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Adult Trauma

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https://www.readbyqxmd.com/read/28340193/addressing-structural-barriers-to-hiv-care-among-triply-diagnosed-adults-project-bridge-oakland
#1
Christina Powers, Megan Comfort, Andrea M Lopez, Alex H Kral, Owen Murdoch, Jennifer Lorvick
People who are "triply diagnosed" with HIV, mental health issues, and substance-related disorders face tremendous barriers connecting to and remaining in HIV care. Authors of this article implemented Project Bridge Oakland (PBO), an intervention based on harm reduction and trauma-informed care, to help maintain continuity of care for triply diagnosed adults through cycles of criminal justice involvement. From August 2011 to December 2014, a clinical social worker and an HIV physician provided intensive case management for 19 clients living in Oakland, California...
March 14, 2017: Health & Social Work
https://www.readbyqxmd.com/read/28333947/surgical-interventions-to-treat-humerus-shaft-fractures-a-network-meta-analysis-of-randomized-controlled-trials
#2
Jia-Guo Zhao, Jia Wang, Xiao-Hui Meng, Xian-Tie Zeng, Shi-Lian Kan
BACKGROUND: There are three main surgical techniques to treat humeral shaft fractures: open reduction and plate fixation (ORPF), intramedullary nail (IMN) fixation, and minimally invasive percutaneous osteosynthesis (MIPO). We performed a network meta-analysis to compare three surgical procedures, including ORPF, IMN fixation, and MIPO, to provide the optimum treatment for humerus shaft fractures. METHODS: MEDLINE, EMBASE, Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, and Cochrane library were researched for reports published up to May 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28333830/minimal-variation-in-anti-a-and-b-titers-among-healthy-volunteers-over-time-implications-for-the-use-of-out-of-group-blood-components
#3
Ulrik Sprogøe, Mark Yazer, Mads Hvidkjær Rasmussen, Berit Antonsen, Claus Bistrup, Kristian Assing
BACKGROUND: Using potentially out-of-group blood components, like low titer A plasma and O whole blood, in the resuscitation of trauma patients is becoming increasingly popular. However, very little is known whether the donors' anti-A and/or -B titers change over time and whether repeated titer measurements on the same donor are required to ensure that each donation produces a low titer product. METHODS: The anti-A and/or -B titers were measured on 56 healthy adult volunteers (47 blood donors; 9 blood center personnel) every three months for 12 consecutive months using an automated solid phase analyzer...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333604/patient-preferences-for-discussing-childhood-trauma-in-primary-care
#4
Ellen Goldstein, Ninad Athale, Andrés F Sciolla, Sheryl L Catz
CONTEXT: Exposure to traumatic events is common in primary care patients, yet health care professionals may be hesitant to assess and address the impact of childhood trauma in their patients. OBJECTIVE: To assess patient preferences for discussing traumatic experiences and posttraumatic stress disorder (PTSD) with clinicians in underserved, predominantly Latino primary care patients. DESIGN: Cross-sectional study. MAIN OUTCOME MEASURE: We evaluated patients with a questionnaire assessing comfort to discuss trauma exposure and symptoms using the Adverse Childhood Experiences (ACE) Study questionnaire and the Primary Care-PTSD screen...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28330737/optimizing-the-assessment-of-pediatric-injury-severity-in-low-resource-settings-consensus-generation-through-a-modified-delphi-analysis
#5
Etienne St-Louis, Dan Leon Deckelbaum, Robert Baird, Tarek Razek
INTRODUCTION: Although a plethora of pediatric injury severity scoring systems is available, many of them present important challenges and limitations in the low resource setting. Our aim is to generate consensus among a group of experts regarding the optimal parameters, outcomes, and methods of estimating injury severity for pediatric trauma patients in low resource settings. MATERIALS AND METHODS: A systematic review of the literature was conducted to identify and compare existing injury scores used in pediatric patients...
March 15, 2017: Injury
https://www.readbyqxmd.com/read/28330688/management-of-spontaneous-pneumomediastinum-are-hospitalization-and-prophylactic-antibiotics-needed
#6
Masatomo Ebina, Akira Inoue, Akihiro Takaba, Koichi Ariyoshi
BACKGROUND: Spontaneous pneumomediastinum is defined as the presence of free air in the mediastinum without any apparent concomitant factors or disease. It is uncommon but usually benign and self-limiting. Generally, patients with spontaneous pneumomediastinum are admitted to hospital, and occasionally, prophylactic antibiotics are administered to prevent mediastinitis. The purpose of this study was to describe practices concerning the feasibility of outpatient treatment and follow-up of spontaneous pneumomediastinum and the necessity of prophylactic antibiotics...
March 10, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28329579/habit-tic-nail-deformity-a-rare-presentation-in-an-8-year-old-boy
#7
S El-Heis, Al Abadie
Habit tic nail deformity is a nail dystrophy resulting from habitual, repetitive trauma to the nail. It is usually acquired in adulthood, however, we report a case of habit tic nail deformity in an 8 year old boy. The diagnosis was made clinically with further history revealing that the boy repeatedly rubbed his thumbnails and pushed the cuticles. Emollient cream (Balneum®) was recommended twice daily and both the patient and his mother were educated on the behavioral nature of this condition. There was marked improvement at 6 months of treatment and further improvement at 12 months...
November 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28328674/the-value-of-the-injury-severity-score-in-pediatric-trauma-time-for-a-new-definition-of-severe-injury
#8
Joshua B Brown, Mark L Gestring, Christine M Leeper, Jason L Sperry, Andrew B Peitzman, Timothy R Billiar, Barbara A Gaines
BACKGROUND: The Injury Severity Score (ISS) is the most commonly used injury scoring system in trauma research and benchmarking. An ISS>15 conventionally defines severe injury; however, no studies evaluate whether ISS performs similarly between adults and children. Our objective was to evaluate ISS and AIS to predict mortality and define optimal thresholds of severe injury in pediatric trauma. METHODS: Patients from the Pennsylvania trauma registry 2000-2013 were included...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328672/pediatric-trauma-under-triage-in-ohio
#9
Juan P Gurria, Lynn Haas, Md Monir Hossain, Mohammad Alfrad Nobel Bhuiyan, Misty Troutt, Suzanne Moody, Richard A Falcone
BACKGROUND: Appropriate and timely triage is an essential component of a trauma system. In the state of Ohio there are 6 verified pediatric trauma centers (PTC) across 8 state regions. The purpose of this study was to better understand the pediatric under-triage rates in the state. METHODS: We utilized the Ohio Trauma Registry from 2007 - 2012, consisting of 14,045 records of children < 16 years admitted to a hospital for greater than 48 hours or who sustained a traumatic death...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28328670/the-trauma-ecosystem-the-impact-and-economics-of-new-trauma-centers-on-a-mature-statewide-trauma-system
#10
David J Ciesla, Etienne E Pracht, Pablo T Leitz, David A Spain, Joseph J Tepas, Kristan L Staudenmayer
INTRODUCTION: Florida serves as a model for the study of trauma system performance. Between 2010 and 2104, 5 new trauma centers were opened along side 20 existing centers. The purpose of this study was to explore the impact of trauma system expansion on system triage performance and trauma center patient profiles. METHODS: A statewide dataset was queried for all injury related discharges from adult acute care hospitals using ICD-9 codes for 2010 and 2014. The dataset, inclusion criteria, and definitions of high-risk injury were chosen to match those used by the Florida department of health in its trauma registry...
March 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28327940/the-nationwide-burden-of-neurological-conditions-requiring-emergency-neurosurgery
#11
Rafael De la Garza Ramos, C Rory Goodwin, Jonathan Nakhla, Rani Nasser, Reza Yassari, Eugene S Flamm, Ali Bydon, Geoffrey Colby, Daniel M Sciubba
BACKGROUND: Neurosurgical emergencies are an important cause of disability and mortality. OBJECTIVE: To examine the nationwide burden of neurological conditions requiring emergency neurosurgery. METHODS: The Nationwide Inpatient Sample database (2002-2011) was queried to identify adult patients with a primary discharge diagnosis of a neurosurgical condition who were admitted urgently/emergently or through a trauma center and underwent surgical intervention within 2 days of admission...
March 10, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28327274/physician-extenders-on-surgical-services-a%C3%A2-systematic-review
#12
Jagdeep Johal, Andrew Dodd
BACKGROUND: With the introduction of resident duty hour restrictions and the resulting in-house trainee shortages, a long-term solution to ensure safe and efficient patient care is needed. One solution is the integration of nurse practitioners (NPs) and physician assistants (PAs) in a variety of health care settings. We sought to examine the use of NPs and PAs on surgical/trauma services and their effect on patient outcomes and resident workload. METHODS: We performed a systematic review of EMBASE, Medline, CINAHL, and the Cochrane Central Register of Controlled Trials...
April 1, 2017: Canadian Journal of Surgery. Journal Canadien de Chirurgie
https://www.readbyqxmd.com/read/28326453/violent-trauma-recidivism-does-all-violence-escalate
#13
R M Nygaard, A P Marek, S R Daly, J M Van Camp
PURPOSE: Rates of trauma patients presenting with history of prior trauma range from 25 to 44%. Outcomes involving recidivists in the setting of intentional trauma, especially penetrating trauma, are conflicting. We hypothesized that if violence does escalate with successive incidence, then injuries due to successive violence should escalate or become increasingly severe with successive admissions. METHODS: The trauma registry from an urban level I adult and pediatric trauma center was queried for injuries due to blunt assault, stabbing, and firearm injury...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28324678/traumatic-stress-symptoms-after-the-november-13th-2015-terrorist-attacks-among-young-adults-the-relation-to-media-and-emotion-regulation
#14
Emmanuel Monfort, Mohammad Hassan Afzali
OBJECTIVE: A major terror attack occurred in the Paris region on 13th November 2015. This event was widely showed, described, and commented in the media. Media consumption may lead to a widespread diffusion of trauma-related symptoms following a collective trauma. These effects may depend on the type of media and emotion regulation strategies used by the media consumer. METHOD: Trauma history, traumatic symptoms, media consumption, psychological distress, and emotion regulation strategies of 451 young adults were assessed by an online survey...
March 6, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28324273/acute-pancreatitis-caused-by-mycoplasma-pneumoniae-an-unusual-etiology
#15
Teresa Valdés Lacasa, María Alejandra Duarte Borges, Alicia García Marín, Covadonga Gómez Cuervo
It is well known that the most important etiologies of acute pancreatitis are gallstones and alcohol consumption. Once these causes have been ruled out, especially in young adults, it is important to consider less frequent etiologic factors such as drugs, trauma, malformations, autoimmunity or systemic diseases. Other rare and less well studied causes of this pathology are infections, among which Mycoplasma pneumoniae has been reported to cause acute pancreatitis as an unusual extrapulmonary manifestation. Here, we report the case of a 21-year-old patient who had acute idiopathic pancreatitis associated with an upper respiratory tract infection...
March 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#16
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323788/traumatic-colon-injury-in-damage-control-laparotomy-a-multicenter-trial-is-it-safe-to-do-a-delayed-anastomosis
#17
Leah Carey Tatebe, Andrew Jennings, Ken Tatebe, Alexandra Handy, Purvi Prajapati, Michael Smith, Tai Do, Gerald O Ogola, Rajesh R Gandhi, Therese M Duane, Stephen Luk, Laura Bruce Petrey
BACKGROUND: Delayed colonic anastomosis after damage control laparotomy (DCL) is an alternative to colostomies during a single laparotomy (SL) in high-risk patients. However, literature suggests increased colonic leak rates up to 27% with DCL, and various reported risk factors. We evaluated our regional experience to determine if delayed colonic anastomosis was associated with worse outcomes. METHODS: A multicenter retrospective cohort study was performed across three Level I trauma centers encompassing traumatic colon injuries from January 2006 through June 2014...
April 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28323644/pediatric-acute-compartment-syndrome
#18
Kristin S Livingston, Michael P Glotzbecker, Benjamin J Shore
Pediatric acute compartment syndrome (PACS) is a clinical entity that must be carefully differentiated from the adult version (ie, acute compartment syndrome). Healthcare providers must understand the variable etiologies of PACS, of which trauma is the most common but can also include vascular insult, infection, surgical positioning, neonatal phenomena, overexertion, and snake and insect bites. In addition to the unique etiologies of PACS, providers must also recognize the different signs and symptoms of PACS...
March 17, 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28323566/racial-differences-in-the-associations-of-posttraumatic-stress-and-insomnia-with-body-mass-index-among-trauma-exposed-veterans
#19
Aaron A Lee, Jeanne M Gabriele
Posttraumatic stress is associated with increased body mass index (BMI) and rates of obesity. Black adults are at greater risk for obesity, trauma exposure, development of posttraumatic stress disorder, and comorbid sleep problems compared to White adults. Accordingly, Black adults with a history of trauma exposure may be at greater risk for elevated BMI associated with posttraumatic stress and insomnia. Multiple linear regression was used to examine race as a moderator of the relationship between posttraumatic symptoms and insomnia with BMI in a sample of Black and White trauma-exposed Veterans (N = 171), controlling for age and sex...
March 21, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28322212/severe-mutilation-of-a-critically-endangered-taiwanese-humpback-dolphin-sousa-chinensis-taiwanensis-by-fishing-gear
#20
John Y Wang, Claryana Araújo-Wang
Direct observations of the causes of injuries to cetaceans are rare events. For very small and declining populations, such events may be even less likely to be observed because of the few individuals that remain. A long-term monitoring program using photographic identification of individuals resulted in the documentation of an individual Taiwanese humpback dolphin Sousa chinensis taiwanensis that survived a harmful interaction with fishing gear. An adult female that was accompanied by a young calf sustained massive damage to several tissue types on her dorsal surface...
March 21, 2017: Diseases of Aquatic Organisms
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