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https://www.readbyqxmd.com/read/28340081/retroocular-and-subdural-hemorrhage-or-hemosiderin-deposits-in-pediatric-autopsies
#1
Marc R Del Bigio, Susan M Phillips
The presence of hemosiderin in the optic nerve sheath and/or retina is sometimes used to estimate the timing of injury in infants or children with suspected non-accidental head trauma. To determine the prevalence of hemosiderin in deaths not associated with trauma, we performed a prospective study of retroocular orbital tissue, cranial convexity, and cervical spinal cord dura mater in infants and children <2.5 years age. In 53 cases of non-traumatic death, approximately 70% had blood or hemosiderin within the orbital fat, ocular muscles, and parasagittal cranial and/or cervical spinal subdural compartment...
March 14, 2017: Journal of Neuropathology and Experimental Neurology
https://www.readbyqxmd.com/read/28338851/do-not-resuscitate-orders-and-early-mortality-in-hip-fracture-patients
#2
Anouk E Simons, Julian Karres, Leontien M G Nijland, Jan M Ultee, Gino M M J Kerkhoffs, Bart C Vrouenraets
Background: factors affecting mortality after hip fracture surgery have been studied extensively. It has been suggested that do-not-resuscitate (DNR) orders are associated with higher mortality in surgical patients due to less aggressive treatment. However, the effect of DNR orders on mortality in hip fracture patients is unknown. The objective of this study was to investigate the effect of DNR orders on early mortality after hip fracture surgery. Methods: all patients undergoing hip fracture surgery between 2004 and 2015 were included in this retrospective study...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338598/characterization-of-distinct-coagulopathic-phenotypes-in-injury-pathway-specific-drivers-and-implications-for-individualized-treatment
#3
S Ariane Christie, Lucy Z Kornblith, Benjamin M Howard, Amanda S Conroy, Ryan C Kunitake, Mary F Nelson, Carolyn M Hendrickson, Carolyn S Calfee, Rachael A Callcut, Mitchell Jay Cohen
BACKGROUND: International normalized ratio (INR) and partial thromboplastin time (PTT) are used interchangeably to diagnose acute traumatic coagulopathy (ATC) but reflect disparate activation pathways. In this study we identified injury/patient characteristics and coagulation factors that drive contact pathway, tissue factor pathway (TF), and common pathway dysfunction by examining injured patients with discordant coagulopathies. We hypothesized that patients with INR/PTT discordance reflect differing phenotypes representing contact vs...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338590/small-changes-big-effects-the-hemodynamics-of-partial-and-complete-aortic-occlusion-to-inform-next-generation-resuscitation-techniques-and-technologies
#4
M Austin Johnson, Anders J Davidson, Rachel M Russo, Sarah-Ashley E Ferencz, Oren Gotlib, Todd E Rasmussen, Lucas P Neff, Timothy K Williams
BACKGROUND: The transition from complete aortic occlusion during Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) can be associated with hemodynamic instability. Technique refinements and new technologies have been proposed to minimize this effect. In order to inform new techniques and technology, we examined the relationship between blood pressure and aortic flow during the restoration of systemic circulation following aortic occlusion at progressive levels of hemorrhage...
March 23, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28338360/resuscitation-promoting-factors-are-important-determinants-of-the-pathophysiology-in-mycobacterium-tuberculosis-infection
#5
Andrew Rosser, Cordula Stover, Manish Pareek, Galina V Mukamolova
Resuscitation promoting factors (Rpf) are peptidoglycan-hydrolyzing enzymes that are pivotal in the resuscitation of quiescent actinobacteria including Mycobacterium tuberculosis. From the published data, it is clear that Rpf are required for the resuscitation of non-replicating bacilli and pathogenesis in murine infection model of tuberculosis, although their direct influence on human Mycobacterium tuberculosis infection is ill-defined. In this review, we describe the progress in the understanding of the roles that Rpf play in human tuberculosis pathogenesis and importance of bacilli dependent upon Rpf for growth for the outcome of human tuberculosis...
February 17, 2017: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#6
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
March 24, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28336538/effects-of-dobutamine-on-intestinal-microvascular-blood-flow-heterogeneity-and-oxygen-extraction-during-septic-shock
#7
Gustavo Adolfo Ospina-Tascón, Alberto Federico García Marín, Gabriel J Echeverri, William Fernando Bermúdez, Humberto José Madriñán Navia, Juan David Valencia, Edgardo Quiñones, Fernando Rodríguez, Angela Marulanda, César Augusto Arango Davila, Alejandro Bruhn, Glenn Hernández, Daniel De Backer
Derangements of microvascular blood flow distribution might contribute to disturbing oxygen extraction by peripheral tissues. We evaluated the dynamic relationships between the mesenteric oxygen extraction ratio (mes-ERO2) and the heterogeneity of microvascular blood flow at the gut and sublingual mucosa, during the development and resuscitation of septic shock in a swine model of fecal peritonitis. Jejunal-villi and sublingual microcirculation were evaluated using a portable intravital-microscopy technique...
March 23, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28336349/decisional-capacity-for-advanced-care-directives-in-parkinson-s-disease-with-cognitive-concerns
#8
Muneer Abu Snineh, Richard Camicioli, Janis M Miyasaki
INTRODUCTION: Physician Orders for Life Sustaining Therapies (POLST) or Goals of Care (GOC) are legal documents to guide intensity of interventions (ICU, resuscitation, hospitalization or comfort care) completed by healthcare professionals following counseling of patients or their designated medical decision makers. Capacity (understanding, appreciation, reasoning and expressing a choice) to consent to POLST or GOC has not been determined among Parkinson's disease (PD) patients. We sought to assess GOC PD decisional capacity for those with cognitive complaints but not dementia...
March 8, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28336026/viscoelastic-studies-effective-tools-for-trauma-and-surgical-resuscitation-efforts
#9
Dagoberto Salinas
Trauma-induced coagulopathy (TIC) is an abrupt disruption of all hemostatic components of coagulation resulting from severe tissue injury and hypoperfusion. The effective management of TIC has remained elusive to clinicians using traditional laboratory methods, challenging efforts to improve outcomes related to uncontrolled bleeding. Recent initiatives have aimed to reduce TIC-associated morbidity and mortality, further invoking trauma experts to explore innovative modalities in the field of viscoelastic studies, such as thromboelastography (TEG) and rotational thromboelastometry (ROTEM)...
April 2017: AORN Journal
https://www.readbyqxmd.com/read/28336016/review-of-issues-and-challenges-of-practicing-emergency-medicine-above-30-000-feet-altitude-2-anonymized-cases
#10
Kam Lun Hon, Karen Ka Yan Leung
We present 2 anonymized cases to identify issues and challenges associated with long-haul in-flight medical emergencies. The first case involved a middle-aged man with a history of carditis on a systemic steroid who developed vomiting and rigor. Four physicians, including a pediatric intensivist, responded to the emergency call. In the second case, a pediatric trainee who was the only onboard medical personnel was summoned for help when a middle-aged man developed acute shortness of breath while traveling on a commercial flight...
March 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28335785/we-need-to-include-bystander-first-aid-in-trauma-research
#11
Håkon Kvåle Bakke, Torben Wisborg
BACKGROUND: The chain of trauma survival is a concept that originated in the area of out-of-hospital cardiac arrest (OHCA) and was adapted to the treatment of trauma. In out-of-hospital cardiac arrest research into bystander first aid has resulted in improved outcome. Whereas, in trauma research the first link of the chain of survival is almost ignored. METHODS: In OHCA, cardiopulmonary resuscitation (CPR) from bystanders has been subject of a vast amount of research, as well as measures and programs to raise the rate of bystander CPR to cardiac arrest victims...
March 23, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28334809/subcutaneous-emphysema-of-scalp-following-resuscitation-in-a-neonate
#12
Avinash Dhaware, Sandeep Kadam, Sanjay Patole
BACKGROUND: Neonatal subcutaneous emphysema of scalp (SES) with air leaks is rare. Case characteristics: Neonate presented with SES in addition to pneumothorax and pneumomediastinum. OBSERVATION: SES resolved after the chest was drained to treat pneumothorax. OUTCOME: Neonate made full recovery. CONCLUSION: Neonatal SES may be associated with air leaks post-resuscitation, which has not been reported.
February 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28333836/the-need-for-optimized-crystalloid-based-resuscitation
#13
Avi Yitzhak, Yuval Glick, Avi Benov, Roy Nadler, Joseph F Rappold, Elon Glassberg
No abstract text is available yet for this article.
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333833/leadership-and-a-casualty-response-system-for-eliminating-preventable-death
#14
Russ S Kotwal, Harold R Montgomery, Ethan A Miles, Curtis C Conklin, Michael T Hall, Stanley A McChrystal
Combat casualties who die from their injuries do so primarily in the prehospital setting. Although most of these deaths result from injuries that are non-survivable, some are potentially survivable. Of injuries that are potentially survivable, most are from hemorrhage. Thus, military organizations should direct efforts toward prehospital care, particularly through early hemorrhage control and remote damage control resuscitation, in order to eliminate preventable death on the battlefield. A systems-based approach and priority of effort for institutionalizing such care was developed and maintained by medical personnel and command-directed by non-medical combatant leaders within the 75th Ranger Regiment, U...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28333831/deployed-skills-training-for-whole-blood-collection-by-a-special-operations-expeditionary-surgical-team
#15
Linda C Benavides, Iain M Smith, Jerome M Benavides, Douglas M Bowley, Heidi A Doughty, Jonathan B Lundy
BACKGROUND: Non-compressible hemorrhage is the leading cause of potentially preventable battlefield death. Combining casualty retrieval from the battlefield and damage control resuscitation (DCR) within the "golden hour" increases survival. However, transfusion requirements may exceed the current blood component stocks held by forward surgical teams. Warm fresh whole blood (WFWB) is an alternative. We report WFWB transfusion training developed by and delivered to a US Golden Hour Offset Surgical Treatment Team (GHOST-T) and the resulting improvement in confidence with WFWB transfusion...
March 22, 2017: Journal of Trauma and Acute Care Surgery
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
#16
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/28333828/prehospital-blood-transfusion-programs-capabilities-and-lessons-learned
#17
Martin D Zielinski, James R Stubbs, Kathleen S Berns, Elon Glassberg, Alan D Murdock, Eilat Shinar, Geir Arne Sunde, Steve Williams, Mark H Yazer, Scott Zietlow, Donald H Jenkins
The Trauma and Hemostasis Oxygenation Research (THOR) network has met in Bergen, Norway every summer over the past six years in an effort to have experts in transfusion, blood banking, military medicine, and trauma surgery exchange ideas, share their experiences, and set an agenda to move the science of remote damage control resuscitation forward. In this manuscript, we supply the lessons shared from the authors/speakers to the reader. These lessons include the experiences of the Norwegian Military with freeze dried plasma and whole blood resuscitation, lessons from extreme remote damage control resuscitation situations on oceanic cruises, and remote blood product resuscitation techniques at Mayo Clinic and the University of Pittsburgh...
March 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28332876/evaluation-and-management-of-adrenal-insufficiency-in-critically-ill-patientsdisease-state-review
#18
Amir H Hamrahian, Maria Fleseriu
Definition of normal adrenal function in critically ill patients remains controversial, despite a large body of literature. Furthermore, evaluation of adrenal function in these patients is complex. A decrease in cortisol breakdown rather than an increase in cortisol production has been suggested as the main contributor to elevated cortisol levels in critically ill patients. The concept of relative adrenal insufficiency has multiple pathophysiological flaws and is not supported by current evidence. Patients with septic shock who are pressor-dependent or refractory to fluid resuscitation should receive a short course of hydrocortisone regardless of their serum cortisol levels or their response to a Cosyntropin stimulation test (CST)...
March 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28332298/impact-of-maternal-obesity-on-very-preterm-infants
#19
Rubia Khalak, Asha Rijhsinghani, Sarah E McCallum
OBJECTIVE: Infants born at less than  34 weeks' gestational age are at higher risk for morbidity and mortality. Data are limited on the impact of maternal obesity on the very preterm infant. This study reviewed whether maternal obesity further increases the intensive care needs of very preterm infants of less than 34 weeks' gestation. METHODS: Maternal and neonatal data for live-born singleton births of 23 0/7 to 33 6/7 weeks' gestation delivering in upstate New York were reviewed...
March 22, 2017: Obesity
https://www.readbyqxmd.com/read/28331644/term-abdominal-pregnancy-revealed-by-amnioperitoneum-in-rural-area
#20
Henri Donald Mutarambirwa, Bruno Kenfack, Jovanny Tsuala Fouogue
Abdominal pregnancy (AP) accounts for 1% of ectopic implantations. In sub-Saharan Africa, the high prevalence of sexually transmitted infections explains the increasing frequency of this pathology. In Cameroon it rose from 1/10000 deliveries (1995) to 3.3/10000 (2015). Authors herein report a case of a viable abdominal pregnancy discovered at term during emergency laparotomy for suspected uterine rupture. The 24-year-old G2P0 patient was HIV-positive, under antiretrovirals, though AP exceptionally occurs in HIV patients...
2017: Case Reports in Obstetrics and Gynecology
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