-adult-a-case-report
#1
Akinori Maeda, Isaku Saku, Shotaro Kanda, Kazuo Saita, Toru Akiyama
INTRODUCTION: Obturator internus muscle (OIM) abscess is a rare condition, usually affecting children after trauma or muscular effort. Blood cultures always yield positive findings, with Staphylococcus aureus being the most common culprit. There are few reports in adults. PRESENTATION OF CASE: We report a case of OIM abscess in an adult. A 24-year-old male was admitted to our hospital because of right hip pain and fever. He was diagnosed with OIM abscess, and methicillin-resistant Staphylococcus aureus (MRSA) was detected on bacterial examination...
February 9, 2018: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29453979/toward-a-meaningful-definition-of-recovery-after-hip-fracture-comparing-two-definitions-for-community-dwelling-older-adults
#2
Mohammad Auais, Suzanne N Morin, Lois Finch, Sara Ahmed, Nancy Mayo
OBJECTIVES: To examine the course of recovery and resulting health-related quality of life (HRQL) after low-trauma hip fracture using two different definitions of recovery. DESIGN: Inception cohort with eight assessments over one year. SETTING: Participants were recruited from a tertiary-care hospital and followed in the community. INTERVENTION: Not applicable PARTICIPANTS: 47 (75% of all eligible) community-dwelling hip fracture patients (≥65 years)...
February 14, 2018: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/29452810/interleukin-6-is-both-necessary-and-sufficient-to-produce-perioperative-neurocognitive-disorder-in-mice
#3
J Hu, X Feng, M Valdearcos, D Lutrin, Y Uchida, S K Koliwad, M Maze
BACKGROUND: Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic target for PND in a mouse model. METHODS: Following institutional approval, adult (12-14 weeks) male C57/Bl6 mice were pretreated with the IL-6 receptor (IL6R) blocking antibody tocilizumab prior to open tibia fracture with internal fixation under isoflurane anaesthesia...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29451058/developmental-differences-in-stress-responding-after-repeated-underwater-trauma-exposures-in-rats
#4
Daniel E Altman, Laurence P Simmons, Chau T Vuong, Rachel M Taylor, Jason C Sousa, Sean R Marcsisin, Victor E Zottig, Nicole L T Moore
Adolescence is a distinct developmental period characterized by behavioral and physiological maturation. Rapid ongoing changes during neurodevelopment in particular present potential opportunities for stress to have lasting effects on longitudinal outcomes of behavioral and neuroendocrine function. While adult stress effects on outcomes during adulthood have been characterized, little is known about the lasting effects of adolescent repeated stressor exposure on outcomes during adolescence. We have previously reported different stress responses in adolescent rats relative to adult rats, including a blunted fear response outcome in adulthood in rats stressed during adolescence...
February 16, 2018: Stress: the International Journal on the Biology of Stress
https://www.readbyqxmd.com/read/29450715/utility-of-mri-for-cervical-spine-clearance-in-blunt-trauma-patients-after-a-negative-ct
#5
Ajay Malhotra, David Durand, Xiao Wu, Bertie Geng, Khalid Abbed, Diego B Nunez, Pina Sanelli
PURPOSE: To determine the utility of cervical spine MRI in blunt trauma evaluation for instability after a negative non-contrast cervical spine CT. METHODS: A review of medical records identified all adult patients with blunt trauma who underwent CT cervical spine followed by MRI within 48 h over a 33-month period. Utility of subsequent MRI was assessed in terms of findings and impact on outcome. RESULTS: A total of 1,271 patients with blunt cervical spine trauma underwent both cervical spine CT and MRI within 48 h; 1,080 patients were included in the study analysis...
February 15, 2018: European Radiology
https://www.readbyqxmd.com/read/29450701/burden-characteristics-and-process-of-care-among-the-pediatric-and-adult-trauma-patients-in-botswana-s-main-hospitals
#6
Michael B Mwandri, Timothy C Hardcastle
BACKGROUND: Botswana is notable among countries with high rates of Road Traffic Collisions (RTC); like many other lower-middle-income countries (LMICs), it lacks trauma systems. The World Health Organization recommends 'Essential Trauma Care' in countries with no formal trauma systems. The proportion of injuries in Emergency Departments and the care process were investigated to gain an overview for enabling the design of a relevant LMICs trauma system. METHOD: Blunt and penetrating trauma patients were included from three major hospitals, examining the proportion of injuries, patient characteristics, the care process and comparing these between pediatrics and adults...
February 15, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29450470/incidence-of-delayed-intracranial-hemorrhage-in-older-patients-after-blunt-head-trauma
#7
James A Chenoweth, Samuel D Gaona, Mark Faul, James F Holmes, Daniel K Nishijima
Importance: Current guidelines conflict on the management of older adults who have blunt head trauma taking anticoagulant and antiplatelet medications. This is partially due to the limited data comparing patients who are taking these medications with those who are not. Objective: To investigate the incidence of delayed traumatic intracranial hemorrhage in older adults with head trauma, including those taking anticoagulant and antiplatelet medications. Design, Setting, and Participants: This prospective observational cohort study included patients 55 years and older who had blunt head trauma and were transported via emergency medical services between August 1, 2015, and September 30, 2016...
February 14, 2018: JAMA Surgery
https://www.readbyqxmd.com/read/29449822/attachment-patterns-and-complex-trauma-in-a-sample-of-adults-diagnosed-with-gender-dysphoria
#8
Guido Giovanardi, Roberto Vitelli, Carola Maggiora Vergano, Alexandro Fortunato, Luca Chianura, Vittorio Lingiardi, Anna Maria Speranza
The current study investigated attachment representations and complex trauma in a sample of gender dysphoric adults. Although it has been proven that the psychological wellbeing of gender diverse persons is largely mediated by family acceptance and support, research on their relationships with parental figures is scarce. A total of 95 adults took part in the study. The attachment distribution was as follows: 27% secure, 27% insecure and 46% disorganized. Regarding early traumas, 56% experienced four or more traumatic forms...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/29448990/open-abdomen-in-liver-transplantation
#9
T Chan, M S Bleszynski, D S Youssef, M Segedi, S Chung, C H Scudamore, A K Buczkowski
INTRODUCTION: Damage control laparotomy with vacuum assisted closure (VAC) is used for selective cases in trauma. In liver transplantation, VAC has also been applied for management of intra-operative hemorrhage. The primary objective was to evaluate peri-operative blood loss and blood product utilization in VAC compared to primary abdominal closure (PAC) at the index transplant operation. METHODS: Retrospective review of all adults undergoing deceased donor liver transplantation (2007-2011) at a single center tertiary care institution...
January 31, 2018: American Journal of Surgery
https://www.readbyqxmd.com/read/29446794/migraine-variants-in-children
#10
A David Rothner
Migraine in children can manifest in ways that are markedly different from adult migraines. In children, migraine variants are often unaccompanied by headache and include conditions such as cyclic vomiting and abdominal migraine. Children who experience these conditions are often thought to have a disorder of the gastrointestinal tract, and when evaluation is unremarkable they may be diagnosed as having a conversion reaction. Complicated migraines, on the other hand, are often accompanied by focal neurological symptoms such as ataxia, hemiparesis, or altered level of consciousness that evoke great consternation in the examining clinician...
February 1, 2018: Pediatric Annals
https://www.readbyqxmd.com/read/29443854/universal-screening-for-intimate-partner-and-sexual-violence-in-trauma-patients-what-about-the-men-an-east-multicenter-trial
#11
Tanya L Zakrison, Rishi Rattan, Davel Milian Valdés, Xiomara Ruiz, Rondi Gelbard, John Cline, David Turay, Xian Luo-Owen, Nicholas Namias, Jessica George, Dante Yeh, Daniel Pust, Brian H Williams
INTRODUCTION: A recent EAST-supported, multicenter trial demonstrated a similar rate of intimate partner and sexual violence (IPSV) between male and female trauma patients, regardless of mechanism. Our objective was to perform a subgroup analysis of our affected male cohort as this remains an understudied group in the trauma literature. METHODS: We conducted a recent EAST-supported, cross-sectional, multicenter trial over one year (03/15-04/16) involving four Level I trauma centers throughout the United States...
February 14, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29442232/neuroimaging-of-first-seizure-in-the-adult-emergency-patients
#12
Kerem Ozturk, Esra Soylu, Cem Bilgin, Bahattin Hakyemez, Mufit Parlak
The aim is to establish the role of head computed tomography (CT) and magnetic resonance imaging (MRI) in adults presenting to the emergency department (ED) with first-time seizure (FS) and to analyze the potential predictor variables for the adverse imaging outcome. We retrospectively reviewed the medical records of all adults who underwent cranial CT or MRI between January 1, 2011, and December 1, 2016, to an academic ED for FS. Patients were excluded if were under 18 years of age, had known recent intracranial pathology, known brain tumor or having a history of trauma...
February 13, 2018: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29441300/trauma-induced-focal-nodular-mucinoses-a-rare-entity
#13
Gunjan Verma, Pooja A Mrig, R K Gautam, Purnima Malhotra
Cutaneous mucinoses refer to disorders with abnormal accumulation of mucin in the skin. Mucin is an amorphous material that is a part of the extracellular matrix in dermis. Cutaneous mucinoses could be primary or secondary. The latter is associated with systemic disorders such as autoimmune diseases, diabetes mellitus, paraproteinemia, or altered thyroid function. Here, we report an adult female patient with trauma-induced cutaneous focal nodular mucinoses on left-sided scapular region. Histology showed replacement of collagen bundles by mucinous deposits in superficial and mid-dermis...
January 2018: Indian Dermatology Online Journal
https://www.readbyqxmd.com/read/29441170/management-of-traumatic-brain-injury-patients
#14
REVIEW
Hari Hara Dash, Siddharth Chavali
Traumatic brain injury (TBI) has been called the 'silent epidemic' of modern times, and is the leading cause of mortality and morbidity in children and young adults in both developed and developing nations worldwide. In recent years, the treatment of TBI has undergone a paradigm shift. The management of severe TBI is ideally based on protocol-based guidelines provided by the Brain Trauma Foundation. The aims and objectives of its management are prophylaxis and prompt management of intracranial hypertension and secondary brain injury, maintenance of cerebral perfusion pressure, and ensuring adequate oxygen delivery to injured brain tissue...
February 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29437736/vertebro-vertebral-fistula-presenting-as-a-pulsatile-tinnitus
#15
Miguel Sá Breda, José Amorim, Jaime Rocha, Luis Dias
Tinnitus is the perception of sound in the absence of a corresponding external acoustic stimulus, resulting in an estimated prevalence of 10% to 15% in adults. Tinnitus may be classified as pulsatile (PT) or continuous (non-PT), and may be subjective (heard only by the patient) or objective (also audible to the examiner). PT is usually related to vascular causes and is pulse synchronous (coinciding with the patient's heartbeat). PT is much less common affecting approximately 4% of patients with tinnitus, but unlike non-PT, usually has a specific identifiable cause...
February 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29433843/biological-alterations-affecting-risk-of-adult-psychopathology-following-childhood-trauma-a-review-of-sex-differences
#16
REVIEW
Ashwini Tiwari, Andrea Gonzalez
Childhood trauma exposure is a significant public health problem. While adult mental health consequences of such experiences are well documented, sex differences in both prevalence and severity are less understood. Sex-based differences in biological circuitry and physiological trauma responses are proposed to potentiate the differential risk for pathogenesis of mental health disorders among adults. This paper will provide a contextualized summary of neuroendocrine, neuroimaging, and behavioral epigenetic studies on biological sex differences contributing to internalizing psychopathology, specifically posttraumatic stress disorder and depression, among adults with a history of childhood abuse...
February 2, 2018: Clinical Psychology Review
https://www.readbyqxmd.com/read/29433802/chest-ultrasonography-for-the-emergency-diagnosis-of-traumatic-pneumothorax-and-haemothorax-a-systematic-review-and-meta-analysis
#17
REVIEW
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
OBJECTIVE: To assess the diagnostic of the chest ultrasonography for the emergency diagnosis of traumatic pneumothorax and haemothorax in adults. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, EMBASE, Scopus, Web of Science and LILACS (up to 2016) were systematically searched for prospective studies on the diagnostic accuracy of ultrasonography for pneumothorax and haemothorax in adult trauma patients. The references of other systematic reviews and the included studies were checked for further articles...
February 8, 2018: Injury
https://www.readbyqxmd.com/read/29433075/glucocorticoid-receptor-gene-methylation-moderates-the-association-of-childhood-trauma-and-cortisol-stress-reactivity
#18
Nina Alexander, Clemens Kirschbaum, Matthis Wankerl, Benjamin J Stauch, Tobias Stalder, Susann Steudte-Schmiedgen, Markus Muehlhan, Robert Miller
Exposure to childhood trauma (CT) has been linked to sustained dysregulations of major stress response systems, including findings of both exaggerated and attenuated hypothalamus-pituitary-adrenal (HPA) axis activity. Likewise, CT constitutes a common risk factor for a broad range of psychiatric conditions that involve distinct neuroendocrine profiles. In this study, we investigated the role of epigenetic variability in a stress-related gene as a potential mediator or moderator of such differential trajectories in CT survivors...
January 31, 2018: Psychoneuroendocrinology
https://www.readbyqxmd.com/read/29432381/systematic-review-of-prehospital-tourniquet-use-in-civilian-limb-trauma
#19
David S Kauvar, Michael A Dubick, Thomas J Walters, John F Kragh
BACKGROUND: Military enthusiasm for limb tourniquet use in combat casualty care has resulted in acceptance by the trauma community for use in the prehospital care of civilian limb injuries. To date there has been no report synthesizing the published data on civilian tourniquet use. The objective of this systematic review was to compile and analyze the content and quality of published data on the civilian use of tourniquets in limb trauma. METHODS: The MEDLINE database was searched for studies on civilian limb tourniquet use in adults published between 2001 and 2017...
February 9, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29432348/trends-of-incidence-and-risk-factors-of-ventilator-associated-pneumonia-in-elderly-patients-admitted-to-french-icus-between-2007-and-2014
#20
Cédric Dananché, Philippe Vanhems, Anaïs Machut, Martine Aupée, Caroline Bervas, François L'Hériteau, Alain Lepape, Jean-Christophe Lucet, Vincent Stoeckel, Jean-François Timsit, Anne Berger-Carbonne, Anne Savey, Thomas Bénet
OBJECTIVES: To assess trends and risk factors of ventilator-associated pneumonia according to age, particularly in the elderly admitted to French ICUs between 2007 and 2014. DESIGN: Multicenter, prospective French national Healthcare-Associated Infection surveillance network of ICUs ("Réseau REA-Raisin"). SETTINGS: Two-hundred fifty six ICUs in 246 settings in France. PATIENTS: Included were all adult patients hospitalized greater than or equal to 48 hours in ICUs participating in the network...
February 9, 2018: Critical Care Medicine
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