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https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#1
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097844/-angel-shaped-phalango-epiphyseal-dysplasia-case-report
#2
René Conci, Alicia Oller, Martín Moya, Adriana Echegaray, Donald Frush
We describe a rare and sporadic condition, characterized by swan neck deformity in hands, hip osteoarthritis in adulthood and malformations of the middle phalanges with an angel shape. The patient is a 4 year old boy who suffered hand trauma and on x-ray examination he was diagnosed with angel-shaped phalango-epiphyseal dysplasia. Based on this diagnosis, his mother, who suffered from constant pain in her hips and lower limbs, was diagnosed with this syndrome as well.
February 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28097118/femur-neck-fracture-in-a-young-marfan-syndrome-patient
#3
Yong-Uk Kwon, Gyu-Min Kong, Jun-Ho Park
Marfan syndrome is an autosomal dominant and could decrease bone mineral density. So patients with Marfan syndrome could vulnerable to trauma in old ages. We present the first report, to the best of our knowledge, of a rare fracture of the femoral neck with a minor traumatic history in a juvenile Marfan syndrome patient whose physis is still open. Although the patient is young, her bone mineral density was low and the geometry of femur is changed like old ages. The femur neck fracture in children is very rare and only caused by high energy trauma, we concluded that the Marfan syndrome makes the bone weaker in young age and preventative medications to avoid fractures in younger Marfan syndrome patients are necessary in early ages...
December 2016: Hip & Pelvis
https://www.readbyqxmd.com/read/28094022/a-case-report-of-an-adolescent-with-cluster-headaches-following-neck-trauma-coincidence-or-trigger
#4
Agnieszka Biedroń, Marek Kaciński, Małgorzata Steczkowska, Anna Świerczyńska
Posttraumatic headaches usually have tension-type or migraine-like characteristics. A correlation between head trauma and cluster headaches (CH) has been previously reported. CH in children are rare and require thorough differential diagnosis. We present an original case of a 15-year-old boy with cluster headaches associated with allodynia probably evoked by a neck trauma. Severe headache attacks started one month after neck trauma. At the beginning clinical presentation of our patient's headaches was very misleading...
January 10, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28093693/a-simple-post-mortem-room-angiography-method-for-the-investigation-of-traumatic-basal-subarachnoid-hemorrhage
#5
Christopher P Johnson, Mike Murphy, George A Johnson, Stephen M Wills, Jonathan E Medcalf
Identifying the site of vascular bleeding in fatal cases of traumatic basal subarachnoid hemorrhage (TBSAH) is important, but can be very difficult to achieve when there is extensive blood clot in the posterior cranial fossa. Post mortem angiography in these circumstances has been reported previously but with mixed results, and is rarely used in current practice within the United Kingdom. We have developed a simple and effective post mortem angiography method, using fluoroscopy and clear modern contrast medium, suitable for use in the autopsy room...
January 17, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28087394/hawkins-type-ii-talar-fracturewithsubtalar-dislocation%C3%A2-a-veryunusualcombination
#6
Romain Gérard, Nathalie Kerfant, Geoffroy Dubois de Mont Marin, Richard Stern, Mathieu Assal
We report the unusualcase of a 16-year-old young man whosustained a rare association of a Hawkins' type-II talar neck fracture with a completemedialsubtalar dislocation (Hawkins type-IIB) thatoccurred as anisolatedinjuryafter indirect trauma during a soccer game. Followingclosedreduction of the subtalar dislocation, standard radiographs and computedtomography (CT)demonstrated a comminuted fracture of the talus involving the base of the talar neck. Open reductionwasperformed and the fracture wasstabilizedby ORIF...
January 10, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28078473/traumatic-atlantoaxial-rotatory-fixation-in-an-adult-patient
#7
María A García-Pallero, Cristina V Torres, Juan Delgado-Fernández, R G Sola
INTRODUCTION: Atlantoaxial rotational fixation (AARF) is a rare entity in adults, with only a few cases reported in the English literature and often associated with a traumatic mechanism. It is an underdiagnosed condition that must be taken into account in the initial assessment of all craniocervical trauma. Both diagnostic and therapeutic delay may be a potential cause of severe neurological damage or even death of the patient. The therapeutic management is controversial given the difficulty of achieving optimum stability and permanent reduction...
January 11, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28073094/the-role-of-lesser-trochanter-fragment-in-unstable-pertrochanteric-a2-proximal-femur-fractures-is-refixation-of-the-lesser-trochanter-worth-the-effort
#8
Christian Ehrnthaller, Alain Christoph Olivier, Florian Gebhard, Lutz Dürselen
BACKGROUND: Instability of osteoporotic pertrochanteric fractures is defined by loss of medial/lateral cortical integrity with the posteromedial fragment including the lesser trochanter being pivotal for load distribution. Literature addressing the importance of lesser trochanter refixation is scarce. To clarify the effect of lesser trochanter refixation on primary stability in these fractures, following study was performed. METHODS: 21 femora were match-paired in 3 groups and osteotomized, creating pertrochanteric fractures (AO-31A2)...
December 30, 2016: Clinical Biomechanics
https://www.readbyqxmd.com/read/28069269/clinical-considerations-for-blunt-laryngotracheal-trauma-in-children
#9
REVIEW
Jeffrey Cheng, Matthew Cooper, Elisabeth Tracy
OBJECTIVE: Systematic review of blunt pediatric laryngeal and tracheal trauma and development of proposed evaluation and management strategy. STUDY DESIGN: Systematic review and proposed clinical consideration algorithm. DATA SOURCES: PubMed, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. REVIEW METHODS: A medical librarian was utilized. RESULTS: 329 titles and abstracts were identified, and 50 reports were included...
December 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28064352/pipeline-embolization-device-for-the-treatment-of-a-traumatic-intracranial-aneurysm-in-a-child
#10
Felipe Padovani Trivelato, Marco Túlio Salles Rezende, Luiz Venâncio Fonseca, Lucas Eduardo Bonadio, Alexandre Cordeiro Ulhôa, Daniel Giansante Abud
INTRODUCTION: Traumatic intracranial aneurysms in children are rare and may occur as the result of closed or penetrating head trauma. Their natural history seems to be more aggressive. Most traumatic aneurysms have complex shape, tending to have a large neck or even a fusiform morphology. CASE REPORT: We present a case of a traumatic carotid artery aneurysm in a 9-year-old girl that was successfully treated with pipeline embolization device. DISCUSSION: Due to its dissecting nature, wall friability and lack of a substantial neck can make surgical clipping and selective coiling difficult and risky...
January 7, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28056150/trends-in-otolaryngology-consultation-patterns-at-an-academic-quaternary-care-center
#11
Kevin J Choi, Russel R Kahmke, Matthew G Crowson, Liana Puscas, Richard L Scher, Seth M Cohen
Importance: The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. Objective: To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. Design, Setting, and Participants: A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014...
January 5, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28056117/alopecia-following-bicoronal-incisions
#12
Sameep Kadakia, Arvind Badhey, Sara Ashai, Thomas S Lee, Yadranko Ducic
Importance: Multiple techniques may be used to perform bicoronal incisions, and alopecia is a known postoperative complication of this procedure. To date, no large studies exist comparing alopecia outcomes among bicoronal incision techniques with and without the use of Raney clips. Objective: To determine (1) whether postoperative alopecia is more common when bicoronal incisions are performed with monopolar cautery, Colorado microdissection tip cautery, or traditional cold steel and (2) whether this outcome is affected by the use of Raney clips...
January 5, 2017: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/28053621/clinical-and-magnetic-resonance-imaging-features-of-compressive-cervical-myelopathy-with-traumatic-intervertebral-disc-herniation-in-cynomolgus-macaque-macaca-fascicularis
#13
Yun-Jung Choi, Hye-Jin Park, Chul-Ho Sohn, Kyeong Cheon Jung, Seong Hoe Park, Jae-Il Lee
Intervertebral disc herniation (IVDH) with nucleus pulposus extrusion, traumatic or not, is a devastating clinical condition accompanied by neurological problems. Here we report a cynomolgus macaque suffering from acute and progressive neurological dysfunction by a blunt trauma due to neck collar, an animal handling device. Tetraplegia, urinary incontinence, decreased proprioception, and imperception of pain were shown on physical and neurological examinations. MRI sagittal T2 weighted sequences revealed an extensive protrusion of disc material between C2 and C3 cervical vertebra, and this protrusion resulted in central stenosis of the spinal cord...
December 2016: Laboratory Animal Research
https://www.readbyqxmd.com/read/28052130/cervical-spine-injuries-a-whole-body-musculoskeletal-model-for-the-analysis-of-spinal-loading
#14
Dario Cazzola, Timothy P Holsgrove, Ezio Preatoni, Harinderjit S Gill, Grant Trewartha
Cervical spine trauma from sport or traffic collisions can have devastating consequences for individuals and a high societal cost. The precise mechanisms of such injuries are still unknown as investigation is hampered by the difficulty in experimentally replicating the conditions under which these injuries occur. We harness the benefits of computer simulation to report on the creation and validation of i) a generic musculoskeletal model (MASI) for the analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby activities...
2017: PloS One
https://www.readbyqxmd.com/read/28045741/is-your-graduating-general-surgery-resident-qualified-to-take-trauma-call-a-15-year-appraisal-of-the-changes-in-general-surgery-education-for-trauma
#15
Aaron Strumwasser, Daniel Grabo, Kenji Inaba, Kazuhide Matsushima, Damon Clark, Elizabeth Benjamin, Lydia Lam, Demetrios Demetriades
BACKGROUND: Trauma training in general surgery residency is undergoing an evolution. Hour restrictions, the growth of subspecialty care and the trend towards non-operative management have altered resident exposure to operative trauma. We sought to identify trends in resident trauma training since the inception of the 80-hour workweek. METHODS: The Accreditation Council for General Medical Education (ACGME) Case Log Statistical Reports for Surgery was abstracted for general surgery resident trauma operative volume for the years 1999-2014...
December 31, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28041757/comparison-of-the-macintosh-laryngoscope-and-blind-intubation-via-the-igel-for-intubation-with-cervical-spine-immobilization-a-randomized-crossover-manikin-trial
#16
Pawel Gawlowski, Jacek Smereka, Marcin Madziala, Lukasz Szarpak, Michael Frass, Oliver Robak
INTRODUCTION: Endotracheal intubation (ETI) using a Macintosh laryngoscope (MAC) requires the head to be positioned in a modified Jackson position, slightly reclined and elevated. Intubation of trauma patients with an injured neck or spine is therefore difficult, since the neck usually cannot be turned or is already immobilized in order to prevent further injury. The iGEL supraglottic airway seems optimal for such conditions due to its blind insertion without the need of a modified Jackson position...
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28039683/injury-epidemiology-in-iran-a-systematic-review
#17
Saber Azami-Aghdash, Homayoun Sadeghi-Bazargani, Hosein Shabaninejad, Hassan Abolghasem Gorji
BACKGROUND: Injuries are the second greatest cause of mortality in Iran. Information about the epidemiological pattern of injuries is effective in decision-making. In this regard, the aim of the current study is to elaborate on the epidemiology of injuries in Iran through a systematic review. METHODS: Required data were collected searching the following key words and their Persian equivalents; trauma, injury, accident, epidemiology, prevalence, pattern, etiology, risk factors and Iran...
January 1, 2017: Journal of Injury & Violence Research
https://www.readbyqxmd.com/read/28032224/asymmetric-c7-pedicle-subtraction-osteotomy-for-correction-of-rigid-cervical-coronal-imbalance-secondary-to-post-traumatic-heterotopic-ossification-a-case-report-description-of-a-novel-surgical-technique-and-literature-review
#18
Alexander A Theologis, Kate D Bellevue, Erion Qamirani, Christopher P Ames, Vedat Deviren
PURPOSE: Deformities of the cervical spine are uncommon in the coronal plane. In this report, a unique case of a 31-year-old male with a fixed, 30° left coronal deformity due to heterotopic ossification 3 years status post poly-trauma was treated with an asymmetric C7 pedicle subtraction osteotomy (PSO). METHODS: Case report. RESULTS: Pre-operatively, the patient had a fixed 45-degree left tilt of his neck and radiographs demonstrated a rigid 30° scoliosis, 7 cm coronal imbalance, and 4 cm negative sagittal balance, diffuse bridging bone between the spinous processes and the facet joints of C5 to T1 bilaterally...
December 28, 2016: European Spine Journal
https://www.readbyqxmd.com/read/28030496/temporary-arterial-shunts-in-damage-control-experience-and-outcomes
#19
Sarah Matthew, Brian P Smith, Jeremy W Cannon, Patrick M Reilly, C William Schwab, Mark J Seamon
BACKGROUND: Arterial shunting is a well-described method to control hemorrhage and rapidly re-establish flow, but optimal shunt dwell times remain controversial. We hypothesized that prolonged shunt dwell times of >6 hours are related to adverse outcomes after major arterial injury. METHODS: A review (2005-2013) of all patients with arterial shunts placed after traumatic injury at our urban Level-I trauma center was undertaken. Patients who expired prior to shunt removal (n=7) were excluded...
December 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28018758/cervical-fracture-subluxation-in-a-patient-with-a-prior-c2-sacrum-fusion-case-report-and-review-of-literature
#20
Yi-Ren Chen, Alvin Y Chan, Kevin K Kumar, Anand Veeravagu
Traumatic injury to an adjacent segment of a previously fused spine is a rare complication of scoliosis surgery. The adjacent spinal segments may be more vulnerable to traumatic fracture or dislocation due to increased strain. We present a patient with prior C2 to sacrum fusion who suffered a C2 fracture/dislocation after falling. A 52-year-old female with a previous C2 to the sacrum fusion for idiopathic scoliosis presented with severe and progressively worsening neck pain after multiple falls. Imaging showed anterior displacement of the C2 vertebral body, fracture of C2, and anterior subluxation of the C1-2 complex on C3...
November 22, 2016: Curēus
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