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Adult Trauma

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https://www.readbyqxmd.com/read/28732255/can-head-trauma-trigger-adult-onset-rasmussen-s-encephalitis
#1
Derrick Soh, Dennis J Cordato, Andrew F Bleasel, Peter Brimage, Roy G Beran
Rasmussen's encephalitis (RE) is a rare unilateral inflammatory brain disorder that causes progressive neurocognitive deterioration and refractory epilepsy including epilepsia partialis continua (EPC). We describe a patient with a unique presentation, where right upper limb EPC due to RE began within 2weeks of a concussive left frontal head injury, in a 36-year-old female without other identifiable etiology, no prior neurological deficit nor suggestion of intracranial pathology or infection, and no preceding seizures...
July 18, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28731843/telemedicine-use-decreases-rural-emergency-department-length-of-stay-for-transferred-north-dakota-trauma-patients
#2
Nicholas M Mohr, J Priyanka Vakkalanka, Karisa K Harland, Amanda Bell, Brian Skow, Dan M Shane, Marcia M Ward
BACKGROUND: Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. OBJECTIVES: This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. METHODS: Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28730756/animal-assisted-psychotherapy-for-young-people-with-behavioural-problems-in-residential-care
#3
Alexander Muela, Nekane Balluerka, Nora Amiano, Miguel Angel Caldentey, Jone Aliri
The aim of this study was to evaluate the impact of an animal-assisted psychotherapy (AAP) programme on clinical symptoms, personal adjustment, and adaptive skills in a group of adolescents in residential care who had experienced childhood trauma and who presented mental health problems and difficulties adapting to the care home environment. The 87 participants (Mage  = 15.17, SD = 1.53) were divided into two groups: a treatment group (25 girls and 27 boys; Mage  = 15.00, SD = 1.55) and a control group (9 girls and 26 boys; Mage  = 15...
July 20, 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28730321/age-and-dressing-type-as-independent-predictors-of-post-operative-infection-in-patients-with-acute-compartment-syndrome-of-the-lower-leg
#4
Mark E Hake, Jordan Etscheidt, Vivek P Chadayammuri, Jacob M Kirsch, Cyril Mauffrey
PURPOSE: The purpose of this study was to determine independent factors, including timing of fasciotomy, that confer an increased risk of post-operative surgical site infection (SSI) in patients presenting with acute compartment syndrome (ACS) of the lower extremity. METHODS: A retrospective analysis was performed on a consecutive cohort of 53 adult patients requiring fasciotomy for lower-extremity fractures complicated by ACS presenting to a single Level I trauma center over a seven-year study period...
July 20, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28729444/an-atoh1-s193a-phospho-mutant-allele-causes-hearing-deficits-and-motor-impairment
#5
Wei Rose Xie, Hsin-I Jen, Michelle L Seymour, Szu-Ying Yeh, Fred A Pereira, Andrew K Groves, Tiemo J Klisch, Huda Y Zoghbi
Atoh1 is a basic helix-loop-helix (bHLH) transcription factor that is essential for the genesis, survival, and maturation of a variety of neuronal and non-neuronal cell populations, including those involved in proprioception, interoception, balance, respiration, and hearing. Such diverse functions require fine regulation at the transcriptional and protein levels. Here we show that serine 193 (S193) is phosphorylated in Atoh1's bHLH domain in vivo Knock-in mice of both sexes bearing a GFP-tagged phospho-dead S193A allele on a null background (Atoh1(S193A/lacZ) ) exhibit mild cerebellar foliation defects, motor impairments, and also partial pontine nucleus migration defects, cochlear hair cell degeneration, and profound hearing loss...
July 20, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28729323/gait-outcomes-of-older-adults-receiving-subacute-hospital-rehabilitation-following-orthopaedic-trauma-a-longitudinal-cohort-study
#6
Saira A Mathew, Paul Varghese, Suzanne S Kuys, Kristiann C Heesch, Steven M McPhail
OBJECTIVES: This study aimed to describe gait speed at admission and discharge from inpatient hospital rehabilitation among older adults recovering from orthopaedic trauma and factors associated with gait speed performance and discharge destination. DESIGN: A longitudinal cohort study was conducted. SETTING: Australian tertiary hospital subacute rehabilitation wards. PARTICIPANTS: Patients aged ≥60 years recovering from orthopaedic trauma (n=746, 71% female) were eligible for inclusion...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28724500/a-20-year-review-of-pediatric-pregnant-trauma-from-a-level-i-trauma-center
#7
Tanya L Zakrison, Xiomara Ruiz, Nicholas Namias, Marie Crandall
BACKGROUND: Trauma in pregnancy remains an important but understudied public health issue. We aimed to determine the prevalence of interpersonal violence in our pregnant trauma population (including pediatric) over the last 20 years, from our Level I trauma center. METHODS: We conducted a descriptive, retrospective chart review to identify all pregnant trauma patients between Jan 1993 and Sept 2013. Pediatric was ≤18 years of age. We evaluated demographics, mechanism of injury, injury location, disposition, and outcome data...
July 11, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28724441/computed-tomography-during-initial-management-and-mortality-among-hemodynamically-unstable-blunt-trauma-patients-a-nationwide-retrospective-cohort-study
#8
Yusuke Tsutsumi, Shingo Fukuma, Asuka Tsuchiya, Tatsuyoshi Ikenoue, Yosuke Yamamoto, Sayaka Shimizu, Miho Kimachi, Shunichi Fukuhara
BACKGROUND: Although many hemodynamically unstable trauma patients undergo computed tomography (CT) to identify a source of bleeding, this practice is currently only recommended by a few guidelines. To clarify whether CT has harmful effects among these patients, we examined the association between CT during initial management and mortality among unstable blunt trauma patients. METHODS: This was a retrospective cohort study based on Japan Trauma Data Bank 2004-2014 registry data...
July 19, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28723840/cervical-spine-evaluation-and-clearance-in-the-intoxicated-patient-a-prospective-western-trauma-association-multi-institutional-trial-and-survey
#9
Matthew J Martin, Lisa D Bush, Kenji Inaba, Saskya Byerly, Martin Schreiber, Kimberly A Peck, Galinos Barmparas, Jay Menaker, Joshua P Hazelton, Raul Coimbra, Martin D Zielinski, Carlos V R Brown, Chad G Ball, Jill R Cherry-Bukowiec, Clay Cothren Burlew, Julie Dunn, C Todd Minshall, Matthew M Carrick, Gina M Berg, Demetrios Demetriades, William Long
INTRODUCTION: Intoxication often prevents clinical clearance of the cervical spine (Csp) after trauma leading to prolonged immobilization even with a normal CT scan. We evaluated the accuracy of CT at detecting clinically significant Csp injury, and surveyed participants on related opinions and practice. METHODS: A prospective multicenter study (2013-2015) at 17 centers. All adult blunt trauma patients underwent structured clinical examination and imaging including a Csp CT, with follow-up thru discharge...
July 19, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#10
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28721570/task-shifting-the-use-of-laypersons-for-acquisition-of-vital-signs-data-for-clinical-decision-making-in-the-emergency-room-following-traumatic-injury
#11
Bryce E Haac, Jared R Gallaher, Charles Mabedi, Andrew J Geyer, Anthony G Charles
IMPORTANCE: In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE: To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital signs in the initial evaluation of trauma patients. DESIGN: We conducted a quasi-experimental study of patients presenting with traumatic injury pre- and post-intervention...
July 18, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28720216/the-effects-of-red-cell-transfusion-donor-age-on-nosocomial-infection-among-trauma-patients
#12
Tyler J Loftus, Ryan M Thomas, Travis W Murphy, Linda L Nguyen, Frederick A Moore, Scott C Brakenridge, Philip A Efron, Alicia M Mohr
BACKGROUND: We hypothesized that packed red blood cell (PRBC) transfusions from older donors would be associated with fewer nosocomial infections among trauma patients. METHODS: We performed a four-year retrospective analysis of 264 consecutive adult trauma patients who received ≥1 PRBC transfusion during admission. The capacity of donor age to predict nosocomial infection was assessed by logistic regression. RESULTS: Thirty-three percent of all patients developed a nosocomial infection...
July 12, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28720045/neonatal-acute-paronychia
#13
Luke Grome, Gregory Borah
BACKGROUND: Paronychia is defined as infection afflicting the eponychial nail folds of the hand or foot. Such infections are rarely reported in the perinatal age group, and not previously described in a neonate younger than 2 weeks. Trauma resulting in inoculation of the nail fold is the most common predisposing factor to paronychia. Oral trauma in the pediatric population from finger sucking predisposes this population to a different set of bacterial pathogens than adults. Contamination can progress to infection and abscess formation within the nail fold with the most prevalent vector in adult infections being Staphylococcus aureus...
February 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28720044/ulnar-artery-aneurysm-in-a-6-month-old-a-case-report
#14
Clifton G Meals, George B Carey, James P Higgins, Benjamin Chang
BACKGROUND: Pediatric ulnar aneurysms are rare and, unlike their adult counterparts, cannot be explained by repetitive trauma to the palm. A small number of case reports describe diagnostic difficulty with these lesions and different treatments. METHODS: We present the case of a 6-month-old with an ulnar artery aneurysm of unknown cause. The diagnosis was supported with magnetic resonance imaging, and the lesion was resected. RESULTS: Because the hand remained well perfused, the ulnar artery was not reconstructed...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28720041/burden-of-hand-maladies-in-us-emergency-departments
#15
David L Colen, Justin P Fox, Benjamin Chang, Ines C Lin
BACKGROUND: Hand conditions commonly present to the emergency department (ED), yet data are lacking regarding the magnitude of hand-related conditions in the emergency setting. The purpose of this study is to describe the burden and quantify the health care resource utilization of hand conditions seen in EDs across the United States. METHODS: Using the National Emergency Department Sample, we identified all ED encounters by patients at least 18 years of age that were associated with a hand condition in 2009 to 2012...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719602/prehospital-immune-responses-and-development-of-multiple-organ-dysfunction-syndrome-following-traumatic-injury-a-prospective-cohort-study
#16
Jon Hazeldine, David N Naumann, Emma Toman, David Davies, Jonathan R B Bishop, Zhangjie Su, Peter Hampson, Robert J Dinsdale, Nicholas Crombie, Niharika Arora Duggal, Paul Harrison, Antonio Belli, Janet M Lord
BACKGROUND: Almost all studies that have investigated the immune response to trauma have analysed blood samples acquired post-hospital admission. Thus, we know little of the immune status of patients in the immediate postinjury phase and how this might influence patient outcomes. The objective of this study was therefore to comprehensively assess the ultra-early, within 1-hour, immune response to trauma and perform an exploratory analysis of its relationship with the development of multiple organ dysfunction syndrome (MODS)...
July 2017: PLoS Medicine
https://www.readbyqxmd.com/read/28719089/development-and-implementation-of-an-emergency-department-telephone-follow-up-system
#17
O John Ma, Mary Tanski, Beech Burns, Elizabeth F Spizman, James A Heilman
Implementing a telephone follow-up system after a patient's emergency department (ED) visit is challenging, but it may improve patient safety and care. This study's objective was to describe the development and implementation of a comprehensive ED telephone follow-up system over a 9-year period. Discharged patients who received a follow-up telephone call within 48 hours of their ED visit included all pediatric patients, those who left without being seen by a provider, and any adult patient with a "high-risk chief complaint," which was defined as a headache, visual problem, chest pain, dyspnea, abdominal pain, syncope, trauma, and neurological-related problems...
July 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28717984/falls-in-older-people-comparing-older-and-younger-fallers-in-a-developing-country
#18
R R Yogi, I Sammy, J F Paul, P Nunes, P Robertson, V Ramcharitar Maharaj
PURPOSE: While falls are common in older people, causing significant mortality and morbidity, this phenomenon has not been extensively studied in the Caribbean. This study aimed to compare falls in older and younger people in this setting. METHODS: We conducted a prospective observational study of older trauma patients in Trinidad, comparing older and younger patients sustaining falls. RESULTS: 1432 adult trauma patients were included (1141 aged 18-64 years and 291 aged 65 years and older)...
July 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28716955/acute-exercise-enhances-the-consolidation-of-fear-extinction-memory-and-reduces-conditioned-fear-relapse-in-a-sex-dependent-manner
#19
Courtney A Bouchet, Brian A Lloyd, Esteban C Loetz, Caroline E Farmer, Mykola Ostrovskyy, Natalie Haddad, Rebecca M Foright, Benjamin N Greenwood
Fear extinction-based exposure therapy is the most common behavioral therapy for anxiety and trauma-related disorders, but fear extinction memories are labile and fear tends to return even after successful extinction. The relapse of fear contributes to the poor long-term efficacy of exposure therapy. A single session of voluntary exercise can enhance the acquisition and consolidation of fear extinction in male rats, but the effects of exercise on relapse of fear after extinction are not well understood. Here, we characterized the effects of 2 h of voluntary exercise during the consolidation phase of contextual or auditory fear extinction learning on long-term fear extinction memory and renewal in adult, male and female, Long-Evans rats...
August 2017: Learning & Memory
https://www.readbyqxmd.com/read/28716636/a-simplified-clinical-prediction-rule-for-prognosticating-independent-walking-after-spinal-cord-injury-a-prospective-study-from-a-canadian-multicenter-spinal-cord-injury-registry
#20
Katharine E Hicks, Yichen Zhao, Nader Fallah, Carly Rivers, Vanessa Noonan, Tova Plashkes, Eugene K Wai, Darren M Roffey, Eve Tsai, Jerome Paquet, Najmedden Attabib, Travis Marion, Henry Ahn, Philippe Phan
BACKGROUND: Context: Traumatic spinal cord injury (SCI) is a debilitating condition with limited treatment options for neurological or functional recovery. The ability to predict the prognosis of walking post-injury with emerging prediction models could aid in rehabilitation strategies and reintegration into the community. PURPOSE: To re-validate an existing clinical prediction model for independent ambulation (van Middendorp et al. 2011) utilising acute and long-term post-injury follow-up data, and to investigate the accuracy of a simplified model using prospectively collected data from a Canadian multicenter SCI database, the Rick Hansen Spinal Cord Injury Registry (RHSCIR)...
July 14, 2017: Spine Journal: Official Journal of the North American Spine Society
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